OpenMed/multicare-articles huggingface dataset:
An elemental diet is effective in the management of diversion colitis
Authors: Andrew Lane, Nicholas Dalkie, Lisa Henderson, James Irwin, Kamran Rostami
Journal: Gastroenterol Hepatol Bed Bench (2021)
Keywords: crohn’s disease, diversion colitis, elemental diet, ileostomy
MeSH terms: Case Reports

The use of an elemental diet in the management of inflammatory gastroenterological diseases has long been accepted as standard management and has shown to both induce and maintain remission in Crohn's disease, but the evidence is lacking for its use in diversion colitis. An elemental diet is one which provides all the required nutrition in a more easily absorbed and hypoallergenic form. In this case report, we present a patient who had a flare of diversion colitis treated with diet alone. She had a significant improvement in her symptoms with a decrease in bowel motions, rectal discharge and pain. This case suggests that there may be some role for the use of an elemental diet in the management of diversion colitis. We also examine some potential mechanisms which may lead to the benefit observed.
A Case of Spondyloarthritis in Patient Affected by Unicentric Castleman's Disease Effectively Managed with Surgery Resection and Tocilizumab Treatment
Authors: M Filippini, S Cartella, O Bonzanini, E Morello, A Tincani
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

A 38-year-old woman was referred to our hospital for rheumatologic manifestations (migrant arthritis and tenosynovitis), without psoriasis or family history of psoriasis, gastroenteric manifestations, or recent genitourinary infections. The instrumental and laboratory tests have suggested a diagnosis of undifferentiated seronegative HLA-B27-positive spondyloarthritis with predominantly peripheral involvement. The symptoms were very severe and resistant to anti-inflammatory drugs and steroids. She had a history of hyaline-vascular unicentric Castleman's disease (HBV, HIV, and HHV-8 negative) treated with surgery resection. After a first pharmacological attempt with sulfasalazine (suspended for urticarial rash), we managed the patient with monotherapy tocilizumab 8 mg/kg, with full response of rheumatologic manifestations. The efficacy of tocilizumab was confirmed even after a follow-up of three years. Our experience seems to describe a new late-onset autoimmune disease (only 21 cases described in literature) potentially related to Castleman's disease. The patient experienced marked improvement from IL-6-based therapy (tocilizumab).
Successful Treatment of Adult-Onset Recurrent Respiratory Papillomatosis with CO2 Laser and Photodynamic Therapy
Authors: Sheng Lu, Yang Liu, Runjie Shi, Pingyu Zhou
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Recurrent respiratory papillomatosis is a noninvasive benign epithelial tumor caused by human papillomavirus. Clinically, it featured rapid growth, multifocus, and frequent recurrence. Though a number of therapies have been investigated, the recurrence after treatment is always a challenge. In this report, we describe a 27-year-old male patient with recurrent respiratory papillomatosis who was treated with CO2 laser therapy followed by 5-aminolevulinic acid photodynamic therapy (ALA-PDT). There was no adverse reaction after treatment and no recurrence during the follow-up time.
Recurrent Peri-Clitoral Abscess with Positive Actinomyces turicensis Culture
Authors: Diana Palacios, Cristina Wallace Huff
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

A peri-clitoral abscess is a condition that is seldom encountered in practice and is found scarcely in the literature. The cause of spontaneous peri-clitoral abscess not associated with female circumcision/genital mutilation is generally unknown. Additionally, there have been no case reports of positive Actinomyces culture at the time of drainage of a peri-clitoral abscess. This case outlines a 42-year-old female with a spontaneous peri-clitoral abscess. The abscess was initially treated with incision and drainage (I&D) and antibiotics, but it later reoccurred necessitating a second I&D with bedside marsupialization and antibiotics targeted at Actinomyces, which grew on the culture after primary I&D.
Partial Extraction Therapy with Early Implant Placement in the Esthetic Zone: A Clinical Case Report
Authors: Saleh N Almohammed, Reem S Abdel-Hafez, Duaa D Ailabouni
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Immediate replacement of teeth designated for extraction is an appealing treatment rationale for both the patient and the operator. However, it has been associated with a greater risk of facial recession and compromised soft-tissue esthetics. Partial extraction therapy (PET) or synonymously socket shield technique (SST) or root membrane technique (RMT) has been proposed to conserve the facial alveolar contour and soft-tissue esthetics. In this article, a special case is described where a root membrane was used to prevent the modeling of the facial aspect of the extraction socket. Partial extraction was performed allowing the socket with the facial root membrane in situ to partially heal for 8 weeks before implant placement. Successful integration and restoration were achieved with very minimal hard- and soft-tissue changes, accentuating satisfactory esthetic results as dictated by objective esthetic assessment. PET with early implant placement may be considered a viable treatment option for selected cases.
A girl with cutaneous lesions, polyarthritis, and antinuclear antibodies positivity
Authors: Jorge L Musuruana, Javier A Cavallasca
Journal: ISRN Dermatol (2011)
MeSH terms: Case Reports

On October 1996, a 14-year-old girl was admitted to the hospital because cutaneous lesions, asthenia, and arthralgias. On examination, there was nonscarring hair thinning with a widened part over the frontal hairline, polymorphic papulosquamous rash on her face, neck, arms, and trunk, and livedo reticularis in her legs. Multiple aphtous ulcers were present on the buccal and nasal mucosa. There was polyarthritis involving the wrist, metacarpophalangeal joints, proximal interphalangeal joints, and metatarsophalangeal joints of both hands and feet. Skin biopsy of the face was compatible with subacute cutaneous lupus erythematosus. She started on prednisone 60 mg/d without improvement, and later hdroxhchloroquine (HCQ) 6 mg/kg/d was added for one year. Cutaneous lesions were almost healed, with just a hypopigmented macules left. Over the last 14 years, she has not shown any cutaneous or systemic manifestations.
The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta-analysis
Authors: Gláucia Fernandes Cota, Marcos Roberto de Sousa, Fábio Nogueira Demarqui, Ana Rabello
Journal: PLoS Negl Trop Dis (2012)
MeSH terms: Clinical Laboratory Techniques / methods, HIV Infections / complications, Leishmaniasis, Visceral / diagnosis, Parasitology / methods, Comparative Study, Evaluation Study, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review, Humans, Molecular Diagnostic Techniques / methods, Sensitivity and Specificity, Serologic Tests / methods

Background:
Human visceral leishmaniasis (VL), a potentially fatal disease, has emerged as an important opportunistic condition in HIV infected patients. In immunocompromised patients, serological investigation is considered not an accurate diagnostic method for VL diagnosis and molecular techniques seem especially promising.
Objective:
This work is a comprehensive systematic review and meta-analysis to evaluate the accuracy of serologic and molecular tests for VL diagnosis specifically in HIV-infected patients.
Methods:
Two independent reviewers searched PubMed and LILACS databases. The quality of studies was assessed by QUADAS score. Sensitivity and specificity were pooled separately and compared with overall accuracy measures: diagnostic odds ratio (DOR) and symmetric summary receiver operating characteristic (sROC).
Results:
Thirty three studies recruiting 1,489 patients were included. The following tests were evaluated: Immunofluorescence Antibody Test (IFAT), Enzyme linked immunosorbent assay (ELISA), immunoblotting (Blot), direct agglutination test (DAT) and polimerase chain reaction (PCR) in whole blood and bone marrow. Most studies were carried out in Europe. Serological tests varied widely in performance, but with overall limited sensitivity. IFAT had poor sensitivity ranging from 11% to 82%. DOR (95% confidence interval) was higher for DAT 36.01 (9.95-130.29) and Blot 27.51 (9.27-81.66) than for IFAT 7.43 (3.08-1791) and ELISA 3.06 (0.71-13.10). PCR in whole blood had the highest DOR: 400.35 (58.47-2741.42). The accuracy of PCR based on Q-point was 0.95; 95%CI 0.92-0.97, which means good overall performance.
Conclusion:
Based mainly on evidence gained by infection with Leishmania infantum chagasi, serological tests should not be used to rule out a diagnosis of VL among the HIV-infected, but a positive test at even low titers has diagnostic value when combined with the clinical case definition. Considering the available evidence, tests based on DNA detection are highly sensitive and may contribute to a diagnostic workup.
Left subclavian artery pseudoaneurysm after a traffic accident: a case report
Authors: J Enamorado-Enamorado, J J Egea-Guerrero, J Revuelto-Rey, E Gordillo-Escobar, C Herrera-Melero
Journal: Case Rep Crit Care (2011)
MeSH terms: Case Reports

The left subclavian artery pseudoaneurysm is a rare entity with few cases reported in the literature. Most injuries were related to iatrogenic manipulation with catheters for canalization of central lines. In rare cases, this injury has been described secondary to a blunt trauma. We present an unusual case of pseudoaneurysm that includes the origin of left subclavian artery in the context of severe multiple injuries after a traffic accident. There were not clavicular or rib fractures, or another type of chest trauma to justify such a vascular injury. Once the injuries that were life threatening for the patient were stabilized, it proceeded to the treatment of the pseudoaneurysm by placing an endovascular prosthesis successfully with a favorable clinical evolution.
Successful treatment with bortezomib-containing regimen of primary plasma cell leukemia: a case report
Authors: Mohammad Bader Obeidat, Ali Mohammad Al-Swailmeen, Abdulmajeed Mohammad Arabeat, Ayman Sulaiman Abukamar
Journal: Pan Afr Med J (2020)
Keywords: plasma cell leukemia, bortezomib, multiple myeloma
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / administration & dosage, Leukemia, Plasma Cell / drug therapy, Case Reports, Aged, Bortezomib / administration & dosage, Dexamethasone / administration & dosage, Doxorubicin / administration & dosage, Follow-Up Studies, Humans, Leukemia, Plasma Cell / diagnosis, Leukemia, Plasma Cell / pathology, Male, Remission Induction, Bortezomib, Dexamethasone, Doxorubicin

Plasma cell leukemia represents the most aggressive form of plasma cell dyscrasia. We report a 67-year old male with no previous medical illnesses presented with anemic symptoms. Blood film revealed 35% circulating plasma cells, bone marrow biopsy showed plasma cells constituting 85%. Diagnosis of primary plasma cell leukemia was completed. Induction chemotherapy with bortezomib, doxorubicin, and dexamethasone was started. After the first cycle, plasma cells in peripheral blood disappeared. The patient had complete remission at evaluation after the third cycle. Re-evaluation after the sixth cycle showed that he maintained remission. As he was non-transplant eligible, he was we kept on maintenance bortezomib. Twenty-four months after the diagnosis, the patient remains in remission.
Complex X chromosome rearrangement associated with multiorgan autoimmunity
Authors: Irén Haltrich, Henriett Pikó, Horolma Pamjav, Anikó Somogyi, Antónia Völgyi, Dezső David, Artúr Beke, Zoltán Garamvölgyi, Eszter Kiss, Veronika Karcagi, György Fekete
Journal: Mol Cytogenet (2015)
Keywords: autoimmune disease, complex x chromosome rearrangement, turner syndrome, type 1 diabetes mellitus, x inactivation disorder
MeSH terms: Case Reports

Background:
Turner syndrome, a congenital condition that affects 1/2,500 births, results from absence or structural alteration of the second sex chromosome. Turner syndrome is usually associated with short stature, gonadal dysgenesis and variable dysmorphic features. The classical 45,X karyotype accounts approximately for half of all patients, the remainder exhibit mosaicism or structural abnormalities of the X chromosome. However, complex intra-X chromosomal rearrangements involving more than three breakpoints are extremely rare.
Results:
We present a unique case of a novel complex X chromosome rearrangement in a young female patient presenting successively a wide range of autoimmune diseases including insulin dependent diabetes mellitus, Hashimoto's thyroiditis, celiac disease, anaemia perniciosa, possible inner ear disease and severe hair loss. For the genetic evaluation, conventional cytogenetic analysis and FISH with different X specific probes were initially performed. The complexity of these results and the variety of autoimmune problems of the patient prompted us to identify the exact composition and breakpoints of the rearranged X as well as methylation status of the X chromosomes. The high resolution array-CGH (assembly GRCh37/hg19) detected single copy for the whole chromosome X short arm. Two different sized segments of Xq arm were present in three copies: one large size of 80,3 Mb from Xq11.1 to Xq27.3 region and another smaller (11,1 Mb) from Xq27.3 to Xq28 region. An 1,6 Mb Xq27.3 region of the long arm was present in two copies. Southern blot analysis identified a skewed X inactivation with ≈ 70:30 % ratios of methylated/unmethylated fragments. The G-band and FISH patterns of the rearranged X suggested the aspect of a restructured i(Xq) chromosome which was shattered and fortuitously repaired. The X-STR genotype analysis of the family detected that the patient inherited intact maternal X chromosome and a rearranged paternal X chromosome. The multiple Xq breakages and fusions as well as inverted duplication would have been expected to cause a severe Turner phenotype. However, the patient lacks many of the classic somatic features of Turner syndrome, instead she presented multiorgan autoimmune diseases.
Conclusions:
The clinical data of the presented patient suggest that fragmentation of the i(Xq) chromosome elevates the risk of autoimmune diseases.
Multiple Primary Lung Cancers With ALK Rearrangement: A Case Report and Literature Review
Authors: Zhou Huimin, Wang Xueting, Qi Qi, Feng Lingxin, Yang Xue, Yu Zhuang, Wang Jing
Journal: Front Oncol (2022)
Keywords: anaplastic lymphoma kinase, combined small cell lung cancer, multiple primary malignant neoplasms, non-small cell lung cancer, small cell lung cancer
MeSH terms: Case Reports

Multiple primary lung cancers (MPLCs) are that patients with lung cancer may present with two primary tumors at the same time (synchronous multiple primary lung cancer, SMPLC) or may develop a second, metachronous primary lung cancer after treatment of the initial lesion. Currently, there are no definitive guidelines for the diagnosis and treatment of multiple primary lung cancers. Herein, we report a case of double primary lung cancers with ALK rearrangement. The patient was treated with chemotherapy, targeted therapy, and radiotherapy. After these treatments, the patient was free of locally recurrent or distant disease at 2 years.
Successful management of heparin-induced thrombocytopenia using argatroban in a very old woman: a case report
Authors: A Putot, S Perrin, H Sordet-Guépet, E de Maistre, P Manckoundia
Journal: Case Rep Med (2013)

Thrombosis due to heparin-induced thrombocytopenia (HIT) is rare but has a severe prognosis. Its management is not always easy, particularly in old patients with renal insufficiency. A 95-year-old woman was hospitalized for dyspnea. Curative treatment with unfractionated heparin was started because pulmonary embolism was suspected. Disseminated intravascular coagulation was then suspected because of thrombocytopenia, hypoprothrombinemia, hypofibrinogenemia, and a positive ethanol gelation test. The first immunoassay for HIT was negative. On the 12th day of hospitalization, bilateral cyanosis of the toes occurred associated with recent deep bilateral venous and arterial thrombosis at duplex ultrasound. New biological tests confirmed HIT and led us to stop heparin and to start argatroban with a positive clinical and biological evolution. Venous and arterial thrombosis associated with thrombocytopenia during heparin treatment must be considered HIT whatever the biological test results are. Argatroban is a good alternative treatment in the elderly.
Cecal volvulus following mini gastric bypass: A case report and review of literature
Authors: Hanan M Alghamdi, Shadi AlShammary, Haitham Lardhi, Wafa AlDhafeeri, Noor AlLababidi
Journal: Int J Surg Case Rep (2018)
Keywords: bariatric surgery, cecal volvulus, intestinal obstruction, mini gastric bypass, post op complication

Introduction:
With the rising worldwide obesity epidemic, bariatric surgeries are gaining popularity as the most effective modality for achieving long term results in weight loss and reducing its metabolic sequels.
Case presentation:
A 36-year-old female presented with a sudden onset of severe abdominal pain for 6 h. The patient underwent Mini gastric bypass (MGB) 2 years prior to presentation. Computed tomography (CT) scan revealed a 14-cm dilatation of the cecum occupying the left upper quadrant of the abdomen with the swirling appearance of the mesentery. These findings were confirmed through emergency exploratory laparotomy to be cecal volvulus. a right hemicolectomy and conversion of MGB to a conventional Roux-en-Y gastric bypass.
Discussion:
a modification of the classical gastric bypass surgery the MGB considered by its advocates to be a safer, simpler, and more effective option. However, serious complications can take place especially in the early learning curve of the procedure.
Conclusions:
We present a unexpected acute in top of chronic cecal volvulus in patient two years post MGB. The uncommon serious complication should be considered one of the differential diagnosis of acute surgical abdomen in those patients.
Case Report of Percutaneous Tract Seeding of Renal Pelvic Tumor: 8-Year Journey
Authors: Paulos Yohannes
Journal: J Endourol Case Rep (2016)
Keywords: percutaneous surgery, percutaneous tract seeding, renal tcc
MeSH terms: Case Reports

A 58-year-old female presented with renal colic and was found to have renal transitional cell carcinoma at the time of percutaneous surgery. She developed percutaneous tract seeding that clinically presented as subcutaneous skin nodules. After local treatment with surgical excision and radiation treatment, the patient developed retroperitoneal recurrence 5 years later. Percutaneous tract seeding is rare. There is no general consensus on prevention of tract seeding during percutaneous resection of renal urothelial tumors. Various recommendations from the literature are discussed.
Goldenhar Syndrome with Dextrocardia and Right Pulmonary Hypoplasia: An Unusual Association
Authors: Nagendra Chaudhary, Sandeep Shrestha, Hemant Kumar Halwai
Journal: Case Rep Genet (2017)
MeSH terms: Case Reports

Goldenhar syndrome (GS), a rare condition, occurring due to defect in development of first and second branchial arches, is characterized by a combination of various anomalies involving face, eyes, ears, vertebrae, heart, and lungs. The etiology of GS is not fully known, although various hypotheses have been proposed along with its genetic association and many other causes. Facial asymmetry and hypoplasia of the mandible are characteristic features of GS along with microtia and preauricular appendages and pits. Dextrocardia or pulmonary hypoplasia in GS has previously been reported separately. We report a 7-year-old female child of GS with combination of anomalies, dextrocardia, and pulmonary hypoplasia, which is a rare association.
Iodine-induced hyperthyroidism-an old clinical entity that is still relevant to daily ICU practice: a case report
Authors: E Brotfain, L Koyfman, A Frenkel, A Smolikov, A Zlotnik, M Klein
Journal: Case Rep Endocrinol (2013)

Objective. Hyperthyroidism has been described as elevated serum free T3 and/or free T4 levels with decreased thyrotropin (TSH) concentrations. The main causes are related to autoimmune and neoplastic pathology. However, it might be caused due to a long-term topical exposure (iodine solution dressing) or by intravenous administration of iodine-containing substances. Both clinical and laboratory features might be presented. The main management is based on interruption of all exposures with iodine solutions and also antithyroid medicine in case of severe laboratory and clinical disturbances. Data Sources. We present a case of iodine-induced hyperthyroidism in a critically ill ICU patient caused by excessive iodine containing antiseptic solution washes and contrast agent administration. The patient was successfully treated by discontinuing iodine exposure and beta-blocker administration. Conclusions. In patients with underlying thyroid gland pathology, thyroid-function tests and clinical observation in the ICU are of critical importance.
Isolated Splenic Lymphangiomas Presenting in an Infant with Isolated Anaemia
Authors: Ameer Kakaje, Raghad Mujahed, Othman Hamdan
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Lymphangiomas are benign tumours of lymphatic vessels which are not linked with the normal lymphatic vessels. Their symptoms usually depend on their location and size as they can compress or block adjacent organs. We present a 9-month-old girl with isolated cavernous lymphangiomas of the spleen, a rare variable of lymphangiomas, with no symptoms. She had an isolated anaemia which could only be explained by the hypersplenism caused by the lymphangiomas. Such a presentation has been very rarely reported in the literature and not mainly in children. Furthermore, this case also illustrates imaging of hypersplenism related to lymphangiomas.
Exploding Head Syndrome Accompanied by Repeating Panic Attacks: A Case Report
Authors: Yoshiyuki Kaneko, Akiomi Kawae, Kaori Saitoh, Yasuhiro Gon, Makoto Uchiyama, Masahiro Suzuki
Journal: Front Psychiatry (2021)
Keywords: case report, clonazepam, exploding head syndrome, panic attack, parasomnia, sleep disorder
MeSH terms: Case Reports

To the best of our knowledge, we report here for the first time a case of exploding head syndrome (EHS) that caused repeating panic attacks. A 62-year-old woman experienced a sudden sensation of a loud noise just before going to sleep. The frequency of these episodes rapidly increased to multiple times per night, and she soon began to fear sleep, which led to the occurrence of nighttime panic attacks. She was diagnosed with EHS at our sleep clinic, and clonazepam was prescribed accompanied by reassurance about the benign nature of this syndrome. The intensity of the loud noise gradually reduced, and her fear of sleep and panic attacks disappeared at around the same time. In this report, we argue the importance of gaining further knowledge about EHS, including that about complicating psychiatric symptoms and that about its treatment.