OpenMed/multicare-articles huggingface dataset:
Nifedipine-Influenced Enlargement of the Masticatory Mucosa in an Elderly Edentulous Patient: A Rare Case Report with a Two-Year Follow-Up
Authors: Shoufu Sun, Yufan Pan, Jichun Zhang, Yunan Jiang
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Drug-influenced gingival enlargement is a common side effect associated with certain medications, particularly calcium channel blockers like nifedipine, which has been extensively documented. However, the occurrence of nifedipine-influenced masticatory mucosa overgrowth in edentulous patients is rare. Here, we present a case of nifedipine-influenced mucosal enlargement persisting in a 67-year-old edentulous patient 3 months after the extraction of all his teeth. The patient underwent flap surgery and alveoloplasty to excise the overgrown tissue, followed by complete denture restoration. The antihypertensive medication was replaced with valsartan. A 2-year follow-up revealed no recurrence of overgrowth, indicating the effectiveness of this management strategy for such clinical situation.
Case report: Case series featuring anastomotic colonic adenocarcinoma following jejunoileal bypass requiring oncologic resection and jejunoileal bypass reversal
Authors: Bryan Miles, Anthony Visioni, Christopher Daigle, Robert Marley, Stephen Brandstetter
Journal: Front Surg (2023)
Keywords: bariatric surgery, case series, colon adenocarcinoma, jejunoileal bypass, jejunoileal bypass reversal
MeSH terms: Case Reports

Like all surgical fields, bariatric surgery has evolved immensely, so much so that previous procedures are now obsolete. For instance, the jejunoileal bypass has fallen out of favor after severe metabolic consequences resulted in prolonged morbidity and even mortality. Despite this, several patients persevered long enough to develop other pathology, such as cancer. This progression has been validated in animal models but not human patients. Nonetheless, contemporary surgeons may encounter situations where they must resect and re-establish intestinal continuity in patients with this antiquated anatomy. When faced with this scenario, the question of whether or not the previously bypassed small bowel can be safely reunited plagues the surgeon remains unanswered. Unfortunately, the literature does not effectively answer this question, even anecdotally through case reports or series. Therefore, we share our experience with three patients who developed colon cancer following jejunoileal bypass and subsequently underwent oncologic resection with simultaneous reversal of their jejunoileal bypasses.
Preterm Prelabour Rupture of Membrane (PPROM) in a Young Female in South-South Nigeria: A Clinical Case Report
Authors: Queen L Ekpa, Mfonabasi I Udoudo, Emmanuella I Nwebeh, Obinna C Nwebeh
Journal: Cureus (2024)
Keywords: case report, gestational age, membranes, prelabor, premature, preterm, rupture, underserved community
MeSH terms: Case Reports

A 30-year-old in a second pregnancy presented with new-onset spontaneous vaginal discharge of clear liquid for two hours at a gestational age of 29 weeks + 6 days; no other symptoms were present. Movement aggravated vaginal fluid leakage. She appeared anxious but otherwise vitally stable. An immediate ultrasound scan revealed reduced liquor volume. Conservative management was followed by the surgical delivery of a live preterm neonate. The neonate was admitted to the Special Care Baby Unit and the mother was monitored post-surgically in the obstetric ward. Several studies have described the etiology, pathogenesis, and various approaches to the management of Preterm Prelabour Rupture of Membranes (PPROM); however, there is no single global guideline for managing this condition. There is a consensus that PPROM is a notable risk factor for preterm labor, and significantly impacts both maternal and neonatal morbidity, as well as neonatal mortality. We compared epidemiology across other countries to the statistics obtained from Nigeria as well as management guidelines. Studies have also described the advantages of conservative management over proactive surgical intervention in improving neonatal outcomes. Moreover, the management of PPROM is affected by healthcare resources in different countries and their national protocol, and the impact is significant in developing countries like Nigeria such as the age of fetal viability and the lack of a national protocol. This paper explores PPROM and an uncommon presentation of spontaneous PPROM in the South-South region of Nigeria with only drainage of liquor. This case exemplifies the management approaches of PPROM in an underserved community and the factors that affect the survival of neonates in these communities. The index patient was initially managed conservatively and subsequently delivered a live preterm neonate surgically with good APGAR (appearance, pulse, grimace, activity, and respiration) scores. We expect this case report to prompt a unifying guideline for managing PPROM cases while encouraging advanced research and financial support of PPROM screening and treatment in low-income countries.
Acute Bilateral Posterior Meniscal Root Tears in the Setting of a Noncontact Anterior Cruciate Ligament Rupture
Authors: Adam V Daniel, Shayne R Kelly, Patrick A Smith
Journal: Case Rep Orthop (2024)
MeSH terms: Case Reports

Combined medial and lateral posterior meniscal root tears in the setting of an acute anterior cruciate ligament (ACL) rupture are extremely rare. The following case report demonstrates a high school football player who sustained a noncontact knee injury while performing a spin move at practice. The patient is a 17-year-old high school football defensive end who was presented to the clinic 1 week following the injury complaining of persistent knee pain with associated swelling, limited range of motion (ROM), and complaint of instability. During physical examination, the patient was found to have anterior cruciate laxity. Magnetic resonance imaging (MRI) demonstrated a complete midsubstance tear of the ACL and increased signal within the posterior horn of the medial meniscus with no obvious signs of pathology localized to the lateral meniscus. ACL reconstruction (ACLR) was performed and intraoperatively, both medial and lateral root tears were found. A standard bone patellar-tendon bone (BTB) autograft ACLR was performed with combined medial and lateral root repair utilizing a transtibial pull-out method for both. The clinical importance is root tears with associated ACL tears can be hard to diagnose on preoperative MRI, especially laterally, so careful assessment of both meniscal roots at the time of arthroscopy is critical. Furthermore, careful creation of the needed root repair tunnels for transtibial repair is critical to avoid coalescence with the ACL tibial tunnel.
Peri-operative management and analgesic strategy for a patient undergoing quadruple limb amputation
Authors: L Fenton-May, M Irvine, D Huckle, P Carter
Journal: Anaesth Rep (2024)
Keywords: amputation, analgesia, regional anaesthesia
MeSH terms: Case Reports

Inadequately managed amputation pain can contribute to postoperative morbidity and mortality. However, amputation pain can be challenging to manage due to its complex nature, with both central and peripheral nociceptive and neuropathic elements. Here, we present the case of a 47-year old man who developed irreversible ischaemic injuries to all four limbs following admission to intensive care with sepsis. He required quadruple amputation and we describe our approach to his peri-operative management including anaesthesia, invasive monitoring and the multi-modal approach to his peri-operative management using a combination of intravenous analgesics, bilateral brachial plexus nerve catheters and a combined spinal and epidural. The patient made a good recovery and was able to return home from a rehabilitation facility 12 months after the operation, able to undertake many tasks himself with the aid of prosthetics.
A Case of Anorexia Nervosa with Focal Cortical Dysplasia
Authors: Hiroki Nemoto, Kazuo Imagawa, Takashi Enokizono, Yosuke Masuda, Masayuki Ide, Takuma Deguchi, Monami Hara, Atsushi Morita, Takahiro Kido, Mai Tanaka, Tatsuyuki Ohto, Hidetoshi Takada
Journal: Case Rep Psychiatry (2024)
MeSH terms: Case Reports

Anorexia nervosa (AN) is a fatal condition associated with extreme underweight and undernutrition. It is more common in young females, with a female-to-male ratio of 10 : 1. Focal cortical dysplasia (FCD) is characterized by dysplasia of the cerebral cortex and is a common cause of pharmacoresistant epilepsy. However, FCD associated with AN has never been reported. We report the first case of AN in a 12-year-old male diagnosed with FCD-type 2 on head magnetic resonance imaging (MRI). He became concerned about lower abdominal distention and began reducing his food intake. He was admitted to our hospital after weight loss of 10 kg in a 1 year. Head MRI showed a localized high-signal area from the cortex to the white matter of the fusiform gyrus near the left hippocampus, with no associated decreased blood flow or electroencephalography (EEG) abnormalities. These findings were characteristic of FCD type II. In males with AN, the search for underlying disease is particularly important. The pathophysiology of the association between AN and FCD is unclear. However, both conditions are reportedly associated with autism spectrum disorder. Further cases are needed to clarify whether FCD is associated with eating disorders.
An Adult Case of Severe Asymptomatic Bilateral Ureteropelvic Junction Obstruction
Authors: Md Fahad Hossain, Syed Sheheryar Shah, Bahar Bastani
Journal: Case Rep Nephrol (2023)
MeSH terms: Case Reports

While ureteropelvic junction (UPJ) obstruction is a well-recognized cause of unilateral or bilateral upper urinary tract dilatation in infants and the pediatric population, its occurrence in adults is less recognized. We present the case of a 68-year-old man who was being evaluated for chronic orthostatic hypotension and was incidentally found to have asymptomatic microscopic hematuria on urinalysis. A CT scan of the abdomen/pelvis, without and with contrast, revealed severe bilateral hydronephrosis due to UPJ obstruction. The patient has remained asymptomatic with preserved normal renal function over 7 years of follow-up.
Presentation and challenges in management of COVID-19 in sickle cell disease: case report
Authors: Sheliza Parvez Thaver, Saliha Shafik Dawood, Nahida Zahir Walli
Journal: Pan Afr Med J (2023)
Keywords: covid-19, sickle cell disease, tanzania, case report, paediatrics
MeSH terms: Acute Chest Syndrome / etiology, Acute Chest Syndrome / therapy, Anemia, Sickle Cell / complications, Anemia, Sickle Cell / therapy, COVID-19 / complications, COVID-19 / therapy, Case Reports, Child, Female, Humans, Pain / etiology, Tanzania

Sickle cell has predominantly been a disease in the sub-Saharan Africa. There is scanty data in Africa and none in Tanzania regarding patients with sickle cell disease infected with COVID-19 especially in the paediatric group. This is concerning because a large population of children living with sickle cell disease are found in this part of the world where scarcity of resources also prevail. This is the first paediatric case of sickle cell disease and COVID-19 reported in Tanzania; highlighting the presentation and challenges faced in management. It is also the first case in literature describing secondary infection in a child with COVID-19 and underlying sickle cell disease. Our patient was a female child of African origin with underlying sickle cell disease who had recurrent admissions. She presented with cough, fever, chest and abdominal pain and was managed for acute chest syndrome and vaso-occlusive crisis. During the second admission, she developed respiratory distress, infection with COVID-19 was confirmed and managed accordingly. However, she was re-admitted due to bilateral arm pain and physical findings were suggestive of secondary respiratory bacterial infection. She was then started on a different treatment plan. Despite challenges faced in the management of the patient, the outcome was favourable. It is important to recognize the presentation of COVID-19 in children with sickle cell disease and challenges faced in management so that the epidemiologic characteristics, spectrum of the disease and its outcomes can be understood better in the context of sub-Saharan Africa.
Case report: A case of unilateral combined central retinal vein occlusion, incomplete central retinal artery occlusion, and papillitis following a third dose of COVID-19 vaccination
Authors: Ami Furukawa, Yukihiko Suzuki, Narumi Nozuki, Naruki Kurosaka, Satomi Kogawa, Shinya Hara, Shinji Ueno
Journal: Front Ophthalmol (Lausanne) (2024)
Keywords: covid-19 vaccination, central retinal vein occlusion, incomplete central retinal artery occlusion, macular edema, papillitis
MeSH terms: Case Reports

Purpose:
The aim of this study was to present a case of severe visual loss due to retinal arteriovenous occlusion and papillitis in one eye following vaccination against coronavirus disease (COVID-19).
Methods:
A 45-year-old man undergoing treatment for hypertension had severely reduced visual acuity in the right eye 1 day after receiving a third dose of a COVID-19 vaccine manufactured by Moderna. Clinical examination showed that the best-corrected visual acuity in the right eye was counting fingers. Other findings included circumferential retinal hemorrhage, perimacular ischemic color, severe macular edema, and severe optic disc swelling, indicating the presence of central retinal vein occlusion, incomplete central retinal artery occlusion, and papillitis. Based on the possibility of post-vaccination inflammation and/or abnormal immune response, three courses of steroid pulse therapy were administered, and the visual acuity slightly improved to 20/1,000.
Results:
Three months after the onset of symptoms, macular edema disappeared; conversely, retinal thinning of the macula and extensive non-perfusion areas mainly on the nasal side were noted.
Conclusion:
The findings in this case suggest that inflammation and abnormal immune response after receiving a COVID-19 vaccination may lead to combined retinal arteriovenous occlusion and papillitis.
Spontaneous remission of choroidal involvement by chronic myelomonocytic leukemia: a case report
Authors: Elisa Diral, Gloria Catalano, Maria Vittoria Cicinelli, Andrea Distefano, Sara Mastaglio, Luca Vago, Maria Teresa Lupo Stanghellini, Massimo Bernardi, Maurilio Ponzoni, Fabio Ciceri, Matteo G Carrabba
Journal: Front Oncol (2024)
Keywords: chronic myelomonocytic leukemia, multimodal imaging analysis, ocular involvement, personalized medicine, watch and wait approach
MeSH terms: Case Reports

Chronic myelomonocytic leukemia (CMML) is a rare hematological disorder characterized by variable risk of evolution to acute myeloid leukemia; to date, allogeneic stem cell transplantation is the only curative treatment. We report a case of choroidal involvement in a woman affected by CMML and presenting only with visual impairment. The patient was initially evaluated for an intensive therapeutic approach, but after biopsy the ocular lesion spontaneously regressed. Thus a "watch and wait" strategy was preferred. One year and a half after initial diagnosis, the patient is alive, with stable hematological disease and without any ocular involvement. Therefore, a close, not invasive follow up could be useful to tailor treatment for patients affected by single ocular lesions in CMML.
Case report: Diagnosis of a patient with Sifrim-Hitz-Weiss syndrome, development and epileptic encephalopathy-14, and medium chain acyl-CoA dehydrogenase deficiency
Authors: Naim Zeka, Eris Zeka, Esra Zhubi, Ilir Hoxha
Journal: Front Pediatr (2023)
Keywords: sifrim–hitz–weiss syndrome, developmental and epileptic encephalopathy, genetic variants, medium-chain acyl-coa dehydrogenase deficiency, neurodevelopmental delay, seizure
MeSH terms: Case Reports

Background:
It is generally recognized that genetic metabolic disorders can result in neurological symptoms such as seizures, developmental delay, and intellectual disability. Heterogeneous clinical presentations make the diagnosis challenging.
Case presentation:
In this case report, we present a unique and complex genetic disorder observed in a female patient who exhibited three pathogenic gene variants in the KCNT1, ACADM, and CHD4 genes. The convergence of these variants resulted in a multifaceted clinical presentation characterized by severe seizures of combined focal and generalized onset, metabolic dysfunction, and neurodevelopmental abnormalities. The identification and functional characterization of these gene variants shed light on the intricate interplay between these genes and the patient's phenotype. EEG revealed an epileptiform abnormality which presented in the inter-ictal period from the left frontal-central area and in the ictal period from the left mid-temporal area. The brain MRI revealed volume loss in the posterior periventricular area and parietal parenchyma, myelin destruction with no sign of hypoxic involvement, and left dominant enlargement of the lateral ventricles secondary to loss of central parenchyma. The patient was diagnosed through exome sequencing with Sifrim-Hitz-Weiss syndrome, development and epileptic encephalopathy-14, and medium-chain acyl-CoA dehydrogenase deficiency. An antiseizure medication regimen with valproic acid, levetiracetam, phenobarbital, and clonazepam was initiated. However, this led to only partial control of the seizures.
Conclusion:
Clinical follow-up of the patient will further define the clinical spectrum of KCNT1, ACADM, and CHD4 gene variants. It will also determine the long-term efficacy of the treatment of seizures and the development of precision medicine for epilepsy syndromes due to gain-of-function variants. Special emphasis should be put on the role and importance of large-scale genomic testing in understanding and diagnosing complex phenotypes and atypical epileptic syndromes.
Severe Hypercalcemia Caused by Calcium-Alkali Syndrome after 15 Years of Postoperative Hypoparathyroidism in a Patient with Undiagnosed Hyperaldosteronism
Authors: Natália Diel Boufleuer, Dimitris V Rados, Tatiana Zambonato, Clara K Maraschin, Beatriz D Schaan
Journal: Case Rep Endocrinol (2024)
MeSH terms: Case Reports

Introduction:
The triad of hypercalcemia, metabolic alkalosis, and acute kidney injury associated with ingesting high doses of calcium and absorbable bases characterizes the calcium-alkali syndrome. Clinical Case. We report the case of a patient with postthyroidectomy hypoparathyroidism 15 years ago due to differentiated thyroid cancer who presented with severe hypercalcemia. He had adequate control of calcemia for many years on treatment with calcitriol and calcium carbonate and hypertension treated with amlodipine, losartan, and hydrochlorothiazide. After a period of loss to follow-up, he suddenly presents with severe hypercalcemia, metabolic alkalosis, and loss of renal function. Upon hydration and withdrawal of calcitriol and calcium replacements, hypercalcemia resolved. The etiological investigation identified no granulomatous or neoplastic diseases, but an aldosterone-producing adrenal incidentaloma was found. The cause of hypercalcemia in this patient was calcium-alkali syndrome due to calcium carbonate replacement potentiated by hydrochlorothiazide and primary aldosteronism. Six months after the hospitalization and suspension of calcium and vitamin D, the patient returned to hypocalcemia, reinforcing the diagnosis.
Conclusion:
Although seldom described, the calcium-alkali syndrome is an expected complication for individuals with postoperative hypoparathyroidism, as they require lifelong calcium and vitamin D supplementation. This case also shows the importance of hydrochlorothiazide use and primary aldosteronism as possible triggers of life-threatening hypercalcemia.
Lofgren Syndrome: Achieving an Accurate Diagnosis for Improved Patient Care
Authors: Leonor Gama, Ana Santos E Silva, Ana Valido, Josiana Duarte, Henrique Rita
Journal: Cureus (2024)
Keywords: bimalleolar edema, differential diagnosis, lofgren syndrome, sarcoidosis, subcutaneous nodules
MeSH terms: Case Reports

Lofgren syndrome is a clinically distinct phenotype of sarcoidosis. It is characterized by the triad of bilateral hilar lymphadenopathy, arthritis (usually the ankles), and fever. We present the case of a 31-year-old male patient who presented with fever and edema in both lower limbs, with palpation of subcutaneous nodules. A chest contrast-enhanced computerized axial tomography (CECT) scan revealed perihilar and mediastinal lymphadenopathy. In making the diagnosis, tuberculosis and lymphoma were both ruled out. A mediastinoscopy confirmed Lofgren syndrome. In medicine, a good differential diagnosis is important, as it will help inform the best treatment for the patient.
Pulmonary infection by Mycobacterium riyadhense: first case report in United Arab Emirates
Authors: Batool A Sawan, Leen O Saleh, Dina Z Al Shaltouni, Mohammad A Sawan, Shefa Gawish, Samar Ahmed, Julio Gomez-Seco, Michael E Otim
Journal: Front Med (Lausanne) (2024)
Keywords: mycobacterium riyadhense, antitubercular drugs, chronic cough, non-tuberculous mycobacteria, pulmonary cavity
MeSH terms: Case Reports

Mycobacterium riyadhense is an emerging slowly growing species that belongs to the group of nontuberculous mycobacteria (NTM) with approximately 20 cases reported worldwide. We highlight the first case of pulmonary infection by Mycobacterium riyadhense in United Arab Emirates (UAE). A 44-year-old female presented with chronic productive cough; a bronchial breathing pattern was appreciated on auscultation of her right upper lung. She was treated multiple times with allergic medications and antibiotics. Thorough investigations revealed Mycobacterium riyadhense and antitubercular drugs were started, eventually she was cured, however she had multiple relapses later. This case report holds a significant potential to make considerable contribution to the diagnosis of NTM, primarily because it presents the first documented case in UAE, as well as insights on how to address possible similar cases in the future.
Pediatric schwannoma of the hypoglossal nerve: a case report and narrative literature overview
Authors: Elena Sofia Marcandella, Alessandro Boscarelli, Flora-Maria Murru, Giuseppe Abbracciavento, Peter Spazzapan, Jurgen Schleef
Journal: Front Oncol (2024)
Keywords: hypoglossal schwannoma, management, neck masses, pediatric schwannoma, tongue disease
MeSH terms: Case Reports

Schwannomas are benign, slow-growing tumors originating from the Schwann cells of nerve sheaths. Extracranial schwannomas are rare, particularly in pediatric populations. Here, we report the case of a hypoglossal schwannoma in a 15-year-old male who experienced tongue paresthesia and fasciculations and difficulty swallowing two years before hospital admission. Magnetic resonance imaging showed an oval mass with sharp and regular limits of approximately 45 × 29 × 25 mm in the cranial portion of the right carotid adipose space, caudal to the right carotid and lateral foramen. The patient underwent surgery, and a histological examination confirmed a schwannoma of the hypoglossal nerve. Six months after surgery, the patient was symptom-free. The literature on schwannomas of the hypoglossal nerve is scarce, with only a few previously reported cases in the adult population. Despite their rarity, schwannomas should be considered in the differential diagnosis of masses located in the neck that present with lingual and occasionally auditory symptoms, even in pediatric patients. Surgical resection is recommended and has a low risk of long-term recurrence.