OpenMed/multicare-articles huggingface dataset:
Endovascular Treatment of Ruptured Renal Artery Aneurysm: A Case-Based Literature Review
Authors: Yub Raj Sedhai, Soney Basnyat, Tawseef Dar, Deepak Acharya
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Renal artery aneurysms are extremely uncommon with a reported incidence of less than one percent in general population. They are being more frequently detected due to increasing availability and use of abdominal imaging. Renal artery aneurysm rupture is an extremely unusual cause of acute flank pain with hemodynamic instability. Given the rarity of diagnoses, clinicians may not consider and address this ruptured renal artery aneurysm early which can potentially lead to adverse clinical outcomes. We report the case of a 55-year-old male who presented with retroperitoneal bleeding from a ruptured aneurysm of the interlobular branch of renal artery. He was endovascularly treated with coil embolization. We have also reviewed the inherent literature.
Case Report: Pediatric Renal Sarcoidosis and Prognostic Factors in Reviewed Cases
Authors: Richard Klaus, Annette Friederike Jansson, Matthias Griese, Tomas Seeman, Kerstin Amann, Bärbel Lange-Sperandio
Journal: Front Pediatr (2021)
Keywords: acute kidney injury, case report, prognostic factor analysis, sarcoidosis, tubulointerstitial nephritis
MeSH terms: Case Reports

Background: Pediatric sarcoidosis is a complex inflammatory disorder with multisystemic manifestations. Kidney involvement in children is rare, and prognostic factors are unknown. Case Report and Methods: We report the case of a 16-year-old girl with multiorgan sarcoidosis and renal involvement. The patient presented with tubulointerstitial nephritis, acute kidney injury (AKI), chest CT disseminated noduli, granulomatous iridocyclitis, giant-cell sialadenitis, and arthralgia. The kidney biopsy revealed non-granulomatous interstitial nephritis. Treatment consisted of initial high-dose methylprednisolone pulse followed by oral prednisolone and methotrexate. Full remission was achieved. In addition, we performed a literature review using PubMed and analyzed data on pediatric renal sarcoidosis cases. Results: We identified 36 cases of pediatric sarcoidosis with renal involvement on presentation and data on the end-of-follow-up glomerular filtration rate (GFR). The data from the literature review showed that renal involvement was slightly more prevalent in males (60%). AKI was present in most of the described patients (84%). Oral prednisolone was used in 35 of 36 cases; in more severe cases, other immunosuppressants were used. We newly identified renal concentration impairment and granulomatous interstitial nephritis as factors with a clear trend toward GFR loss at the end of follow-up, emphasizing the importance of kidney biopsy in symptomatic patients. In contrast, higher GFR at presentation and hypercalcemia were rather favorable factors. According to the identified predictive factors, our patient has a good prognosis and is in remission. Conclusion: The factors indicating a trend toward an unfavorable renal outcome in pediatric sarcoidosis are renal concentration impairment and granulomatous interstitial nephritis at presentation, while a higher GFR is beneficial.
Case Report: Probable Myocarditis After Covid-19 mRNA Vaccine in a Patient With Arrhythmogenic Left Ventricular Cardiomyopathy
Authors: Edgardo Alania-Torres, Herminio Morillas-Climent, Alexandre García-Escrivá, Paul Vinueza-Buitrón, Inmaculada Poquet-Catalá, Esther Zorio, Ignacio José Sánchez-Lázaro, Emilio Galcerá-Jornet, Alfonso Valle-Muñoz
Journal: Front Cardiovasc Med (2021)
Keywords: covid-19, arrhythmogenic left ventricular cardiomyopathy, myocarditis, myopathy, vaccine
MeSH terms: Case Reports

Arrhythmogenic left ventricular cardiomyopathy (ALVC) is a rare heritable heart-muscle disorder characterized by a progressive loss of left ventricular myocardium and its replacement by fibrofatty tissue. Myocarditis is an inflammatory disease of the heart that may occur secondary to infections, immune system activation or exposure to drugs. Hot phases of ALVC present with chest pain and troponin rise, mimicking acute viral myocarditis and indicate a progression of the disease. Recently, myocarditis has also been described as an infrequent complication of coronavirus disease 2019 (Covid-19) mRNA vaccines. We herein report for the first time a case of probable myocarditis induced by Covid-19 vaccine in a patient with previous medical history of ALVC. We aim to highlight the common characteristics of ALVC and Covid-19 vaccine myocarditis and work through the differential diagnosis of these two entities.
Case Report: Anterior Cruciate Ligament Calcification in a Patient With Chondrocalcinosis: Micro-Computed Tomography Presentation
Authors: Alberto Grassi, Giacomo Dal Fabbro, Milena Fini, Stefano Zaffagnini, Annapaola Parrilli
Journal: Front Surg (2021)
Keywords: micro-ct (computed tomography), anterior cruciate ligament, calcification, chondrocalcinosis, knee, μct and 3d reconstruction
MeSH terms: Case Reports

In this case report, an incidental postoperative diagnosis of anterior cruciate ligament (ACL) calcification, associated with calcification of posterior cruciate ligament (PCL) and lateral meniscus insertions, was made using micro-computed tomography (μCT) technology in a knee specimen obtained during a total knee replacement (TKR) surgery due to painful tri-compartmental osteoarthritis (OA) with chondrocalcinosis signs at preoperative X-ray. Anterior cruciate ligament calcification is an uncommon finding, and conventional X-ray and MRI are not so helpful in its identification. μCT scan, in contrast, is of interest because it provides highly spatial three-dimensional information with excellent visualization of bones and calcifications. The μCT technology used in this case report allowed us to perform a detailed analysis and a 3-D reconstruction of the calcium pyrophosphate dihydrate (CPPD) crystal deposition about the knee without the need to section the specimens into slice as performed in previous studies. The 3-D model obtained with μCT scan permits to gain more insight into the shape of the calcification within the fibers of the ligamentous structures of the joint.
Twin pregnancy in the unicornuate uterus and non-communicating rudimentary horn: A case report
Authors: Leili Hafizi, Nayereh Ghomian
Journal: Int J Reprod Biomed (2019)
Keywords: mullerian ducts, uterus, twin pregnancy
MeSH terms: Case Reports

Background: A unicornuate uterus is present in 0.1% of the general population. This müllerian anomaly carries significant obstetrical risk including abortion, preterm delivery, and rudimentary horn ruptures. Case: The patient is a 24-yr-old primigravida with 12-wk gestational age and a twin pregnancy in the unicornuate uterus and non-communicating rudimentary horn. One fetus in the unicornuate uterus and other in the rudimentary horn that was ruptured. In urgent laparotomy rudimentary horn and fallopian tube excised. Pregnancy in the unicornuate uterus was continued and at 38-wk gestational age, cesarean section due to premature rupture of the membrane was performed and then normal fetus was delivered. Conclusion: Twin pregnancy in a unicornuate uterus and rudimentary horn is a rare condition that carries a considerable risk to the mother. There is a need for increased awareness of this rare condition to prevent maternal morbidity and mortality.
Rare Cause of Recurrent Hypoglycemia: Insulin Autoimmune Syndrome
Authors: Rungsima Tinmanee, Rungpailin Buranagan, Sirirat Ploybutr, Raweewan Lertwattanarak, Apiradee Sriwijitkamol
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

We report a case of insulin autoimmune syndrome associated with several autoantibodies, presenting with recurrent hypoglycemia, predominantly in the postprandial period, which improved by dietary management and spontaneously resolved within two months. Differentiation from other causes of hyperinsulinemic hypoglycemia, such as insulinoma, is important to avoid unnecessary invasive procedures or surgical interventions. The 75-gram oral glucose tolerance test (OGTT) and mixed meal test showed a typical pattern, which may be useful indirect evidence of insulin autoimmune syndrome.
Irreducible Anterior Shoulder Dislocation with Interposition of the Long Head of the Biceps and Greater Tuberosity Fracture: A Case Report and Review of the Literature
Authors: Konstantinos Pantazis, Andreas Panagopoulos, Irini Tatani, Basilis Daskalopoulos, Ilias Iliopoulos, Minos Tyllianakis
Journal: Open Orthop J (2017)
Keywords: anterior, greater tuberosity fracture, irreducible, long head of biceps, open reduction, shoulder dislocation
MeSH terms: Case Reports

Background:
Failure of closed manipulative reduction of an acute anterior shoulder dislocation is seldom reported in the literature and is usually due to structural blocks such as soft tissue entrapment (biceps, subscapularis, labrum), bony fragments (glenoid, greater tuberosity) and severe head impaction (Hill-Sachs lesion).
Case report:
We present a case of an irreducible anterior shoulder dislocation in a 57-year-old male patient after a road-traffic accident. He had severe impaction of the head underneath glenoid rim and associated fracture of the greater tuberosity. Closed reduction performed in the emergency room under sedation and later at the theatre under general anaesthesia was unsuccessful. Open reduction using the dectopectoral approach revealed that the reason for obstruction was the posterolateral entrapment of the biceps tendon between the humeral head and the tuberosity fragment. Reduction was achieved after subscapularis tenotomy and opening of the joint; the tuberosity fragment was fixed with transosseous sutures and the long head of the biceps tendon was tenodesized. The patient had an uneventful postoperative recovery and at his last follow up, 12 months postoperatively, he had a stable joint, full range of motion and a Constant score of 90.
Conclusion:
A comprehensive literature review revealed 22 similar reports affecting a total of 30 patients. Interposition of the LHBT alone or in combination with greater tuberosity fracture was the most common obstacle to reduction, followed by subscapularis tendon interposition and other less common reasons. Early surgical intervention with open reduction and confrontation of associated injuries is mandatory for a successful outcome.
ALKG1269A mutation as a potential mechanism of acquired resistance to crizotinib in an ALK-rearranged inflammatory myofibroblastic tumor
Authors: Sebastian Y F Michels, Andreas H Scheel, Thomas Wündisch, Johannes M Heuckmann, Roopika Menon, Michael Puesken, Carsten Kobe, Helen Pasternack, Carina Heydt, Matthias Scheffler, Rieke Fischer, Anne M Schultheis, Sabine Merkelbach-Bruse, Lukas Heukamp, Reinhard Büttner, Jürgen Wolf
Journal: NPJ Precis Oncol (2017)
MeSH terms: Case Reports

Inflammatory myofibroblastic tumors are rare mesenchymal neoplasms frequently harboring oncogenic chromosomal rearrangements, most commonly, involving the ALK (anaplastic lymphoma kinase) gene. Treatment of this molecularly defined subgroup with the anaplastic lymphoma kinase inhibitor crizotinib has shown to be effective. However, comparable to lung adenocarcinoma, resistance inevitably develops. Second generation anaplastic lymphoma kinase inhibitors such as ceritinib are able to overcome acquired resistance to crizotinib. Here, we report the case of a patient with an inflammatory myofibroblastic tumors harboring a DCTN1-ALK fusion who developed resistance to crizotinib treatment. Next-generation sequencing of a rebiopsy sample revealed the acquisition of the ALKG1269A mutation as a mechanism of resistance. Therapy with ceritinib resulted in a short but profound clinical, metabolic and morphologic response. This case illustrates that (i) different tumor entities may share similar oncogenic driver mechanisms, rendering them vulnerable for the same therapeutic substances and (ii) likewise, the same mode of resistance may occur under targeted therapy among different tumor entities.
A Case of Advanced Glaucoma with Increased Episcleral Venous Pressure in a 17-Year-Old with Eisenmenger Syndrome
Authors: Leanne Grech, Adrian Mifsud, Maryanne Caruana, Francis Carbonaro
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

Eisenmenger syndrome refers to reversal of shunt and central cyanosis due to pulmonary hypertension induced by congenital heart disease with a large systemic-to-pulmonary shunt. We report a case of a 17-year-old man with Eisenmenger syndrome who presented with gradual deterioration in visual acuity and was diagnosed with advanced secondary open angle glaucoma. There have been reports of patients suffering from thrombosis due to hyperviscosity associated with this syndrome; however, to our knowledge, the association of secondary open angle glaucoma with Eisenmenger syndrome has not yet been documented.
Oocyte cryopreservation in the setting of a vascular endothelial growth factor (VEGF)-producing paraneoplastic syndrome: a case report and review of literature
Authors: Emily Spurlin, Paula Brady
Journal: Fertil Res Pract (2020)
Keywords: controled ovarian hyperstimulation, oncofertility, oocyte cryopreservation, ovarian hyperstimulation syndrome, poems paraneoplastic syndrome
MeSH terms: Case Reports

Background:
Many reproductive aged women with new oncologic diagnoses choose to undergo emergency oocyte or embryo cryopreservation prior to initiating potentially gonadal toxic oncologic therapies. Ovarian hyperstimulation syndrome (OHSS) is a potential complication of these treatments and can be particularly dangerous in these patients due to their underlying medical illness and by delaying lifesaving oncology treatment. This case report details a multipronged approach to OHSS prevention in a patient with a paraneoplastic syndrome defined by overproduction of vascular endothelial growth factor (VEGF), which is also primarily responsible for OHSS.
Case presentation:
A 29 year old nulligravid woman was diagnosed with a rare multisystem paraneoplastic syndrome (Polyradiculoneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder and skin changes, known as POEMS) and presented for fertility preservation consultation prior to autologous stem cell transplant. She successfully underwent oocyte cryopreservation without complications due to aggressive OHSS prophylaxis with both a dopamine agonist and aromatase inhibitor during and after stimulation and a gonadotropin releasing hormone agonist (GnRH-A) for final oocyte maturation, without delay in her subsequent oncology treatment.
Conclusions:
This is the first report of a patient with POEMS undergoing controlled ovarian hyperstimulation (COH). Oocyte cryopreservation was successful and without complications due to a combination of prophylactic measures against OHSS (cabergoline, letrozole and GnRH-A trigger) and close collaboration between reproductive endocrinology and oncology. This case demonstrates the use of combined measures in targeting VEGF overproduction and OHSS risk during COH.
Use of PEG-asparaginase in monomorphic epitheliotropic intestinal T-cell lymphoma, a disease with diagnostic and therapeutic challenges
Authors: Cesar Gentille, Qian Qin, Andreia Barbieri, Pingali Sai Ravi, Swaminathan Iyer
Journal: Ecancermedicalscience (2017)
Keywords: eatl, meitl, asparaginase
MeSH terms: Case Reports

Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), previously known as enteropathy associated T-cell lymphoma (EATL) type II, is a rare haematological malignancy with a difficult and delayed diagnosis. Symptoms can include abdominal pain, weight loss, and chronic diarrhoea. However, most patients are only diagnosed after complications, such as perforation or obstruction, have developed. There is no standard treatment for MEITL; most accepted regimens consist of surgical resection and anthracycline-based chemotherapy. Prognosis is poor with an approximate survival of less than a year. Even though other therapies, such as autologous stem cell transplant, has shown promising results, not all patients can tolerate this course of treatment especially if they are elderly, have several comorbidities or are malnourished. Innovative therapies that improve survival and can be used as an alternative for more intensive treatment are needed. We report the use of PEG-asparaginase along with conventional anthracycline therapy in a 70-year-old woman diagnosed with MEITL, who went into remission and survived for more than one year before succumbing to relapsed disease.
Electroconvulsive therapy use for refractory status epilepticus in an implantable vagus nerve stimulation patient: A case report
Authors: Lauren Katzell, Emily M Beydler, Richard Holbert, Laura Rodriguez-Roman, Brent R Carr
Journal: Front Psychiatry (2023)
Keywords: case reports, electroconvulsive therapy, refractory epilepsy, status epilepticus, vagus nerve stimulation
MeSH terms: Case Reports

Introduction:
Status epilepticus (SE) has a mortality rate of 20 to 50%, with acute symptomatic SE having a higher risk compared to chronic SE. Electroconvulsive therapy (ECT) has been utilized for the treatment of refractory SE with a success rate estimate of 57.9%. There are no known reported cases of concomitant use of vagus nerve stimulation (VNS) and ECT for the treatment of super refractory SE (SRSE) available in the literature.
Case description:
We present a 44-year-old female with a history of developmental delay, epilepsy, an implantable VNS for 6 years, and traumatic brain injury with subsequent hygroma who presented with progressive aphasia, declining mental status, and daily generalized seizures lasting up to 20 min. Seizures had increased from her baseline of one seizure per day controlled with topiramate 200 mg three times daily and lamotrigine 400 mg twice daily. She was diagnosed with SRSE after being intubated and placed on eight anti-epileptic drugs (AEDs) that failed to abort SE. ECT was attempted to terminate SE. Due to a prior right craniotomy with subsequent right hygroma, eight treatments of ECT were performed over three sessions using a right anterior, left temporal (RALT) and subsequently a bitemporal electrode placement. The VNS remained active throughout treatment. Various ECT dosing parameters were attempted, varying pulse width and frequency. Although ECT induced mild transient encephalographic (EEG) changes following ECT stimulations, it was unable to terminate SE.
Discussion:
This case describes various treatment strategies, constraints, and device limitations when using ECT for the treatment of SE. With wide variability in efficacy rates of ECT in the treatment of SE in the literature, successful and unsuccessful cases offer information on optimizing ECT total charge dose and parameters that yielded success. This case demonstrates an instance of ECT inefficacy in the treatment of SRSE. Here, we discuss the rationale behind the various ECT settings that were selected, and constraints arising from the antiepileptic burden, VNS, and intrinsic limitations of the ECT device itself.
Case Report: Pneumocephalus after labor epidural anesthesia
Authors: Beatriz Nistal-Nuño, Manuel Ángel Gómez-Ríos
Journal: F1000Res (2014)

Lumbar epidural anesthesia is commonly used for labor analgesia. The 'loss-of- resistance' to air technique (LORA) is generally employed for recognition of the epidural space. One of the rare complications of this technique is pneumocephalus (PC). Here we describe the case of a parturient who developed a frontal headache when locating the epidural space using LORA. On the second day after epidural injection, the patient exhibited occipital headaches with gradual worsening. Computed tomography scans of the brain indicated PC. Following symptomatic treatment, our patient was discharged on the 13th day. We concluded that the amount of air used to identify the epidural space in LORA should be minimized, LORA should not be used after dural puncture and the use of saline avoids PC complications.
Case Report: Zolpidem's paradoxical restorative action: A case report of functional brain imaging
Authors: Jennifer Boisgontier, Kévin Beccaria, Ana Saitovitch, Thomas Blauwblomme, Lelio Guida, Ludovic Fillon, Christelle Dufour, Jacques Grill, Hervé Lemaitre, Stéphanie Puget, Alice Vinçon-Leite, Volodia Dangouloff-Ros, Sarah Charpy, Sandro Benichi, Raphaël Levy, Charles-Joris Roux, David Grévent, Marie Bourgeois, Lila Saidoun, Raphaël Gaillard, Monica Zilbovicius, Nathalie Boddaert
Journal: Front Neurosci (2023)
Keywords: brain function, neural circuits, neurological recovery, paradoxical effect, zolpidem

Zolpidem is a sedative drug that has been shown to induce a paradoxical effect, restoring brain function in wide range of neurological disorders. The underlying functional mechanism of the effect of zolpidem in the brain in clinical improvement is still poorly understood. Thus, we aimed to investigate rest brain function to study zolpidem-induced symptom improvement in a patient who developed postoperative pediatric cerebellar mutism syndrome, a postoperative complication characterized by delayed onset transient mutism/reduced speech that can occur after medulloblastoma resection. The patient experienced clinical recovery after a single dose of zolpidem. Brain function was investigated using arterial spin labeling MRI and resting-state functional MRI. Imaging was performed at three time-points: preoperative, postoperative during symptoms, and after zolpidem intake when the symptoms regressed. Whole brain rest cerebral blood flow (CBF) and resting state functional connectivity using Pearson coefficient correlations between pairs of regions of interest were investigated two-by-two at the different time points. A comparison between postoperative and preoperative images showed a significant decrease in rest CBF in the left supplementary motor area, Broca's area, and the left striatum and a decrease in functional connectivity within the dentato-thalamo-cortical and cortico-striato-pallido-thalamo-cortical loops. Post-zolpidem images showed increased CBF in the left striatum and increased functional connectivity within the disrupted loops relative to postoperative images. Thus, we observed functional changes within the broader speech network and thalamo-subcortical interactions associated with the paradoxical effect of zolpidem in promoting clinical recovery. This should encourage further functional investigations in the brain to better understand the mechanism of zolpidem in neurological recovery.
Overlapping anti-NMDAR encephalitis and multiple sclerosis: A case report and literature review
Authors: Pan Liu, Hui Yan, Haizhe Li, Chunhua Zhang, Yanfang Li
Journal: Front Immunol (2023)
Keywords: anti-nmdar encephalitis, demyelinating disease, multiple sclerosis, mycophenolate mofetil, overlap
MeSH terms: Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / drug therapy, Multiple Sclerosis / complications, Multiple Sclerosis / diagnosis, Multiple Sclerosis / drug therapy, Review, Case Reports, Autoantibodies, China, Humans, Male, Receptors, N-Methyl-D-Aspartate, Autoantibodies, Receptors, N-Methyl-D-Aspartate

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune-mediated disease characterized by complicated neuropsychiatric symptoms and the detection of cerebrospinal fluid antibodies against the GluN1 subunit of the NMDAR. With the proposed clinical method, more anti-NMDAR encephalitis patients have been discovered since its first report. However, anti-NMDAR encephalitis overlapping with multiple sclerosis (MS) is rare. Herein we report a male patient with anti-NMDAR encephalitis who developed MS in mainland China. Furthermore, we summarized the characteristics of patients who were diagnosed with overlapping MS and anti-NMDAR encephalitis in previous studies. Additionally, we pioneered the use of mycophenolate mofetil in immunosuppressive therapy, providing a novel therapeutic alternative for overlapping anti-NMDAR encephalitis and MS.