OpenMed/multicare-articles huggingface dataset:
Complexities in Managing Psychosis in a Patient With Stiff-Person Syndrome: A Case Report
Authors: Marie Jean, Ramprasad Paidi, Gokul Paidi, Sayma Akhter
Journal: Cureus (2024)
Keywords: muscle spasms, neurotransmitter, psychiatric disorders, psychosis, stiff person syndrome
MeSH terms: Case Reports

Stiff-person syndrome (SPS) is an uncommon autoimmune neurological disorder marked by painful muscle stiffness, muscle spasms, and limb weakness. Neurological symptoms in SPS can mimic a psychogenic movement disorder in which symptoms are triggered by sudden movement and emotional distress, which might delay proper treatment. However, psychiatric symptoms are far less common, and there is limited understanding regarding the co-occurrence of psychiatric conditions. Psychiatric symptoms include nonspecific anxiety, agoraphobia, and depression, which can be triggered by sudden movement, noise, or emotional stress. This case report dives into the psychiatric manifestations seen in a patient with SPS. The case report focuses on a 42-year-old female with SPS, migraines, systemic lupus erythematosus, Sjogren's syndrome, and a psychiatric history of anorexia, depression, and anxiety. Her unique presentation underscored the necessity for a multidisciplinary approach to psychiatric care. The patient was evaluated and managed during her admission to the psychiatric unit for unspecified psychosis. Her course included a complicated medical evaluation for cardiovascular and neurologic symptoms and comprehensive psychiatric management. She manifested resistance to specific psychiatric medications and care strategies. She had atypical presentations, like sensory symptoms and left-sided chest pain. She exhibited paranoia and psychosis, which were managed with a combination of pharmacologic treatments, including aripiprazole. Psychotic symptoms were resolved upon discharge, with an emphasis on strict outpatient follow-up. This case report enhances our understanding of the clinical nuances associated with SPS and its intersection with psychiatric symptoms. The objective of this case report is to detail the diagnostic and therapeutic complexities of managing psychosis in a patient with SPS, along with a pre-existing complex medical and psychiatric profile, and to contribute to a deeper understanding of SPS and associated psychiatric conditions and more effective management strategies.
Ocular Rosacea: Don't Forget Eyelids and Skin in the Assessment of This Stubborn Ocular Surface Disease
Authors: Joobin Khadamy
Journal: Cureus (2024)
Keywords: acne rosacea, azithromycin in mgd, azithromycin in rosacea, eyelid care for ocular rosacea, eyelid hygiene for blepharitis, ocular rosacea, ocular surface disease index (osdi), speed dry eye questionnaire, systemic treatment for rosacea, the national rosacea society
MeSH terms: Case Reports

Ocular rosacea, a subset of rosacea affecting the ocular surface, poses a diagnostic challenge due to its elusive presentation and overlapping symptoms with other ocular surface diseases (OSDs). This report emphasizes the critical role of a comprehensive evaluation, particularly focusing on eyelid and skin assessment, in diagnosing and effectively managing ocular rosacea-related ocular surface symptoms. The case study highlights a 69-year-old female initially diagnosed with common dry eye disease, subsequently identified with ocular rosacea following a meticulous examination revealing subtle ocular and skin manifestations. Treatment encompassed a tailored approach combining systemic and local therapies, emphasizing proper eyelid hygiene. Objective improvements were observed in ocular surface parameters and patient-reported symptom scores, showcasing the significance of an integrated approach addressing ocular and dermatological aspects in managing ocular rosacea. This report underscores the importance of heightened clinical suspicion, thorough assessments, and comprehensive management strategies in optimizing outcomes for patients with OSD, particularly ocular rosacea.
Macrodystrophia Lipomatosa: A Case Report and Relevant Anatomical Considerations
Authors: Inês Da Mata, António Proença Caetano
Journal: J Belg Soc Radiol (2024)
Keywords: mri, macrodactyly, macrodystrophia lipomatosa, musculoskeletal
MeSH terms: Case Reports

Macrodactyly, a often congenital anomaly, entails abnormal enlargement of digits, predominantly affecting hands or feet, either in isolation or as part of a syndromic condition. The authors present a case of Macrodystrophia Lipomatosa (ML), a form of macrodactyly, in a 62-year-old patient, emphasizing macrodactyly manifestations through clinical and radiological assessments. Additionally, the authors explore anatomical aspects related to nerve distribution in affected digits, providing a comprehensive understanding of ML. Teaching Point: Explore macrodactyly, emphasizing digits nerve plexus anatomy, which can reveal crucial clues for diagnosing a specific form of this anomaly.
A Case of Atraumatic Angular Vein Thrombosis
Authors: Sneha B Gajarla, Natalia Davila, Rodney Guiseppi, Mikelson MomPremier
Journal: Cureus (2024)
Keywords: angular vein, lemierre's and lemierre's-like syndrome, thrombophlebitis, thrombosis, virchow’s triad
MeSH terms: Case Reports

Angular vein thrombosis is a rare vascular disorder marked by the occlusion of the angular vein by a blood clot. We report the case of a 70-year-old woman who presented with a visible bulge near her left nasojugal groove for one week and had no other associated symptoms or pertinent medical history. Subsequent maxillofacial CT scans with contrast revealed left angular vein thrombosis with dilation of the facial vein inferiorly. Despite its rarity, angular vein thrombosis poses a diagnostic challenge due to overlapping symptoms with other vascular and nonvascular pathologies. This case highlights the importance of early identification to prevent complications such as facial venous circulation obstruction and clot migration to the cavernous sinus.
Giant leiomyoma management during elective cesarean section: a case report
Authors: Ottavio Cassardo, Giuseppe Perugino, Francesco Nesa, Manuela Wally Ossola, Enrico Ferrazzi, Francesco D Ambrosi
Journal: Pan Afr Med J (2023)
Keywords: cesarean myomectomy, case report, leiomyoma, uterus exteriorization
MeSH terms: Leiomyoma / diagnosis, Leiomyoma / surgery, Uterine Myomectomy, Case Reports, Adult, Cesarean Section, Fear, Female, Humans, Pregnancy, Uterus

We present the unique case of a 44-year-old gravida 3 para 2 woman with complaints of monolateral perception of fetal movements who underwent elective cesarean section and hysterectomy for the presence of an exceptionally voluminous infralegamentary leiomyoma. Cesarean section required in-depth preoperative planning and was possible only after gravid uterus exteriorization. Myomectomy and hysterectomy were then necessary to reestablish the physio-anatomical pelvic environment. The patient was discharged after regular and uncomplicated postoperative time. In recent years, the paradigma of avoiding cesarean myomectomy due to fear of hemorrhage has been questioned by many authors and in certain cases cesarean myomectomy may even be undeferrable. We describe an innovative surgical technique which could be useful to obstetricians approaching similar uterine masses during cesarean sections.
Case report: A cystic capillary hemangioma located at the conus medullaris mimicking hemangioblastoma
Authors: Jiachen Sun, Jiuhong Li, Ziba Ayi, Feilong Yang, Junlin Hu, Xuhui Hui, Haifeng Chen, Jiaojiang He
Journal: Front Neurol (2024)
Keywords: capillary hemangioma, conus medullaris, cystic, hemangioblastoma, mimicking, spinal
MeSH terms: Case Reports

Capillary hemangiomas, usually found in skin and mucosal tissues, are rarely encountered within the spinal cord, presenting a significant diagnostic challenge. We report a rare case of intradural extramedullary capillary hemangioma at the conus medullaris in a 66-year-old female patient. Our initial diagnosis leaned towards a cystic hemangioblastoma based on MRI findings due to the presence of cystic formation with an enhanced mural nodule. However, surgical exploration and subsequent pathological examination revealed the lesion as a capillary hemangioma. To the authors' knowledge, this case may represent the first documented instance of a spinal capillary hemangioma that mimics a cystic hemangioblastoma.
Paraneoplastic dermatomyositis and Hodgkin's lymphoma in a 14-year-old girl: a case report and literature review
Authors: Yanyan Ling, Huaiqiang Hu, Xiangyan Xu, Jianli Feng, Mingzhe Li, Huan Li, Ming Cheng, Xiaoling Wang
Journal: Front Oncol (2024)
Keywords: hodgkin’s lymphoma, juvenile dermatomyositis, malignancy, nodular sclerosing hodgkin’s lymphoma, paraneoplastic syndrome
MeSH terms: Case Reports

Background:
Juvenile dermatomyositis (JDM) is a rare autoimmune myopathy whose main clinical manifestations include a characteristic rash, symmetrical proximal muscle weakness, and elevated muscle enzymes. While approximately one-third of adult patients with dermatomyositis (DM) develop malignancies, typically within a year of diagnosis, this phenomenon is not commonly observed in patients with JDM. In this study, we present a rare case of both JDM and Hodgkin's lymphoma (HL) diagnosed in an adolescent female patient.
Case description:
A 14-year-old girl with proximal muscle weakness and myalgia for 8 weeks was admitted to the hospital and ultimately received a diagnosis of DM. A thorough physical examination revealed enlarged lymph nodes on both sides of the cervical, and a lymph node biopsy was performed to diagnose HL. After she underwent radiotherapy and chemotherapy, her symptoms of both HL and DM were alleviated.
Conclusion:
The phenomenon of JDM as a paraneoplastic syndrome associated with HL is very rare. Thus, routine cancer screening for DM in adolescents is currently not recommended. The diagnosis of JDM requires a detailed physical examination, and further tumor screening is necessary for patients with unusual physical findings, such as atypical rashes, enlarged lymph nodes, and enlargement of the spleen and/or liver. Even if no malignancy is detected when JDM is diagnosed, long-term follow-up is necessary.
Hypoglycemia From Metastatic Meningeal Solitary Fibrous Tumor Occurring Over Two Decades After Initial Diagnosis
Authors: John J Orrego, Joseph A Chorny
Journal: JCEM Case Rep (2023)
Keywords: nicth, sft, hemangiopericytoma, non-islet cell tumor hypoglycemia, paraneoplastic hypoglycemia, solitary fibrous tumor
MeSH terms: Case Reports

Despite multiple intracranial and extracranial relapses associated with a widely metastatic meningeal solitary fibrous tumor (formerly classified as hemangiopericytoma), a 66-year-old type 2 diabetic man was first diagnosed with paraneoplastic hypoglycemia 23 years after the original diagnosis and 12 years after the onset of extracranial metastatic disease. An enlarging mass entirely replacing the left kidney measuring 11.6 × 10 × 28 cm, which had not been locally treated before, was considered to be the putative source of IGF-2 excess. The insulin-like effects of IGF-2 not only ameliorated his long-standing type 2 diabetes mellitus, but also caused spontaneous fasting hypoglycemia. The physiopathology, clinical manifestations, diagnostic approach, and treatment of non-islet cell tumor hypoglycemia are briefly discussed here. Palliative tumor debulking improved the hypoglycemia by day 11 after radiation therapy and glucose monitoring with continuous glucose monitoring system (Dexcom G6) facilitated the patient's management and gave him peace of mind.
Chromogenic Black Dental Staining in Children: A Case Report
Authors: Sattam T Alammari, Fahad M Al Rubaie, Bandar S Shukr
Journal: Cureus (2024)
Keywords: black stains, chromogenic bacteria, chromogenic staining, extrinsic discoloration, pediatric dentistry
MeSH terms: Case Reports

Chromogenic black dental staining is an extrinsic dental discoloration seen in daily dental practice, especially in children. These stains are commonly seen as black dots or lines along the cervical third of the teeth. They can affect both primary and permanent dentitions. The evidence is contradictory regarding its etiology, with links to different microbial, dietary, and iatrogenic factors. It was suggested that the back discoloration contains traces of insoluble ferric salt due to the interaction between hydrogen sulfide-producing chromogenic bacteria and iron in the saliva or gingival secretions. The current article aims to overview black dental staining in children and present a case report on a pediatric patient.
Case report: Recurring and treatment-resistant depression in acquired hepatocerebral degeneration due to a congenital portosystemic shunt
Authors: Takehiro Tamura, Shunsuke Takagi, Akane Hayakawa, Jun Oyama, Junya Fujino, Hiroki Shiwaku, Hidehiko Takahashi, Genichi Sugihara
Journal: Front Psychiatry (2024)
Keywords: acquired hepatocerebral degeneration, congenital portosystemic shunt, depression, manganese, shunt embolization
MeSH terms: Case Reports

Introduction:
Acquired hepatocerebral degeneration (AHD) is a neurological condition associated with cerebral manganese (Mn) accumulation caused by portosystemic shunts (PSS), usually because of advanced liver disease. AHD is diagnosed by the identification of T1-weighted brain magnetic resonance imaging (MRI) hyperintensities coupled with the presence of PSS and neurological symptoms. Clinical presentations primarily involve motor dysfunction and cognitive impairment. As a result of the frequently concurrent hepatic encephalopathy, the psychiatric symptoms of AHD alone remain unclear. This report is the first documentation of unique psychiatric symptoms of AHD due to a congenital PSS (CPSS) and suggests the efficacy of shunt embolization in achieving sustained remission of psychiatric symptoms in such cases.
Methods:
A 57-year-old Japanese woman presented with recurrent severe depression, pain, and somatosensory hallucinations, along with fluctuating motor dysfunction, including parkinsonism, and cognitive impairments. Psychiatric interventions, including antidepressants, antipsychotics or electroconvulsive therapy, had limited efficacy or did not prevent relapse.
Results:
T1-weighted MRI showed bilateral hyperintensity in the globus pallidus. No history of Mn exposure or metabolic abnormalities, including copper, was identified. Furthermore, no evidence of liver dysfunction or hyperammonemia was found. Eventually, a gastrorenal shunt was observed on contrast-enhanced abdominal computed tomography. The diagnosis of AHD due to CPSS was made based on the clinical manifestations and abnormal imaging findings. Shunt embolization was performed, which prevented the relapse of psychiatric symptoms and substantially reduced the T1-weighted MRI hyperintensities.
Conclusions:
This case highlights the potential involvement of AHD in adult-onset psychiatric symptoms, even in the absence of liver disease. Furthermore, this case underscores the efficacy of shunt embolization in treating the psychiatric symptoms of AHD due to CPSS.
Corynebacterium bovis infection after autologous fat grafting in breast augmentation: a case report
Authors: Xin You, Yao Yao, JianHua Gao, YunJun Liao
Journal: Front Cell Infect Microbiol (2023)
Keywords: corynebacterium bovis, bacterial infection, breast augmentation, fat graft, high-throughput dna sequencing
MeSH terms: Adipose Tissue, Mammaplasty / methods, Case Reports, Research Support, Non-U.S. Gov't, Humans, Retrospective Studies, Transplantation, Autologous / adverse effects, Transplantation, Autologous / methods, Corynebacterium bovis

In this report, we present a case study of a rare human bacterium, Corynebacterium bovis, which caused an infection in a patient who had undergone autologous fat-based breast augmentation using cryopreserved fat. This infection occurred during a secondary fat grafting procedure. To identify the bacteria causing the infection, we used high-throughput DNA sequencing technology since this bacterium is seldomly reported in human infections. The patient was successfully treated with intravenous imipenem. We also discuss potential factors that may have contributed to this unusual bacterial infection and propose that DNA sequencing can be a useful tool in cases where standard culture techniques fail to identify the causative agent. Additionally, we highlight the importance of further research on the cryopreservation of fat. In summary, this case highlights the possibility of rare bacterial infections occurring after fat grafting procedures and emphasizes the importance of identifying the causative agent through advanced techniques such as DNA sequencing. Further research is needed to improve our understanding of the risks associated with cryopreservation of fat and to identify ways to prevent these types of infections in the future.
From Suspected COVID-19 to Anti-synthetase Syndrome: A Diagnostic Challenge in the Pandemic Era
Authors: Sérgio Gomes Ferreira, Luís Fernandes, Sara Santos, Sofia Ferreira, Mónica Teixeira
Journal: Cureus (2024)
Keywords: anti-synthetase, covid-19, immunomediated, interstitial lung disease, pneumonia
MeSH terms: Case Reports

Anti-synthetase syndrome (ASS), a rare immunomediated disease, is characterized by multiple signs and symptoms. Not all patients develop the entire clinical spectrum of the syndrome, as it often varies depending on the involved antibodies. In this case report, a 53-year-old non-smoking woman had complaints of fatigue and dyspnea on exertion for five weeks. The outpatient study revealed creatine kinase (CK) 351U/L, ANAs+, anti-SSa+, normal echocardiogram, and a chest X-ray suggesting imaging suspicion of SARS-CoV-2 pneumonia. Referred to the emergency department, she was hospitalized for bilateral interstitial pneumonia without respiratory failure. Three SARS-CoV-2 polymerase chain reaction tests were negative. She underwent a five-day course of dexamethasone 6mg due to suspected coronavirus disease 2019 (COVID-19) sequelae with favorable progress. About a month later, she experienced fatigue, exertional intolerance, morning cough, and Raynaud's phenomenon episodes. Anti-SARS-CoV-2 antibodies were negative, and a follow-up chest CT showed bilateral organizing pneumonia. Bronchofibroscopy and bronchoalveolar lavage with cytology suggestive of inflammatory appearance, predominantly CD8+ lymphocytes, were performed. Subsequently, positive results for anti-OJ antibodies were obtained. A diagnosis of ASS was established, and prednisolone was initiated at 60mg/day with a tapering regimen, resulting in clinical and radiological improvement. Additional therapy with azathioprine was proposed. This case is presented due to highly suggestive COVID-19 imaging changes, emphasizing the importance of a high suspicion of ASS, despite nearly exclusive pulmonary involvement, with only one isolated elevated CK value and no musculoskeletal complaints. It is also noteworthy for the association with anti-OJ antibodies, rarely identified, often presenting interstitial lung disease as an isolated manifestation.
Effectiveness of 18F-FDG PET/CT in finding lung metastasis from a retroperitoneal paraganglioma
Authors: Tomonori Chikasue, Seiji Kurata, Shuji Nagata, Shuichi Tanoue, Akiko Sumi, Mizuki Gobaru, Toru Hisaka, Toshihiro Hashiguchi, Takuya Furuta, Jun Akiba, Kiminori Fujimoto, Toshi Abe
Journal: Asia Ocean J Nucl Med Biol (2024)
Keywords: 123i-mibg scintigraphy, 18f-fdg pet/ct, lung metastasis, paraganglioma, retroperitoneal tumor
MeSH terms: Case Reports

A 50-year-old woman was diagnosed with iron deficiency anemia on general medical examination. Further, contrast-enhanced abdominal CT and magnetic resonance imaging revealed a large hypervascular mass with internal degeneration and necrosis in the retroperitoneal space. She was referred to our hospital for further evaluation and treatment. Because the paraganglioma was most likely as the imaging diagnosis, 123I-MIBG scintigraphy was performed. It revealed the marked abnormal accumulation in the retroperitoneal lesion indicating the paraganglioma and no other abnormal accumulation was noted. Several plasma catecholamines and their urinary metabolites were normal. On the subsequent 18F-FDG PET/CT, high FDG uptake was found in the retroperitoneal lesion (SUVmax=38). FDG uptake was also found in a small nodule at the base of the lower lobe of the right lung (SUVmax= 9.8). Contrast-enhanced imaging revealed a hypervascular nodule at the base of the right lung, suggesting pulmonary metastasis of a paraganglioma. The abdominal lesion and right lung nodule were excised, and retroperitoneal paraganglioma and pulmonary metastasis were diagnosed based on the pathology findings. In this case, 18F-FDG PET/CT was useful in the search for paraganglioma metastasis. We report a relationship between 123I-MIBG accumulation and 18F-FDG uptake in paraganglioma and review the relevant literature.
Case report: Beneficial long-term effect of the atrial-flow-regulator device in a pediatric patient with idiopathic pulmonary arterial hypertension and recurring syncope
Authors: Joseph Pattathu, Sebastian Michel, Anja Ingrid Tengler, Guido Mandilaras, Andre Jakob, Robert Dalla Pozza, Nikolaus A Haas
Journal: Front Cardiovasc Med (2023)
Keywords: atrial flow regulator (afr) - device, atrial septostomy, cardiac catherization intervention, pediatric cardiology, pulmonary arterial hypertension
MeSH terms: Case Reports

We report the long-term effect after successfully implanting an 8 mm Atrial-flow-regulator (AFR) device in a 7-year-old girl with idiopathic pulmonary hypertension with persistent syncope under triple therapy with significant improvement after implantation and absence of any further syncope. Early Implantation of the AFR device (Occlutech, Germany) can be efficient and safe interventional therapy option for pulmonary arterial hypertension with a history of syncope.
Case report: Variability in clinical features as a potential pitfall for the diagnosis of Barth syndrome
Authors: Nicola Tovaglieri, Silvia Russo, Emanuele Micaglio, Angela Corcelli, Simona Lobasso
Journal: Front Pediatr (2023)
Keywords: tafazzin, cardiolipin remodeling, cardiomyopathy, neutropenia, rare x-linked disease
MeSH terms: Case Reports

Background:
Barth syndrome is a rare genetic disease characterized by cardiomyopathy, skeletal muscle weakness, neutropenia, growth retardation and organic aciduria. This variable phenotype is caused by pathogenic hemizygous variants of the TAFAZZIN gene on the X chromosome, which impair metabolism of the mitochondrial phospholipid cardiolipin. Although most patients are usually diagnosed in the first years of life, the extremely variable clinical picture and the wide range of clinical presentations may both delay diagnosis. This is the case reported here of a man affected with severe neutropenia, who was not diagnosed with Barth syndrome until adulthood.
Case presentation:
We describe herein a family case, specifically two Caucasian male cousins sharing the same mutation in the TAFAZZIN gene with a wide phenotypic variability: an infant who was early diagnosed with Barth syndrome due to heart failure, and his maternal cousin with milder and extremely different clinical features who has received the same diagnosis only at 33 years of age.
Conclusions:
Our report supports the underestimation of the prevalence of Barth syndrome, which should be always considered in the differential diagnosis of male patients with recurrent neutropenia with or without signs and symptoms of cardiomyopathy.