OpenMed/multicare-articles huggingface dataset:
Case report: A pediatric case of Bickerstaff brainstem encephalitis after COVID-19 vaccination and Mycoplasma pneumoniae infection: Looking for the culprit
Authors: Gabriele Monte, Stefano Pro, Fabiana Ursitti, Michela Ada Noris Ferilli, Romina Moavero, Laura Papetti, Giorgia Sforza, Giorgia Bracaglia, Federico Vigevano, Paolo Palma, Massimiliano Valeriani
Journal: Front Immunol (2022)
Keywords: bickerstaff brainstem encephalitis, covid-19 vaccination, mycoplasma pneumoniae, anti-gq1b antibody, immune-mediated diseases
MeSH terms: Autoimmune Diseases of the Nervous System, COVID-19, Encephalitis, Pneumonia, Mycoplasma, Case Reports, Brain Stem, COVID-19 Vaccines, Child, Gangliosides, Humans, Vaccination, COVID-19 Vaccines, Gangliosides

Bickerstaff brainstem encephalitis (BBE) is a rare, immune-mediated disease characterized by the acute onset of external ophthalmoplegia, ataxia, and consciousness disturbance. It has a complex multifactorial etiology, and a preceding infectious illness is seen in the majority of cases. Immune-mediated neurological syndromes following COVID-19 vaccination have been increasingly described. Here we report the case of a child developing BBE 2 weeks after COVID-19 vaccination. Despite nerve conduction studies and CSF analysis showing normal results, BBE was diagnosed on clinical ground and immunotherapy was started early with a complete recovery. Later, diagnosis was confirmed by positive anti-GQ1b IgG in serum. Even if there was a close temporal relationship between disease onset and COVID-19 vaccination, our patient also had evidence of a recent Mycoplasma pneumoniae infection that is associated with BBE. Indeed, the similarity between bacterial glycolipids and human myelin glycolipids, including gangliosides, could lead to an aberrantly immune activation against self-antigens (i.e., molecular mimicry). We considered the recent Mycoplasma pneumoniae infection a more plausible explanation of the disease onset. Our case report suggests that suspect cases of side effects related to COVID-19 vaccines need a careful evaluation in order to rule out well-known associated factors before claiming for a causal relationship.
Case Report: Cariprazine in a Patient With Schizophrenia, Substance Abuse, and Cognitive Dysfunction
Authors: Jose Rodriguez Cruz, Johan Sahlsten Schölin, Stephan Hjorth
Journal: Front Psychiatry (2021)
Keywords: antipsychotics, cariprazine, cognitive dysfunction, drug abuse, negative symptoms schizophrenia, quetiapine
MeSH terms: Case Reports

This case report describes a 30-year old male diagnosed with schizophrenia at the age of 23, and with a long history of drug abuse. He had previously received a wide range of antipsychotic drug treatment regimens, all with some degree of effect, but never with complete symptom relief. He was also suffering from persistent cognitive and negative symptoms. At the time of admission in our clinic, he was on Quetiapine (QUE) and Haloperidol (HAL). It was therefore decided to substitute HAL for Cariprazine (CAR)-an agent with a novel pharmacological and clinical profile-in the hope of gaining increased efficacy, particularly in the cognitive and negative symptom domains. Within 3 weeks of the switch from HAL to CAR the patient clearly improved, and notably so in the aforementioned symptom areas. A number of subsequent adjustments of antipsychotic dosages and adjunct medications during the ensuing months resulted in an apparently more stable alleviation of positive as well as negative and cognitive symptoms, including markedly improved personal and social capabilities. Interestingly, some time after initiating CAR treatment the patient also reported that from being a heavy smoker (60 cig/d) he had cut down and eventually ceased smoking entirely; furthermore, he has remained clean of other substance abuse since his first admission in 2020. The joint treatment with CAR in combination with QUE thus seems to have improved the patient's cognitive functioning as well as possibly his susceptibility to substance abuse.
Monocular visual loss due to herniation of gyrus rectus: A case report with review of literature
Authors: K Sharma, A K Srivastava, V Kanaujia, S Jaiswal, A K Jaiswal
Journal: Oman J Ophthalmol (2010)
Keywords: gyrus rectus, anterior visual pathway, suprasellar cistern
MeSH terms: Case Reports

The authors present an unusual case of a polar mass in the frontal lobe of the brain, causing acute monocular visual loss in a 50-year-old woman with history of breast carcinoma treated with surgery, radiation and chemotherapy. Neuroimaging demonstrated herniation of the gyrus rectus into the suprasellar cistern resulting in compression of the anterior visual pathway.
A Rare Case of Calcified Simple Mesenteric Cyst in a 70-Year-Old Woman
Authors: Alazar Berhe Aregawi, Alemwosen Teklehaimanot Alem
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Mesenteric cysts are one of the rare causes of intra-abdominal masses. They account for 1 in 100,000 cases in adults and 1 in 20,000 cases in children. Mesenteric cysts are commonly found in the small intestine, up to 60% of cases, and occasionally in the colon. The clinical presentation of patients with mesenteric cysts is so variable and nonspecific. It ranges from being asymptomatic to features of acute abdomen very rarely. Surgery is the treatment of choice. Complete excision with negative margins plays a curative role in avoiding the risk of recurrence as well. Here, we present the case of a 70-year-old woman who came to Hawassa University Comprehensive Specialized Hospital with abdominal swelling for a 5-month duration. She had an abdominal ultrasound, which suggested a calcified mesenteric cyst with internal hemorrhage. The patient was taken to the OR with the impression of an intra-abdominal mass for exploratory laparotomy. The mass was completely excised and was subjected to pathology, which turned out to be a calcified simple mesenteric cyst, and the purpose of this case report is to alert physicians that although the preoperative diagnosis of mesenteric cysts is difficult, it should be considered in the differential diagnosis of a patient presenting with an intra-abdominal mass.
Maxillary Sinus Lift Using Autologous Periosteal Micrografts: A New Regenerative Approach and a Case Report of a 3-Year Follow-Up
Authors: Saturnino Marco Lupi, Arianna Rodriguez Y Baena, Claudia Todaro, Gabriele Ceccarelli, Ruggero Rodriguez Y Baena
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

This case report discusses about an innovative bone regeneration method that involves the use of autologous periosteal micrografts, which were used for a maxillary sinus floor lift in a 52-year-old female patient. This method allows for harvesting of a graft that is to be seeded on a PLGA scaffold and involves collection of a very little amount of palatal periosteal tissue in the same surgical site after elevation of a flap and disaggregation of it by using a Rigenera® filter. Histological samples collected at the time of implant installation demonstrate a good degree of bone regeneration. The clinical and radiographic outcomes at the 3-year follow-up visit showed an adequate stability of hard and soft tissues around the implants. This report demonstrates the possibility to obtain a sufficient quality and quantity of bone with a progenitor cell-based micrograft and in turn make the site appropriate for an implant-supported rehabilitation procedure, with stable results over a period of two years.
Acute pulmonary embolism with arrhythmia associated with minimal change disease in adults: a case report
Authors: Chunyan Rong, Xuhan Liu, Baoguo Wang, Weihua Zhang
Journal: Front Cardiovasc Med (2023)
Keywords: mcd, vte, arrhythmia, minimal change disease, pulmonary embolism
MeSH terms: Case Reports

Background:
Minimal change disease (MCD) is a common pathological type of nephrotic syndrome (NS), and is one of the most common causes of NS in children, but is not common in adults. MCD is sensitive to corticosteroid therapy and has a good prognosis, but is prone to relapse. Venous thromboembolism (VTE) is less common in MCD.
Case presentation:
We report a case of acute pulmonary embolism (PE) with arrhythmia associated with MCD in adults. The hypercoagulable state caused by MCD through multiple systems may be one of the important causes of thrombosis in this patient. In addition to the conventional corticosteroid therapy, he was started on anticoagulation for VTE and PE. His hospital course was complicated by atrial tachyarrhythmias initially controlled by amiodarone but he required readmission due to recurrent atrial flutter. His clinical condition became more stable after radiofrequency ablation.
Conclusion:
VTE associated with MCD in adults is rare. Treatment of MCD with corticosteroids may be associated with a higher risk of developing blood clots. This type of case is relatively rare and should be paid attention to. The mechanism of VTE in MCD is still a direction worthy of further research.
Croup as Unusual Presentation of Post-transplantation Lymphoproliferative Disorder after Liver Transplantation in an 18-month-old Child
Authors: A Keshtkari, S M Dehghani, M Haghighat, M H Imanieh, A Nasimfard, G Yousefi, H Javaherizadeh
Journal: Int J Organ Transplant Med (2016)
Keywords: immunosuppression, liver transplantation, lymphoproliferative disorders, prednisolone, rituximab, tacrolimus
MeSH terms: Case Reports

Post-transplantation lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation that occurs due to immunosuppression and other risk factors. PTLD may present with involvement of other organs and with unusual presentation. The presentation is often extranodal (e.g., in the gastrointestinal tract, lung, or the central nervous system). Herein, we report on a 1.5-year-old girl who underwent liver transplantation almost 5 months prior to admission. She was on medications such as tacrolimus and prednisolone. Her presentation was started with symptoms of the upper respiratory infection followed by croupy cough and respiratory distress with no response to usual treatments. She had respiratory arrest during broncoscopy. Therefore, emergency tracheostomy was done. Biopsy from the paratracheal mass revealed large B cell non-Hodgkin lymphoma (PTLD, monomorphic and high grade). This case presentation shows that persistent upper airway symptoms, particularly stridor and croupy cough, in children who underwent liver transplant should be further evaluated; the physician needs to have a high degree of clinical suspicion for the diagnosis of PTLD in this situation.
A case report of recovery of menstrual function following a nutritional intervention in two exercising women with amenorrhea of varying duration
Authors: Rebecca J Mallinson, Nancy I Williams, Marion P Olmsted, Jennifer L Scheid, Emily S Riddle, Mary Jane De Souza
Journal: J Int Soc Sports Nutr (2013)
Keywords: amenorrhea, bone mineral density, energy intake, resumption of menses, treatment

Increasing caloric intake is a promising treatment for exercise-associated amenorrhea, but strategies have not been fully explored. The purpose of this case report was to compare and contrast the responses of two exercising women with amenorrhea of varying duration to an intervention of increased energy intake. Two exercising women with amenorrhea of short (3 months) and long (11 months) duration were chosen to demonstrate the impact of increased caloric intake on recovery of menstrual function and bone health. Repeated measures of dietary intake, eating behavior, body weight, body composition, bone mineral density, resting energy expenditure, exercise volume, serum metabolic hormones and markers of bone turnover, and daily urinary metabolites were obtained. Participant 1 was 19 years old and had a body mass index (BMI) of 20.4 kg/m(2) at baseline. She increased caloric intake by 276 kcal/day (1,155 kJ/day, 13%), on average, during the intervention, and her body mass increased by 4.2 kg (8%). Participant 2 was 24 years old and had a BMI of 19.7 kg/m(2). She increased caloric intake by 1,881 kcal/day (7,870 kJ/day, 27%) and increased body mass by 2.8 kg (5%). Resting energy expenditure, triiodothyronine, and leptin increased; whereas, ghrelin decreased in both women. Resumption of menses occurred 23 and 74 days into the intervention for the women with short-term and long-term amenorrhea, respectively. The onset of ovulation and regular cycles corresponded with changes in body weight. Recovery of menses coincided closely with increases in caloric intake, weight gain, and improvements in the metabolic environment; however, the nature of restoration of menstrual function differed between the women with short-term versus long-term amenorrhea.
Nonleukemic granulocytic sarcoma of knee: a case report
Authors: Ibrahim Elghissassi, Hanane Inrhaoun, Hind Mrabti, Hassan Errihani
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Granulocytic sarcoma (GS) is a rare extramedullary tumor composed of immature myeloid cells. It is usually associated with leukemia or other myeloproliferative disorders. It occurs very rarely without overt hematologic diseases. A 19-year-old man presented with left knee mass. Biopsy with pathological analysis showed lymphoma aspect. Immunostains yielded the diagnosis of GS with myeloperoxidase and CD43 positivity. There was no systemic manifestation of leukemia, and bone marrow biopsiy was negative for neoplastic infiltration. Chemotherapy by CHOP was efficient, and the patient remaind alive and healthy 40 months after the end of treatment. The case is discussed in the framework of the existing literature about the diagnosis, treatment, and prognosis of this very rare condition.
Could the Novel Oral Anticoagulants Be Used for Coronary Artery Aneurysm?
Authors: Quanxiang Yan, Libing Ning, Yu Jian, Wencong Yang, Qinghua Yuan, Zhimin Du
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Coronary artery aneurysms (CAAs) are uncommon in coronary angiography, and left main coronary artery aneurysms are rare. There is no consensus for the treatment of CAAs. A young patient with left coronary artery aneurysm diagnosed by coronary angiography and with recurrent acute myocardial infarction was treated with rivaroxaban and aspirin. The patient had no angina for 6 months. Novel oral anticoagulants combined with antiplatelet agents may be appropriate for the treatment of CAAs.
Simultaneous occurrence of five prothrombotic induced vaso-occlusive phenomena and focal nodular hyperplasia due to prolonged use of combined oral contraceptive pills
Authors: Martin Ian Kamanda, Muriithi Ian Mathenge
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

This is a rare case of a patient simultaneously presenting with five complications associated with the prolonged (5 years) use of combined oral contraceptives. The two main ingredients of combined oral contraceptives responsible for thromboembolism are estrogen (estradiol) and progestogen (progestin). Progestins are linked with occlusion of arteries while estrogens can induce both arterial and venous thrombosis. This case represents a patient with portal vein thrombosis, superior mesenteric vein thrombosis, coeliac artery occlusion, splenic and jejunal infarction and focal nodular hyperplasia.
A rare case of Meigs syndrome in pregnancy
Authors: Asaph Ziruma, Misai Hukuimwe, Michael Nyakura, Rumbidzai Majangara, Mervyn Venge
Journal: Pan Afr Med J (2019)
Keywords: meigs syndrome, fibrothecoma, pregnancy
MeSH terms: Meigs Syndrome / diagnosis, Ovarian Neoplasms / diagnosis, Pregnancy Complications, Neoplastic / diagnosis, Case Reports, Abortion, Spontaneous / etiology, Ascites / diagnosis, Ascites / pathology, CA-125 Antigen / blood, Female, Humans, Laparotomy / methods, Meigs Syndrome / pathology, Ovarian Neoplasms / pathology, Pregnancy, Pregnancy Complications, Neoplastic / pathology, Ultrasonography / methods, Young Adult, CA-125 Antigen

We present a case of Meigs syndrome in a 19 year old woman. We suspected metastatic ovarian cancer after she had presented in her first pregnancy at 12 weeks gestation. Ultrasound scan had confirmed a complex solid mass in the left adnexa, measuring 7cm x 8cm, a viable 12 weeks pregnancy and gross ascites. She had elevated Ca 125 and serum beta - HCG. She went on to have a spontaneous miscarriage while being worked up for exploratory laparotomy. At laparotomy, a left sided solid ovarian mass 8cm x 10cm with a smooth surface and intact capsule was found. This was later confirmed to be a fibrothecoma at histology. The patient went on to recover without any further reaccumulation of ascites.
Spontaneous relocation of a posterior dislocation of mobile bearing in a medial unicompartmental knee replacement
Authors: Hussein Noureddine, Jaimes Aird, Paul Latimer
Journal: Case Rep Orthop (2012)
MeSH terms: Case Reports

We describe a case of spontaneous relocation of a posterior dislocation of the mobile bearing in a medial unicompartmental knee replacement, prior to surgical intervention. We are unaware of any similar cases in the published literature. This paper highlights some clinical issues around this type of dislocation.
Iatrogenic retinal detachment secondary to inadvertent subretinal injection during posterior sub-Tenon triamcinolone injection
Authors: Rajya Laxmi Gurung
Journal: GMS Ophthalmol Cases (2019)
Keywords: cystoid macular oedema, pars plana vitrectomy, retinal detachment, triamcinolone acetonide
MeSH terms: Case Reports

Objective: To report a case of iatrogenic retinal detachment due to inadvertent globe penetration during posterior sub-Tenon injection Methods: A 65-year-old female was given posterior sub-Tenon injection of triamcinolone acetonide for pseudophakic cystoid macular oedema. The globe was inadvertently perforated with superior macula off retinal detachment. Results: She underwent immediate pars plana vitrectomy but failed to regain significant vision improvement. Conclusion: According to the literature, retinal detachment as a complication of posterior sub-Tenon injection is rare. This complication may be prevented by adhering to the standard practice of injecting slowly avoiding any undue pressure.
Spiral Fracture in Young Infant Causing a Diagnostic Dilemma: Nutritional Rickets versus Child Abuse
Authors: Sonia Kaushal, Manish Raisingani, Raphael David, Bina Shah
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Fractures are uncommon in young, nonambulatory infants. The differential diagnosis includes nonaccidental injury (NAI) and metabolic bone disease, including rickets. While rickets typically present after six months of age, multiple cases have been reported in younger infants. We report a case of an 11-week-old male infant who presented with a spiral fracture of the humerus and no radiologic evidence of rickets. A detailed psychosocial assessment failed to reveal any risk factors for NAI. The patient had elevated alkaline phosphatase and PTH with low 25 hydroxyvitamin D and 1,25 dihydroxyvitamin D levels. Additionally, the mother was noncompliant with prenatal vitamins, exclusively breastfeeding without vitamin D supplementation, and had markedly low vitamin D levels 15 weeks postpartum. The biochemical data and history were consistent with rickets. Given the diagnostic dilemma, the working diagnosis was rickets and the patient was started on ergocalciferol with subsequent normalization of his laboratory values and healing of the fracture. These findings are consistent with nutritional rickets largely due to maternal-fetal hypovitaminosis D. This case highlights that in young infants rickets should be considered even in the absence of positive radiologic findings. Additionally, it illustrates the importance of maintaining adequate vitamin D supplementation during pregnancy and early infancy.
Case Report: Anti-LGI1 Encephalitis Following COVID-19 Vaccination
Authors: Yair Zlotnik, Avi Gadoth, Ibrahim Abu-Salameh, Anat Horev, Rosa Novoa, Gal Ifergane
Journal: Front Immunol (2022)
Keywords: covid-19 vaccination, covid-19 vaccination adverse effect, anti-lgi1 autoimmune encephalitis, autoimmune encephalitis (ae), case report
MeSH terms: Autoantibodies / blood, Autoantibodies / cerebrospinal fluid, Autoimmune Diseases / immunology, BNT162 Vaccine / adverse effects, COVID-19 / prevention & control, Encephalitis / immunology, Intracellular Signaling Peptides and Proteins / immunology, SARS-CoV-2 / immunology, Vaccination / adverse effects, Case Reports, Autoantibodies / immunology, Autoimmune Diseases / blood, Autoimmune Diseases / cerebrospinal fluid, Autoimmune Diseases / drug therapy, COVID-19 / virology, Cognitive Dysfunction / blood, Cognitive Dysfunction / cerebrospinal fluid, Cognitive Dysfunction / drug therapy, Cognitive Dysfunction / immunology, Encephalitis / blood, Encephalitis / cerebrospinal fluid, Encephalitis / drug therapy, Glucocorticoids / administration & dosage, Humans, Hyponatremia / blood, Hyponatremia / cerebrospinal fluid, Hyponatremia / drug therapy, Hyponatremia / immunology, Male, Methylprednisolone / administration & dosage, Middle Aged, Prednisone / administration & dosage, Treatment Outcome, Autoantibodies, Glucocorticoids, Intracellular Signaling Peptides and Proteins, LGI1 protein, human, BNT162 Vaccine, Prednisone, Methylprednisolone

Anti-leucine rich glioma inactivated 1 (LGI1) autoimmune encephalitis (AE) is characterized by cognitive impairment or rapid progressive dementia, psychiatric disorders, faciobrachial dystonic seizures (FBDS) and refractory hyponatremia. Since December 2020, millions of people worldwide have been vaccinated against COVID-19. Several soft neurological symptoms like pain, headache, dizziness, or muscle spasms are common and self-limited adverse effects after receiving the COVID-19 vaccine. However, several major neurological complications, despite the unproven causality, have been reported since the introduction of the COVID-19 vaccine. Herein, we describe a 48 years old man presenting with rapidly progressive cognitive decline and hyponatremia diagnosed with anti LGI1 AE, occurring shortly after the second dose of mRNA COVID -19 vaccine and possibly representing a severe adverse event related to the vaccination. Response to high dose steroid therapy was favorable. As millions of people worldwide are currently receiving COVID-19 vaccinations, this case should serve to increase the awareness for possible rare autoimmune reactions following this novel vaccination in general, and particularly of anti-LGI1 AE.