OpenMed/multicare-articles huggingface dataset:
Case Report: Plasma Biomarkers Reflect Immune Mechanisms of Guillain-Barré Syndrome
Authors: Chia-Lun Wu, Chung-Hao Chao, Shun-Wen Lin, Yu-Yi Chien, Wen-Yi Huang, Wei-Chieh Weng, Feng-Chieh Su, Yi-Chia Wei
Journal: Front Neurol (2021)
Keywords: bdnf, guillain–barré syndrome, luminex, bead-based multiplexing immuno assay, blood biomarker, cytokine, immune mechanism
MeSH terms: Case Reports

This case series reported a group of patients with Guillain-Barré syndrome (GBS) and their plasma cytokine changes before and after immunotherapy. We aimed to understand GBS's pathogenesis and pathophysiology through observing the interval differences of the representative cytokines, which were the thymus and activation regulated chemokine (TARC) for T-cell chemotaxis, CD40 ligand (CD40L) for cosimulation of B and T cells, activated complement component C5/C5a, and brain-derived neurotrophic factor (BDNF) for survival and regenerative responses to nerve injuries. The fluorescence magnetic bead-based multiplexing immunoassay simultaneously quantified the five cytokines in a single sample. From June 2018 to December 2019, we enrolled five GBS patients who had completed before-after blood cytokine measurements. One patient was diagnosed with paraneoplastic GBS and excluded from the following cytokine analysis. The BDNF level decreased consistently in all the patients and made it a potential biomarker for the acute stage of GBS. Interval changes of the other four cytokines were relatively inconsistent and possibly related to interindividual differences in the immune response to GBS triggers, types of GBS variants, and classes of antiganglioside antibodies. In summary, utilizing the multiplexing immunoassay helps in understanding the complex immune mechanisms of GBS and the variation of immune responses in GBS subtypes; this method is feasible for identifying potential biomarkers of GBS.
Case Report: Meningoencephalomyelitis of Unknown Etiology Manifesting as a Bilateral Cranial Polyneuropathy in 3 Dogs
Authors: Hilary A Levitin, Rachel Lampe, Silke Hecht
Journal: Front Vet Sci (2020)
Keywords: mue, muo, brain, canine, cranial nerve, inflammatory
MeSH terms: Case Reports

A bilateral cranial polyneuropathy was the primary magnetic resonance imaging (MRI) finding in three medium to large breed dogs diagnosed with meningoencephalomyelitis of unknown etiology. All three dogs presented with a progressive history of vestibular ataxia with either central vestibular or multifocal central nervous system (CNS) neuroanatomical localization. Brain MRI revealed variable degree of bilateral enlargement and/or increased contrast enhancement of the optic, oculomotor, trigeminal, facial, and vestibulocochlear nerves, as well as enhancement of the orbital fissure (oculomotor, trochlear, ophthalmic branch of trigeminal, and abducens nerves). There was evidence of intracranial and cranial cervical meningeal contrast enhancement in all three dogs and of cervical spinal cord lesions in 2. In all cases, more cranial nerves were affected than indicated by neurological examination. Cerebrospinal fluid (CSF) analysis was consistent with a mononuclear pleocytosis in 2 cases and a mixed cell (predominantly lymphocytic) pleocytosis in 1 case. All dogs were treated with immune suppressing medications and showed clinical improvement, although some cranial nerve deficits were persistent at follow up 2 months later. These are the first known cases of MUE diagnosed ante-mortem in a canine population documenting bilaterally symmetrical lesions affecting multiple cranial nerves. While MUE is a common cause of non-infectious inflammatory disease in dogs, it likely encompasses more classifications than have previously been reported, and should remain a differential for dogs of all ages and sizes presenting with cranial nerve deficits.
Case Report: Next Generation Sequencing in Clinical Practice-A Real Tool for Ending the Protracted Diagnostic Odyssey
Authors: Alena S Limonova, Alexandra I Ershova, Alexey N Meshkov, Anna V Kiseleva, Mikhail G Divashuk, Marina V Kurkina, Oxana M Drapkina
Journal: Front Cardiovasc Med (2022)
Keywords: abcg8, genetic testing, macrothrombocytopenia, next generation sequencing, premature coronary artery disease, sitosterolemia
MeSH terms: Case Reports

We reported a case of sitosterolemia, which is a rare genetic disease, characterized by increased plant sterol absorption and great heterogeneity of clinical manifestations. Our patient was initially referred to the lipid clinic due to high cholesterol levels and premature cardiovascular disease. Diagnosis of familial hypercholesterolemia was established in accordance with the Dutch Lipid Clinic Network criteria. Next-generation sequencing was later performed, which revealed a nonsense mutation in the ABCG8 gene, which led to the diagnosis of sitosterolemia. The aim of our report is to demonstrate, how genetic testing helped to make the correct diagnosis and to explain many of the patient's health problems, which etiology remained unclear for many years.
Multifocal Nodular Fatty Sparing Mimicking Hepatic Tumors
Authors: Mohamed Lameir Mukhtar Hussein, Ahmad L F Yasin, Akram Twair, Adham Darweesh
Journal: Cureus (2023)
Keywords: case report, fatty liver, hepatic pseudotumor, nodular focal fat sparing, opposed phase mri
MeSH terms: Case Reports

Hepatic steatosis is frequent; however, it may present with unusual patterns, resulting in a diagnostic dilemma. Herein, we present a case of fatty liver and multifocal nodular hepatic lesions that were found to be due to multifocal nodular fatty sparing, which mimics metastasis or primary multifocal tumors. As the differential diagnosis of such lesions can be difficult based on ultrasound alone, the knowledge of Magnetic Resonance Imaging (MRI) findings is crucial. It enables the radiologists to make the correct diagnosis and alleviate the patient from unnecessary biopsies.
Management of oroantral communication using buccal advanced flap
Authors: Akram Belmehdi, Karima El Harti
Journal: Pan Afr Med J (2019)
Keywords: oroantral fistula, buccal advancement flap, maxillary sinus, oroantral communication
MeSH terms: Oroantral Fistula / surgery, Surgical Flaps, Case Reports, Cheek, Female, Humans, Male, Middle Aged, Oroantral Fistula / pathology, Young Adult

Oroantral communication (OAC) or fistula (OAF) is an open pathological communication between the oral cavity and maxillary sinus which mostly occurs as a result of extraction of upper molars and premolars, iatrogenic complications or from dental infections, osteomyelitis, radiation therapy or trauma. Several alternative techniques modalities have been described throughout the years for the management of OAC and OAF which show both advantages and limitations. The most employed surgical flaps are of three types: advanced buccal flap, palatal flap and buccal fat pad flap. The authors present two clinical cases: oroantral communication and oroantral fistula, both were treated by using buccal advancement flap.
Killing Two Birds With One Stone: Effective Control of Both Non-Small Cell Lung Cancer and Progressive Multifocal Leukoencephalopathy With Atezolizumab, A Case Report
Authors: Nicolas Lambert, Majdouline El Moussaoui, Caroline Ritacco, Martin Moïse, Astrid Paulus, Philippe Delvenne, Frédéric Baron, Bernard Sadzot, Pierre Maquet
Journal: Front Immunol (2022)
Keywords: jc virus (jcv), pd1 and pdl1, pml - progressive multifocal leucoencephalopathy, atezolizumab, immune checkpoint inhibitors (ici), immunotherapy, lung adecarcinoma, non small cell lung cancer (nsclc)
MeSH terms: Carcinoma, Non-Small-Cell Lung / complications, Carcinoma, Non-Small-Cell Lung / drug therapy, JC Virus, Leukoencephalopathy, Progressive Multifocal / diagnosis, Leukoencephalopathy, Progressive Multifocal / drug therapy, Leukoencephalopathy, Progressive Multifocal / etiology, Lung Neoplasms / complications, Lung Neoplasms / drug therapy, Opportunistic Infections / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antibodies, Monoclonal, Humanized, Humans, Immune Checkpoint Inhibitors / therapeutic use, Male, Antibodies, Monoclonal, Humanized, Immune Checkpoint Inhibitors, atezolizumab

Treating patients with cancer complicated by severe opportunistic infections is particularly challenging since classical cancer treatments, such as chemotherapy, often induce profound immune suppression and, as a result, may favor infection progression. Little is known about the potential place of immune checkpoint inhibitors in these complex situations. Here, we report a 66-year-old man who was concomitantly diagnosed with non-small cell lung cancer and progressive multifocal leukoencephalopathy. The patient was treated with anti-PD-L1 antibody atezolizumab, which allowed effective control of both lung cancer and progressive multifocal leukoencephalopathy, as demonstrated by the patient's remarkable neurologic clinical improvement, JC viral load reduction in his cerebrospinal fluid, regression of the brain lesions visualized through MRI, and the strict radiological stability of his cancer. In parallel, treatment with atezolizumab was associated with biological evidence of T-cell reinvigoration. Hence, our data suggest that immune checkpoint inhibitors may constitute a treatment option for patients with cancer complicated by severe opportunistic infections.
Intrathecal Pump Implantation in the Cisterna Magna for Treating Intractable Cancer Pain
Authors: Yaling Lou, Yuefeng Rao, Zhiying Feng
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports, Retracted Publication

A 54-year-old male patient with postoperative axillary lymph node, intrapulmonary, intracranial, and cervical spine metastases of left liver cancer was suffering from severe, persistent, and pricking pain in the right dorsal shoulder and right arm since 3 months. The drug dose of the fentanyl transdermal patch was gradually increased after admission and an adjuvant analgesic was also included, but neither treatment alleviated the pain. It was gradually alleviated after intramedullary analgesic infusion through intrathecal pump implantation in cistern magna. Terminally ill patients often have the desire to spend their remaining time at home, which however becomes a challenge in the face of refractory pain. At present, no palliative chemoradiation or ablative or stimulant neurosurgical options are available to manage pain in cancer patients. Based on the findings of this report, we concluded that an intramedullary drug infusion system can have a significant analgesic effect in patients with cervical metastasis and refractory cancer pain.
Hip Mobilization at Preterm Age May Accelerate Developmental Dysplasia Recovery
Authors: Mariana Callil Voos, Soares de Moura Maria Clara Drummond, Renata Hydee Hasue
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Purpose:
Few studies have described mobilization approaches in developmental dysplasia of the hip (DDH). The present study describes the hip mobilization of a preterm infant (born at 33 6/7 weeks of gestational age) diagnosed with DDH.
Design and methods:
During the 43-day hospital stay, the infant was seen twice a week (ten sessions, 20 minutes each). All sessions included hip approximation maneuvers, with the hip positioned in abduction, lateral rotation and flexion, and lower limbs passive mobilization, which were taught to the mother. Early intervention with auditory, tactile, visual, and vestibular stimulations was also performed. The infant was assessed with hip ultrasound before and after treatment.
Results:
At 34 2/7 weeks of gestational age, she was classified as Graf IIa (left: alpha: 55°, beta: 68°; right: alpha: 59°, beta: 64°). At 40 5/7 weeks, she was classified as Graf I for left (alpha: 67°; beta: 42°) and right (alpha: 66°; beta: 42°) hips.
Practical implications:
The intervention seemed to accelerate the acquisition of stability of dysplasic hips in a preterm infant. The outcome supports further investigation of hip approximation maneuvers as part of early stimulation in preterm infants with DDH during hospital stay.
Bacteremia Caused by Kocuria kristinae from Egypt: Are There More? A Case Report and Review of the Literature
Authors: Reem M Hassan, Dina M Bassiouny, Yomna Matar
Journal: Case Rep Infect Dis (2016)

Kocuria kristinae is opportunistic Gram-positive cocci from the family Micrococcaceae. It is usually considered part of the normal flora that rarely is isolated from clinical specimens. Here, we report a case of Kocuria kristinae bacteremia; to the best of our knowledge, this is the first report from Egypt.
Anti-NMDAR encephalitis in Crohn's disease undergoing long-term infliximab treatment: A case report
Authors: Shin Ju Oh, Young Nam Kwon, Chang Kyun Lee, Jin San Lee
Journal: Front Immunol (2022)
Keywords: crohn ‘s disease, anti-n-methyl-d-aspartate, anti-tumor necrosis factor-α, autoimmune encephalitis, infliximab
MeSH terms: Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis, Crohn Disease / complications, Crohn Disease / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Case-Control Studies, Humans, Infant, Newborn, Infliximab / adverse effects, Male, Tumor Necrosis Factor Inhibitors, Tumor Necrosis Factor-alpha / therapeutic use, Infliximab, Tumor Necrosis Factor Inhibitors, Tumor Necrosis Factor-alpha

Infliximab, a chimeric monoclonal antibody against anti-tumor necrosis factor-α (TNF-α), has revolutionized the management of inflammatory bowel disease. However, a recent nested case-control study showed that anti-TNF-α therapy exposure in patients with autoimmune diseases is associated with an increased risk of inflammatory central nervous system (CNS) events. A 27-year-old man diagnosed with Crohn's disease at 17 years of age was referred to our clinic for suffering with Wernicke's aphasia and the right-hand weakness over two weeks. Nine years of treatment for Crohn's disease with infliximab anti-TNF-α therapy was well tolerated. An initial MRI revealed diffuse leptomeningeal enhancement along the bilateral cerebral sulci without any parenchymal abnormalities. Cerebrospinal fluid (CSF) and serum N-methyl-D-aspartate receptor (NMDAR) antibody testing yielded positive results. Anti-NMDAR encephalitis was diagnosed, and the patient was treated with rituximab. A follow-up brain MRI showed new multiple cerebral lesions in the left insular cortex and subcortical white matter of the left frontal and temporal gyri. Approximately 8 months after symptom onset, the CSF and serum NMDAR antibody converted to negative. Twelve months later, the patient fully recovered from anti-NMDAR encephalitis without any neurological deficits and is currently being treated with the anti-interleukin 12/23 agent ustekinumab for Crohn's disease. This is the first report of not only a patient with infliximab-associated anti-NMDAR encephalitis in Crohn's disease but also of an inflammatory non-demyelinating CNS event during long-term suppression of TNF-α. Our case highlights the need for clinicians to recognize the possibility of a paradoxical autoimmune response occurring with novel biological therapies.
Necrotizing retinitis of multifactorial etiology
Authors: Ruxandra Angela Pirvulescu, Cherecheanu Alina Popa, Mihaela Oana Romanitan, Dana Obretin, Raluca Iancu, Danut Vasile
Journal: Rom J Ophthalmol (2017)
Keywords: cytomegalovirus, herpes simplex type 1, acute necrotizing retinitis, corticotherapy, panuveitis, vasculitis
MeSH terms: Cytomegalovirus / isolation & purification, Cytomegalovirus Retinitis / etiology, Eye Infections, Viral / etiology, Herpes Simplex / etiology, Herpesvirus 1, Human / isolation & purification, Retinal Necrosis Syndrome, Acute / etiology, Case Reports, Aged, Antibodies, Viral / blood, Antiviral Agents / therapeutic use, Cytomegalovirus / immunology, Cytomegalovirus Retinitis / diagnosis, Cytomegalovirus Retinitis / drug therapy, Drug Therapy, Combination, Eye Infections, Viral / diagnosis, Eye Infections, Viral / drug therapy, Female, Glucocorticoids / therapeutic use, Herpes Simplex / diagnosis, Herpes Simplex / drug therapy, Herpesvirus 1, Human / immunology, Humans, Immunoglobulin G / blood, Immunoglobulin M / blood, Panuveitis / virology, Retinal Necrosis Syndrome, Acute / diagnosis, Retinal Necrosis Syndrome, Acute / drug therapy, Antibodies, Viral, Antiviral Agents, Glucocorticoids, Immunoglobulin G, Immunoglobulin M

Introduction. We present the case of a 73-year-old woman with osteoporosis, who presented to the emergency room with a sudden vision loss and ocular pain in the right eye, which appeared two days before. The patient mentioned loss of appetite, weight loss for three months and low fever for two weeks. Materials and methods. Among the ophthalmological findings, the most important were panuveitis, and large confluent necrotic areas in the peripheral retina. The patient was diagnosed with RE Panuveitis and acute necrotizing retinitis. Results. Blood exams showed leukocytosis and monocytosis, thrombocytosis and anemia. Further investigations showed high levels of Cytomegalovirus (CMV) anti IgG and Herpes Simplex (HS) type 1 virus anti IgM, urinary infection, and secondary hepatic cytolysis. The CT and MRI of the thorax and abdomen showed no sign of neoplastic disease, and no explanation for the CMV infection was found. The patient received general corticotherapy and antiviral therapy, and, after one month, RE BCVA was 20/ 30. Particularity of the case. Acute necrotizing retinitis in an old patient with CMV and HSV type 1, associated with secondary hepatic cytolysis, without any other immunosuppressive disease and very good outcome.
Distinct immune response in two MERS-CoV-infected patients: can we go from bench to bedside?
Authors: Emmanuel Faure, Julien Poissy, Anne Goffard, Clement Fournier, Eric Kipnis, Marie Titecat, Perinne Bortolotti, Laura Martinez, Sylvain Dubucquoi, Rodrigue Dessein, Philippe Gosset, Daniel Mathieu, Benoit Guery
Journal: PLoS One (2014)
MeSH terms: Adaptive Immunity / immunology, Coronavirus / immunology, Coronavirus Infections / immunology, Immunity, Innate / immunology, Respiratory Tract Infections / immunology, Translational Research, Biomedical, Case Reports, Research Support, Non-U.S. Gov't, Chemokine CXCL10 / metabolism, Coronavirus Infections / virology, Fatal Outcome, Humans, Interferon-alpha / metabolism, Interferon-gamma / metabolism, Interleukin-10 / metabolism, Interleukin-12 / metabolism, Interleukin-17 / metabolism, Male, Middle Aged, Middle East, Models, Immunological, Respiratory Tract Infections / virology, Treatment Outcome, Virus Replication / physiology, CXCL10 protein, human, Chemokine CXCL10, Interferon-alpha, Interleukin-17, Interleukin-10, Interleukin-12, Interferon-gamma

One year after the occurrence of the first case of infection by the Middle East Respiratory Syndrome coronavirus (MERS-CoV) there is no clear consensus on the best treatment to propose. The World Health Organization, as well as several other national agencies, are still working on different clinical approaches to implement the most relevant treatment in MERS-CoV infection. We compared innate and adaptive immune responses of two patients infected with MERS-CoV to understand the underlying mechanisms involved in the response and propose potential therapeutic approaches. Broncho-alveolar lavage (BAL) of the first week and sera of the first month from the two patients were used in this study. Quantitative polymerase chain reaction (qRTPCR) was performed after extraction of RNA from BAL cells of MERS-CoV infected patients and control patients. BAL supernatants and sera were used to assess cytokines and chemokines secretion by enzyme-linked immunosorbent assay. The first patient died rapidly after 3 weeks in the intensive care unit, the second patient still recovers from infection. The patient with a poor outcome (patient 1), compared to patient 2, did not promote type-1 Interferon (IFN), and particularly IFNα, in response to double stranded RNA (dsRNA) from MERS-CoV. The absence of IFNα, known to promote antigen presentation in response to viruses, impairs the development of a robust antiviral adaptive Th-1 immune response. This response is mediated by IL-12 and IFNγ that decreases viral clearance; levels of both of these mediators were decreased in patient 1. Finally, we confirm previous in vitro findings that MERS-CoV can drive IL-17 production in humans. Host recognition of viral dsRNA determines outcome in the early stage of MERS-CoV infection. We highlight the critical role of IFNα in this initial stage to orchestrate a robust immune response and bring substantial arguments for the indication of early IFNα treatment during MERS-CoV infection.
Successful Pregnancy Outcome after Open Strassman Metroplasty for Bicornuate Uterus
Authors: Edgar Gulavi, Steve Kyende Mutiso, Charles Mariara Muriuki, Abraham Mukaindo Mwaniki
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Introduction:
Müllerian duct anomalies represent a group of congenital malformations that result from failure to complete bilateral paramesonephric duct elongation, fusion, canalization, or septal resorption. These anomalies are rare in the general population with a bicornuate or didelphys uterus being among the common ones. Bicornuate uterine malformations are of clinical significance due to their adverse reproductive outcomes. Metroplasty has been shown to improve reproductive outcomes of bicornuate uterine malformations. We document a case of bicornuate uterus that was managed with Strassman metroplasty and a subsequent successful pregnancy outcome.
Case:
A Black African lady was seen with a history of six prior miscarriages. Her diagnostic workup revealed a bicornuate uterus for which she had a Strassman metroplasty performed. She later conceived and was followed up to term with a successful live birth.
Conclusion:
Strassman metroplasty is a rare procedure in Sub-Saharan Africa and this case seeks to add to the body of knowledge on surgical management of Müllerian duct anomalies specifically bicornuate uterus in this region. This case report aims to increase the awareness of Müllerian duct abnormalities specifically bicornuate uterus in cases of recurrent miscarriages and highlight the diagnostic strategies to investigate and to demonstrate management options in low resource settings.
Giant primary retroperitoneal teratoma in an adult: a case report
Authors: Poonam Mathur, Miguel A Lopez-Viego, Myron Howell
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Teratomas are bizarre neoplasms derived from embryonic tissues that are typically found only in the gonadal and sacrococcygeal regions of adults. Retroperitoneal teratomas are rare and present challenging management options. We report here the case of a histologically unusual retroperitoneal tumor detected on computed tomography during the workup of abdominal pain in a 32-year-old male. The evaluation and treatment of this condition and a review of the literature are included in this paper.
Metastases to the breast: great radiological mimicker of primary breast carcinoma and a forgotten entity. A case series of three patients and a review of the literature
Authors: Jaspreet Sangha Brar, Lena Lo, Jill Wong
Journal: BJR Case Rep (2017)

Metastases to breast accounts for 0.5-1.3% of all breast malignancies, with the exclusion of leukaemia and lymphoma. These have a wide range of clinical and radiological manifestations and their diagnosis is difficult. There is a need to distinguish them from primary breast carcinoma to prevent unnecessary mastectomy. Imaging and immunohistological correlation plays a vital role in distinguishing this. Our case series review describes the clinical presentation, radiological and histopathological appearances of three patients who presented to our institution.