OpenMed/multicare-articles huggingface dataset:
Dynamic Changes in AQP4-IgG Level and Immunological Markers During Protein-A Immunoadsorption Therapy for NMOSD: A Case Report and Literature Review
Authors: Bo Chen, Chuan Qin, Man Chen, Hai-Han Yu, Ran Tao, Yun-Hui Chu, Bi-Tao Bu, Dai-Shi Tian
Journal: Front Immunol (2021)
Keywords: aqp4-igg, case report, neuromyelitis optica spectrum disorder, protein-a immunoadsorption, rescue therapy
MeSH terms: Aquaporin 4 / immunology, Biomarkers / blood, Immunoglobulin G / immunology, Neuromyelitis Optica / therapy, Plasmapheresis / methods, Staphylococcal Protein A / immunology, Case Reports, Research Support, Non-U.S. Gov't, Review, Adult, Complement C3 / immunology, Complement C4 / immunology, Female, Humans, Immunoglobulin G / blood, Interleukin-8, Lymphocyte Count, Neuromyelitis Optica / blood, Neuromyelitis Optica / immunology, Tumor Necrosis Factor-alpha / blood, Tumor Necrosis Factor-alpha / immunology, Aquaporin 4, Biomarkers, Complement C3, Complement C4, Immunoglobulin G, Interleukin-8, Staphylococcal Protein A, Tumor Necrosis Factor-alpha

The changes in the serum levels of aquaporin-4-IgG (AQP4-IgG), immunoglobulins, and inflammatory mediators in neuromyelitis optica spectrum disorder (NMOSD) cases treated with immunoadsorption have been rarely described in detail. Here we report a 29-year-old steroid-resistant NMOSD female with a severe disability (bilateral blindness and paraplegia) who received protein-A immunoadsorption as a rescue treatment. During the total 5 sessions, the circulating level of AQP4-IgG, immunoglobulins, and complement proteins (C3 and C4) showed a rapid and sawtooth-like decrease, and the serum AQP4-IgG titer declined from 1:320 to below the detectable limit at the end of the 3rd procedure. Of all the antibodies, IgG had the biggest removal rate (>96.1%), followed by IgM (>66.7%) and IgA (53%), while complement C3 and C4 also dropped by 73% and 65%, respectively. The reduced pro-inflammatory cytokines (interleukin-8 and tumor necrosis factor-α) and marked increased lymphocyte (T and B cell) counts were also observed. The improvement of symptoms initiated after the last session, with a low AQP4-IgG titer (1:32) persisting thereafter. Accordingly, protein-A immunoadsorption treatment could be one of the potential rescue therapies for steroid-resistant NMOSD patients with a severe disability.
Case Report: Fatal Neurotoxicity Following Resmethrin Poisoning in a Child
Authors: Lilin Huang, Shumei Peng, Ronghan Li, Dongping Huang, Danyu Xie
Journal: Front Pediatr (2021)
Keywords: child, neuroimaging, neurotoxicity, pyrethroid, resmethrin poisoning
MeSH terms: Case Reports

Resmethrin, a type I pyrethroid insecticide, can activate sodium channels, causing neurotoxicity in both mammals and insects. Possible routes of poisoning include inhalation, dermal contact and ingestion. There are no specific symptoms for resmethrin poisoning. Until now, no antidote has been available for resmethrin. Resmethrin poisoning is rarely reported in children. Here, we report a fatal case of resmethrin poisoning that might have been caused by accidental ingestion by a 26-month-old child. He presented with neurotoxic symptoms that included vomiting, recurrent seizures, and coma. The cranial CT showed extensive lesions of low intensity in the bilateral white matter, thalamus, brainstem, and cerebellum. Lumbar punctures showed increased intracranial pressure (ICP > 25 mmHg). Cerebrospinal fluid (CSF) tests revealed that protein was elevated to 289.2 mg/dL without pleocytosis. Resmethrin was detected in his blood by liquid chromatography-mass spectrometry, which confirmed the diagnosis of resmethrin poisoning. The child developed brain stem herniation and then was declared brain dead at the 77th h after admission. Resmethrin poisoning can be fatal, and it requires immediate diagnosis and treatment. Previous studies reported that cranial CT and CSF analyses were all normal in patients with pyrethroid poisoning. This case might extend the knowledge of neuroimaging and CSF analysis in children with resmethrin poisoning.
Case of Massive Hydatid Pulmonary Embolism Incidentally Discovered in a 56-Year-Old Woman with Posttraumatic Abdominal Pain
Authors: Zied Mezgar, Mariem Khrouf, Houda Ben Soltane, Mohamed Mahjoub, Sihem Ben Fredj, Amel Amara, Maher Jedidi, Samar Hajer Sandid, Sarra Zaouali, Ines Waz, Asma Saada, Mehdi Methamem
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Hydatid pulmonary embolism rarely occurs. It arises from the rupture of a hydatid heart cyst or the opening of a visceral hydatid cyst into the venous circulation. We report a case with pulmonary hydatidosis resulting in a massive bilateral pulmonary embolism in a 56-year-old woman with history of hepatic echinococcosis. A brief overview of clinical features and radiologic findings is presented.
Cardiac magnetic resonance findings in neuronal ceroid lipofuscinosis: A case report
Authors: Giancarlo Todiere, Stefania Della Vecchia, Maria Aurora Morales, Andrea Barison, Ivana Ricca, Alessandra Tessa, Elisa Colombi, Filippo Maria Santorelli
Journal: Front Neurol (2022)
Keywords: cln3, batten disease, cardiac magnetic resonance, cardiac pathology, neuronal ceroid lipofuscinosis
MeSH terms: Case Reports

Cardiac magnetic resonance imaging (MRI) is an essential tool for the study of hypertrophic cardiomyopathies (HCM) and for differentiating HCM from conditions with increased ventricular wall thickness, such as cardiac storage diseases. Although cardiac MRI is already used for the diagnosis and characterization of some forms of storage diseases involving the myocardium, it has not yet been used to study myocardial involvement in neuronal ceroid lipofuscinosis (NCL). Here, we describe comprehensive cardiac MRI findings in a patient with the CLN3 form of NCL showing basal inferior interventricular septal hypertrophy with maintained indexed LV mass within reference values and low T1-native values. MRI findings support a finding of abnormal storage material within the myocardium in CLN3 disease. We recommend the possible routine use of cardiac MRI for early diagnosis of cardiac involvement in CLN3 disease (also termed juvenile NCL) and to monitor the effects of emerging CLN3 therapies on the myocardium as well.
Anemia revealing a collagenous gastritis in a young Tunisian man
Authors: Imen Akkari, Karim Skandrani, Atef Ben Abdelkader, Soumaya Mrabet, Elhem Ben Jazia
Journal: Pan Afr Med J (2018)
Keywords: gastritis, anemia, collagen diseases, endoscopy, iron deficiency
MeSH terms: Anemia / etiology, Collagen Diseases / diagnosis, Gastritis / diagnosis, Case Reports, Biopsy, Collagen / metabolism, Collagen Diseases / drug therapy, Collagen Diseases / physiopathology, Follow-Up Studies, Gastritis / drug therapy, Gastritis / physiopathology, Glucocorticoids / therapeutic use, Humans, Male, Tunisia, Young Adult, Glucocorticoids, Collagen

Collagenous gastritis is a rare entity, characterized by the deposition of a subepithelial collagenous band with an inflammatory infiltrate in the mucosa. We report the first Tunisian case revealed by severe anemia. Lesions were limited to the stomach and remained unchanged on 3 series biopsies during a 24 month follow up despite treatment with corticosteroids. The cause of the disease remains unknown; our findings suggest that lesions of collagenous gastritis may result from a local immune process.
Extensive Craniocervical Abscess after Transoral Ganglionic Local Opioid Analgesia at the Superior Cervical Ganglion for Atypical Trigeminal Neuralgia: Report of a Severely Complicated Case
Authors: Christoph Sproll, Bernd Turowski, Rita Depprich, Norbert R Kübler, Marion Rapp, Julian Lommen, Henrik Holtmann
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Ganglionic local opioid analgesia (GLOA) describes the application of low-dose opioids close to sympathetic as, for example, to the superior cervical ganglion. GLOA can be effective in different pain syndromes affecting the head and face region and has been considered to be a safe technique with few complications reported so far. We present the case of a patient who received a single, transoral GLOA for a refractory trigeminal neuralgia. The patient subsequently developed an extensive epidural abscess at the craniocervical junction, requiring ultimately transoral odontoid resection and dorsal stabilisation. This severe complication challenges the role of transoral infiltration therapies in analgetic medicine.
Pituitary as a Source of HCG: Residual Levels After Bilateral Testicular Tumor Removal
Authors: Richard Santen, Farhad Hasan, Katie Thoren, Azeez Farooki
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: hcg, pituitary secretion, testicular tumor
MeSH terms: Chorionic Gonadotropin, beta Subunit, Human / blood, Pituitary Gland / metabolism, Testicular Neoplasms / physiopathology, Testicular Neoplasms / surgery, Case Reports, Review, Follicle Stimulating Hormone / blood, Humans, Luteinizing Hormone / blood, Male, Orchiectomy, Young Adult, Chorionic Gonadotropin, beta Subunit, Human, Luteinizing Hormone, Follicle Stimulating Hormone

Context:
Challenging clinical scenario in which elevated β-human chorionic gonadotropin (HCG, subsequently termed HCG) levels suggested occult tumor metastases after removal of bilateral testicular cancers and metastases from them and as well as after chemotherapy.
Case report:
A 22-year-old male, post excision of bilateral testicular tumors, who had no imaging or clinical evidence of residual tumor but an elevated HCG raising the question of the presence and location of occult tumor metastases. Clinical Questions. Does luteinizing hormone (LH) cross-react with HCG in current assays? What levels of testosterone and estradiol are necessary to suppress LH and follicle-stimulating hormone (FSH) in a male patient with bilateral orchiectomy, and therefore lacking inhibin? Does the pituitary secrete HCG and under what circumstances?
Assessment:
Current HCG assays no longer cross-react with LH as did prior assays, but the presence of heterophile antibodies and other factors such as biotin can still cause false positive HCG levels. In the chronic post-orchiectomy state, the pituitary is relatively resistant to LH and FSH suppression by testosterone. The pituitary secretes HCG in very small amounts unless interruption of negative feedback results in high LH and FSH whereupon HCG levels become elevated. Clinical Conclusion. A GnRH antagonist suppressed both LH and HCG in this patient indicating that the elevated HCG was secreted by the pituitary and not by occult tumor metastases. Further credence for this conclusion resulted from the lack of a progressive increase in HCG levels over a 4-year period of follow-up and from no evidence of metastatic tumors on serial imaging.
Pure Motor Monoparesis in the Leg due to a Lateral Medullary Infarction
Authors: Hiromasa Tsuda, Kozue Tanaka, Shuji Kishida
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

A 76-year-old man with essential hypertension abruptly presented with slight left-sided leg weakness, despite normal strength in the other extremities. Left-sided Babinski's reflex was detected. There were no other neurologic abnormalities. Cranial magnetic resonance imaging demonstrated a small infarction in the lower lateral medulla oblongata on the left side. Cranial magnetic resonance angiography demonstrated an absence of flow of the left vertebral artery. He became asymptomatic within 10 days under intravenous antiplatelet agent. The corticospinal tract fibers innervating the lower extremity caudal to the pyramidal decussation might be involved. We emphasize that this is a first reported case of pure motor monoparesis in the leg due to lateral medullary infarction.
Case Report: Deutetrabenazine as an Adjunctive Treatment for Stuttering
Authors: Catherine A Ha, Gerald A Maguire
Journal: Front Psychiatry (2021)
Keywords: d2 receptor antagonists, vmat 2, deutetrabenazine, stuttering, tardive dyskinesia (td)
MeSH terms: Case Reports

Childhood-Onset Fluency Disorder (Stuttering) is a neurodevelopmental disorder in which disturbances occur in the normal fluency and time patterning of speech. While the dopamine system has been well-described in its neurophysiology, there currently is no FDA-approved treatment for stuttering. Second-generation antipsychotics, which have been effective in the treatment of schizophrenia and bipolar disorder, act as dopamine D-2 receptor antagonists at the postsynaptic neuron and have been shown to reduce the symptoms of stuttering. However, the D-2 receptor antagonist and partial agonist agents carry the potential for metabolic side effects and can potentially lead to movement disorders. Deutetrabenazine, a VMAT-2 inhibitor indicated to treat hyperkinetic movement disorders, is a potential candidate in the treatment of stuttering, based on its mechanism of action in decreasing dopamine activity while not carrying the risk of metabolic adverse events.
Cystic artery pseudoaneurysm secondary to acute cholecystitis: an unusual cause for haemobilia
Authors: Thomas Charles Hall, Walter Sprenger De Rover, Said Habib, Maruti Kumaran
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Pseudoaneurysm of the cystic artery is a rarely described cause of haemobilia. We report the unusual presentation of upper gastrointestinal haemorrhage due to a pseudoaneurysm of the cystic artery secondary to acute cholecystitis that was complicated by gallbladder perforation and liver abscess in an 88-year-old male. The original CT scan had demonstrated a high density focus in the gallbladder neck that was thought to represent a calculus. Selective embolization of the cystic artery resulted in cessation of the haemorrhage. Owing to the patient's frailty and comorbidities, he was not considered suitable for cholecystectomy. The case emphasizes the need for a high level of awareness of pseudoaneurysmal disease in association with inflammatory conditions.
Case Report: Pathologic Complete Response to Pembrolizumab in Combination With Neoadjuvant Chemotherapy in a Patient With Stage IIB Squamous Lung Cancer
Authors: Lin Zhang, Wuqian Mai, Wenyang Jiang, Qing Geng
Journal: Front Surg (2020)
Keywords: pd-1/pd-l1, lung cancer, neoadjuvant therapy, pathological complete response (pcr), pembrolizumab
MeSH terms: Case Reports

The emergence of PD-1 antibodies has radically changed the therapeutic profiles of lung cancer, which has the highest incidence and mortality rate among all cancers worldwide. Pembrolizumab, an anti-PD-1 antibody, has been proven to have strong anti-tumor activity in a variety of clinical studies. Here, we described a patient with stage IIB squamous lung cancer who has benefited from a preoperative pembrolizumab plus chemotherapy regimen. The addition of pembrolizumab to neoadjuvant chemotherapy before surgery led to a pathologic complete response and the avoidance of left pneumonectomy. This case highlights the effect of neoadjuvant pembrolizumab plus chemotherapy on non-small cell lung cancer patients and has provided a promising choice in future clinical practice.
Encephalitis and myositis caused by Trachipleistophora hominis diagnosed by metagenomic next-generation sequencing-a case report
Authors: Haipeng Zheng, Ying Tan, Xudan Chen, Jinfeng Chen, Linghua Li, Jian Wang
Journal: Front Cell Infect Microbiol (2023)
Keywords: mngs, trachipleistophora hominis, brain infection, microsporidia, myositis
MeSH terms: Encephalitis / diagnosis, Microsporidia, Myositis / diagnosis, Myositis / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, High-Throughput Nucleotide Sequencing, Humans, Male, Trachipleistophora hominis

Background:
Myositis is the main manifestation of Trachipleistophora hominis (T. hominis) infection and other microsporidians infection in immunocompromised patients. Clinical differential diagnosis of different microsporidians can be challenging, as the standard technique to distinguish various microsporidia species, transmission electron microscopy (TEM), is time-consuming and relies on equipment and experienced staffs who can perform the test and interpret the results.
Case presentation:
We report a 37-year-old Chinese man with acquired immune deficiency syndrome (AIDS) developed headache and muscle pain in the extremities. Tramadol was used to relieve his pain. Infectious lesions in his brain were detected by cerebral magnetic resonance imaging (MRI). Oval-shaped pathogens was observed by biopsy of right gastrocnemius. Finally, T. hominis was identified by metagenomic next-generation sequencing (mNGS) in the gastrocnemius tissue and cerebrospinal fluid. After a 12-week course of antifungal treatment and antiretroviral therapy, the patient recovered from the encephalitis and myositis caused by T. hominis.
Conclusion:
This report described the diagnosis and treatment of the first case of encephalitis caused by T. hominis. And mNGS is recommended for the rapid diagnosis of uncommon pathogens.
Long-Term Follow-Up of Adamantinoma of the Tibia Complicated by Metastases and a Second Unrelated Primary Cancer: A Case Report and Literature Review
Authors: Brendan R Southam, Alvin H Crawford, David A Billmire, James Geller, Daniel Von Allmen, Adam P Schumaier, Sara Szabo
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Adamantinoma is a rare, low-grade malignant tumor of the bone which grows slowly and typically occurs in the diaphysis of long bones, particularly in the tibia. Adamantinomas have the potential for local recurrence and may metastasize to the lungs, lymph nodes, or bone. We report a case of a 14-year-old female with a tibial adamantinoma who underwent wide resection with limb salvage and has subsequently been followed up for 18 years. The patient went on to have both a local soft tissue recurrence 5 years after the resection and metastases to both an inguinal lymph node and the right lower lobe of the lung 8 years after that recurrence, all of which have been treated successfully with marginal resections. Unique to this case, the patient was also incidentally found to have chromophobe-type renal cell carcinoma when undergoing a partial nephrectomy to resect a presumed metastasis of her adamantinoma. Genetic testing has not revealed any known genetic predisposition to cancer.
Balloon-guided inflation osteoplasty in the treatment of Hill-Sachs lesions of the humeral head: case report of a new technique
Authors: Gunther H Sandmann, Sebastian Siebenlist, Florian B Imhoff, Philipp Ahrens, Markus Neumaier, Thomas Freude, Peter Biberthaler
Journal: Patient Saf Surg (2016)
Keywords: balloon osteoplasty, hill-sachs lesion, shoulder dislocation
MeSH terms: Case Reports

Background:
The use of the extra-vertebral balloon osteoplasty is increasing and in the meanwhile it has become a safe surgical technique in the treatment of tibial head, distal radius and calcaneus fractures. In addition, we already could show in a biomechanical setup that the balloon osteoplasty might be a safe tool for reduction in the treatment of Hill-Sachs lesions, but clinical application has not been performed so far.
Case presentation:
We report the case of a 53 year- old male patient who was referred to our Trauma department (level I trauma center) after the first manifestation of a posterior shoulder dislocation due to an epileptic seizure, originated in a- up to this date unknown -glioblastoma. After closed reduction of the dislocated shoulder the X-ray showed a subcapital fracture of the proximal humerus with a large reversed Hill-Sachs lesion. We performed an open surgery via a deltoideopectoral approach and balloon osteoplasty was used to reduce the impression fracture (Hill-Sachs lesion) before fixing the fracture with a locking plate. In the post-operative CT scan we could show an anatomical reduction of the Hill-Sachs lesion. At the follow-up examination one year after surgery the patient reached full range of motion and stated no re-dislocation of the shoulder nor instability or pain.
Conclusion:
The reduction of an impressed humeral head fracture by use of balloon osteoplasty is a safe technique. This technique could be a new option in the treatment of Hill-Sachs lesions and might be an alternative to well known standard procedures like the remplissage or tendon transfers without affecting rotation.
Extra-striatal ptake of 99mTc-TRODAT SPECT in a erebral eningioma: A Case Report
Authors: Mahsa Sabour, Ali Shoeibi, Somayeh Ghahremani, Ramin Sadeghi
Journal: Asia Ocean J Nucl Med Biol (2019)
Keywords: meningioma, nuclear medicine, parkinsonism, trodat
MeSH terms: Case Reports

We reported a 71 years old woman, with history of rest and postural tremor, bradykinesia and memory problems. In her dynamic MRI, a contrast-enhanced tumor in the cerebellopontine (CP) angle was found which was compatible with a meningioma. 99mTc-TRODAT SPECT showed decreased activity in the left putamen, indicating idiopathic Parkinson disease. There was also a focus of increased activity on the right side of the skull base, which was compatible with meningioma in MRI.
Malignant peripheral nerve sheath tumor associated with neurofibromatosis type 1, with metastasis to the heart: a case report
Authors: Masanori Kitamura, Naoki Wada, Shigenori Nagata, Norishige Iizuka, Yu-Fen Jin, Miki Tomoeda, Michiko Yuki, Norifumi Naka, Nobuhito Araki, Chikao Yutani, Yasuhiko Tomita
Journal: Diagn Pathol (2010)
MeSH terms: Heart Neoplasms / secondary, Nerve Sheath Neoplasms / secondary, Neurofibromatosis 1 / pathology, Soft Tissue Neoplasms / pathology, Case Reports, Review, Amputation, Surgical, Autopsy, Biopsy, Chemotherapy, Adjuvant, Fatal Outcome, Heart Neoplasms / therapy, Humans, Lung Neoplasms / secondary, Lung Neoplasms / therapy, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Recurrence, Local, Nerve Sheath Neoplasms / therapy, Neurofibromatosis 1 / therapy, Soft Tissue Neoplasms / therapy, Thigh, Treatment Outcome

A rare case is presented of a 61-year-old man with a malignant peripheral nerve sheath tumor associated with neurofibromatosis type 1, with metastasis to the heart. The primary tumor originated in the right thigh in 1982. Since then, the patient has had repeated local recurrences in spite of repeated surgical treatment and adjuvant chemotherapy. He has developed previous metastases of the lung and heart. The patient died of cardiac involvement.
Dysautonomia in autism spectrum disorder: case reports of a family with review of the literature
Authors: Derrick Lonsdale, Raymond J Shamberger, Mark E Obrenovich
Journal: Autism Res Treat (2011)

Case histories of a mother and her two children are reported. The mother was a recovered alcoholic. She and her two children, both of whom had symptoms that are typical of autistic spectrum disorder, had dysautonomia. All had intermittently abnormal erythrocyte transketolase studies indicating abnormal thiamine pyrophosphate homeostasis. Both children had unusual concentrations of urinary arsenic. All had symptomatic improvement with diet restriction and supplementary vitamin therapy but quickly relapsed after ingestion of sugar, milk, or wheat. The stress of a heavy metal burden, superimposed on existing genetic or epigenetic risk factors, may be important in the etiology of autism spectrum disorder when in combination. Dysautonomia has been associated with several diseases, including autism, without a common etiology. It is hypothesized that oxidative stress results in loss of cellular energy and causes retardation of hard wiring of the brain in infancy, affecting limbic system control of the autonomic nervous system.