OpenMed/multicare-articles huggingface dataset:
Cushing´s syndrome: high aggressiveness of low-grade tumors
Authors: Faycal El Guendouz, Sara Derrou, Fouad Atoini, Hassan Ouleghzal, Somaya Safi
Journal: Pan Afr Med J (2020)
Keywords: cushing’s syndrome, cortisol, endogenous, exogenous, exposition, supraphysiological
MeSH terms: Adrenocorticotropic Hormone / metabolism, Carcinoid Tumor / complications, Cushing Syndrome / etiology, Lung Neoplasms / complications, Case Reports, Adult, Carcinoid Tumor / diagnosis, Carcinoid Tumor / pathology, Female, Humans, Hydrocortisone / metabolism, Lung Neoplasms / diagnosis, Lung Neoplasms / pathology, Neoplasm Grading, Adrenocorticotropic Hormone, Hydrocortisone

Cushing´s syndrome is caused by prolonged exposition supraphysiological to endogenous or exogenous cortisol. Ectopic production of adrenocorticotropic hormone by lung carcinoid tumors is relatively rare. Most documented cases have been reported individually. This rare neoplasm low grade that may secrete adrenocorticotropin (ACTH) leading to rapid development of hypercortisolism which is the main mode of discovery, can be a real aggressive form. This report shows a high aggressiveness of this endocrine neoplasia, wich was marked on the general, morphological, bone and psychiatric level. The trivialization of clinical signs had caused the delay in diagnosis with irreparable bone consequences.
Paternally derived translocation t(8;18)(q22.1;q22)pat associated in a patient with developmental delay: Case report and review
Authors: Lakshmi Rao, Murthy Kanakavalli, Venkata Padmalatha, Pratibha Nallari, Lalji Singh
Journal: J Pediatr Neurosci (2010)
Keywords: balanced reciprocal translocation, giemsa–trypsin–giemsa banding and fish, chromosomes 8 and 18, delayed milestones, translocation carrier
MeSH terms: Case Reports

The common cause of mental impairment and the wide range of physical abnormalities is balanced chromosome rearrangement. As such, it is difficult to interpret, posing as a diagnostic challenge in human development. We present a unique familial case report with the paternally inherited autosomal-balanced reciprocal translocation involving chromosomal regions 8q and 18q. The etiology of the translocation, i.e. 46,XX,t(8;18)(q22.1;q22) was detected by conventional high-resolution Giemsa-Trypsin-Giemsa-banding and fluorescence in situ hybridization techniques. The father was found to be the carrier of the chromosome defect and also the same was observed in the first female child referred with a history of delayed milestone development. However, the second female child showed normal 46, XX karyotype. This is the first report of reciprocal translocation involving 8q and 18q associated with the delayed milestone development. The reason likely may be due to the rearrangement of genetic material at these breakpoints having a crucial relationship and thus manifesting developmental delay in the progeny. Accordingly, this paper also shows genetic counseling discussion for the cause.
Lymphoma Involving the Heart: A Case Report
Authors: Randa Tabbah, Elissar Nohra, Rachoin Rachoin, Kabalan Saroufim, Bassam Harb
Journal: Front Cardiovasc Med (2020)
Keywords: cardiac tumors, case report, lymphoma, pleuropericarditis, primary, right heart
MeSH terms: Case Reports

Background: We describe a rare case of cardiac malignancy that counts for <1% of the primary cardiac tumors with a poor prognosis. Case summary: It's a rare case of a primary cardiac lymphoma in a 59-year-old patient who presented for recurrent pleuropericarditis with low-grade fever and night sweats. Investigations revealed an infiltrating mass in the right atrioventricular groove involving the right atrium and the right ventricular free wall. Pathology confirmed the diagnosis of non-Hodgkin's lymphoma. Chemotherapy with R-CHOP regimen was a success, but the patient suffered from recurrence with a complete remission after a second chemotherapy cycle. He was a candidate for bone marrow transplant to reduce other possible relapses. Discussion: Early diagnosis is better for long-term prognosis and improves quality of life.
Nonbacterial osteitis of the clavicle: longitudinal imaging series from initial diagnosis to clinical improvement
Authors: E Roos, M Maas, S J M Breugem, G R Schaap, J A M Bramer
Journal: Case Rep Rheumatol (2015)

Nonbacterial osteitis is a rare autoinflammatory disease. Often it is mistaken for a tumor or osteomyelitis. We present a case of a twelve-year-old girl referred to our hospital because of a lesion of the right clavicle. The differential diagnoses were sarcoma, osteitis, and Langerhans cell histiocytosis. After biopsy the diagnosis nonbacterial osteitis (NBO) was established. Treatment of choice is a nonsteroidal anti-inflammatory drug. This case report gives a complete follow-up of the disease, showing the pitfalls of the diagnosis.
Tachycardia during Treatment with Risperidone and Paliperidone Palmitate in a Patient without Previous Cardiovascular Disease
Authors: Zachary Orlins, Brian Barnett
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Here, we present the case of a patient who initiated risperidone and developed persistent tachycardia, which was exacerbated by subsequent administration of paliperidone palmitate despite treatment with propranolol. This patient's experience emphasizes the need for psychiatrists to regularly monitor vital signs after risperidone/paliperidone initiation, dosage increase, or overdose to identify and appropriately manage this potentially harmful side effect. Increasing clinician awareness of this rare side effect will help protect patients with serious mental illness who regularly rely upon these medications, particularly in their long-acting injectable formulations.
Bilateral orbital plasmacytomas as first sign of extramedullary progression post CAR-T therapy: case report and literature review
Authors: Javier Nogués-Castell, Silvia Feu-Basilio, Óscar Felguera García, Carlos Fernández de Larrea, Aina Oliver-Caldés, Olga Balagué Ponz, Jessica Matas Fassi
Journal: Front Oncol (2023)
Keywords: car-t, chimeric antigen receptor therapy, orbital multiple myeloma, orbital plasmacytoma, plasma cells leukemia
MeSH terms: Case Reports

Background:
Plasma cell leukemia (PCL) is an aggressive and rare form of plasma cell dyscrasia characterized by peripheral blood expression, poor prognosis, and high relapse rates. Extramedullary plasmacytomas are common in this entity and can affect various organs and soft tissues. Chimeric antigen receptor-T-cell (CAR-T) therapy is a novel immunotherapy for hematological malignancies with promising results. However, it is not indicated for PCL, and experience in this condition is limited. This case is a rare presentation of bilateral orbital plasmacytomas after CAR-T therapy in a patient with PCL history.
Case presentation:
We present the case of a 51-year-old female patient with a history of previous primary PCL treated with CAR-T therapy achieving complete response and without evidence of systemic progression. Six months after the treatment, she developed subacute proptosis and ptosis on the left eye.An orbital CT scan was performed and showed an orbital tumor in both eyes. A surgical biopsy with histological examination revealed plasma cells, consistent with a plasmacytoma. PET-CT and MRI confirmed the presence of tumors in both orbits. The patient was treated with dexamethasone and chemotherapy along with palliative radiation therapy to the left orbit which had a good response.
Conclusion:
Orbital involvement in multiple myeloma and PCL is rare, with plasmacytomas being more common in other parts of the body. In this report, we present a case of a patient with PCL history, treated with multiple therapeutic lines including CAR-T therapy, who presented bilateral orbital plasmacytomas as the first sign of extramedullary progression after the treatment. This case should be considered by specialist to be aware that the orbits are a possible location of extramedullary progression.
Localized IgG4-related disease manifested on the tongue: a case report
Authors: Helya Hashemi, Andreas Thor, Erik Hellbacher, Marie Carlson, Miklós Gulyás, Lena Blomstrand
Journal: Ups J Med Sci (2021)
Keywords: igg4-related disease, rituximab, differential diagnosis, histopathology, localized, monoclonal antibody, oral lesion, tongue
MeSH terms: Carcinoma, Squamous Cell, Immunoglobulin G4-Related Disease, Mouth Neoplasms, Case Reports, Humans, Plasma Cells, Tongue

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition that can affect multiple organs. IgG4-RD may show a variety of initial symptoms. In the oral mucosa, lesions present as inflammatory fibrosis with a large number of IgG4-positive plasma cells. Evaluating treatment is a well-known problem in IgG4-RD due to the absence of an established assessment system. There are difficulties in defining the severity of the disease, which is why treatment is primarily based on its clinical manifestations. We present a case report of localized IgG4-RD with ulcerative and proliferative manifestations on the tongue, which clinically mimicked oral squamous cell carcinoma. A tumor-like lesion on the tongue can indicate something else other than the malignant or reactive changes commonly found in the oral mucosa. Multiple differential diagnoses of these atypical oral lesions, including localized IgG4-RD, should be considered.
A Case Report on Metamizole-Induced Agranulocytosis: Is the Benefit Worth the Risk?
Authors: Rita Carvalho, Célia Henriques, Marco Fernandes, Cláudio Gouveia, Catarina Gama
Journal: Cureus (2023)
Keywords: agranulocytosis, dipyrone, fever, metamizole, neutropenia
MeSH terms: Case Reports

Metamizole is a drug with analgesic and antipyretic properties widely available in Portugal. Its use is highly controversial because of the risk of agranulocytosis, a rare but serious adverse event. A 70-year-old female patient with a recent history of treatment with metamizole for post-surgery fever and pain presented to the ED with sustained fever, diarrhea, and painful mouth ulcers. Laboratory tests revealed agranulocytosis. The patient was placed under protective isolation and started treatment with granulocyte-colony stimulating factor (G-CSF) and empiric antibiotic therapy with piperacillin/tazobactam and vancomycin for neutropenic fever. After an extensive workup, no source of infection was identified. During hospitalization, infectious and neoplastic causes of agranulocytosis were investigated, but the results were negative. Metamizole-induced agranulocytosis was suspected. The patient completed a total of three days of G-CSF and eight days of empiric antibiotic therapy with sustained clinical improvement. She was discharged completely asymptomatic and remained clinically stable during follow-up without a resurgence of agranulocytosis. This case report is intended to increase awareness of metamizole-induced agranulocytosis. While this is a well-known side effect, it is also often overlooked. It is paramount that both physicians and patients know how to correctly manage metamizole to prevent and promptly treat agranulocytosis.
Correction of thumb angulations after physiolysis of delta phalanges in a child with Rubinstein-Taybi syndrome: a case report
Authors: Kousuke Iba, Takuro Wada, Toshihiko Yamashita
Journal: Case Reports Plast Surg Hand Surg (2015)
Keywords: delta phalanx, rubinstein–taybi syndrome, angular deformity, correction, free-fat graft, physiolysis, thumb
MeSH terms: Case Reports

Resection of the midzone of the continuous epiphysis of a delta phalanx (physiolysis) and its replacement by a free-fat graft from local tissue was performed to improve severe radial angulation of the both thumbs in a 22-month-old child with Rubinstein-Taybi syndrome. Fifty-two months after surgery, satisfactory results were obtained for pinch function, appearance, and radiographic findings. Previous reports have indicated that corrective osteotomy of the thumbs in Rubinstein-Taybi syndrome has an associated risk of incomplete correction and >30% of recurrence, because severe preoperative deformities of the delta phalanx make angulatory osteotomies difficult. Additionally, physiolysis is a less invasive procedure than corrective osteotomy and offers a reduced risk of incomplete or excess correction, physeal injury, or osteonecrosis in younger children. Therefore, physiolysis appears to be useful as an initial means of correcting severe thumb angulations secondary to a delta phalanx. We reported a case in which the physiolysis of the delta phalanx significantly improved severe angular deformities of the thumbs in association with Rubinstein-Taybi syndrome.
Acute Frontal Lobe Dysfunction Following Prefrontal Low-Frequency Repetitive Transcranial Magnetic Stimulation in a Patient with Treatment-Resistant Depression
Authors: Guilhem Carle, Mehdi Touat, Nicolas Bruno, Damien Galanaud, Charles-Siegfried Peretti, Antoni Valero-Cabré, Richard Levy, Carole Azuar
Journal: Front Psychiatry (2017)
Keywords: antidepressant, depression, executive dysfunction, frontal syndrome, state-dependency, transcranial magnetic stimulation
MeSH terms: Case Reports

The potential of repetitive transcranial magnetic stimulation (rTMS) to treat numerous neurological and psychiatric disorders has been thoroughly studied for the last two decades. Here, we report for the first time, the case of a 65-year-old woman suffering from treatment-resistant depression who developed an acute frontal lobe syndrome following eight sessions of low-frequency rTMS (LF-rTMS) to the right dorsolateral prefrontal cortex while also treated with sertraline and mianserin. The pathophysiological mechanisms underlying such an unexpected acute frontal lobe dysfunction are discussed in relation to the therapeutic use of LF-rTMS in combination with pharmacotherapy in depressed patients.
Diaphragmatic crural eventration
Authors: K Sivakumar
Journal: J Indian Assoc Pediatr Surg (2008)
Keywords: diaphragmatic defects, gastric volvulus, right crus of diaphragm
MeSH terms: Case Reports

Aim:
We evaluated patients with gastric volvulus secondary to diaphragmatic pathology.
Materials and methods:
Eight patients (5 males and 3 females) presented to the author in a tertiary care center during 1997-2006 were analyzed in terms of age, sex, symptomatology, diagnosis and predisposing factors.
Observations:
Six had an acute presentation and rest had chronic symptomatology. The two patients who had total gangrene stomach died postoperatively and one patient died preoperatively due to aspiration. All the cases presented with acute symptoms had diaphragmatic pathology, and out of these, three cases had the specific entity, which is named as diaphragmatic crural eventration.
Conclusions:
Diaphragmatic crural eventration is characterized by the defective development of the right crus of diaphragm, and this is embryologically significant as the right crus and ligaments of the stomach develop from dorsal mesoesophagus and mesogastrium. The author recommends a closer look for this defect of diaphragm while operating a case of gastric volvulus.
A Review on Clostridioides Difficile Testing and How to Approach Patients With Multiple Negative Tests: A Case Report
Authors: Raghav Bassi, Pranav Prakash, Anuoluwa Oyetoran, Rabab Elsadek, Isaac Loseke, John R Leibach
Journal: Cureus (2023)
Keywords: cdiff colitis, cdiff testing, false-negative, multiple negative tests, pseudomembrane
MeSH terms: Case Reports

Clostridioides difficile (C. difficile) is an important nosocomial infection that is commonly associated with antibiotic use with pseudomembranous colitis being present in only 13% of cases. Disease severity ranges from asymptomatic carriers to severe complicated disease, based on clinical and laboratory findings. There is no single rapid FDA-approved test to diagnose C. difficile infections (CDI) and diagnosis usually requires a multi-step diagnostic approach. C. difficile testing usually begins with the C. difficile toxin and glutamate dehydrogenase antigen screen (GDH). If testing is negative for either, then nucleic acid amplification testing (NAAT) is done to confirm the diagnosis. Endoscopic evaluation may be required in rare instances when there is a high clinical suspicion of disease with negative testing. Here, we present an interesting case of a patient with multiple negative C. difficile toxin and GDH tests. Given the high index of clinical suspicion of CDI, the patient underwent a colonoscopy which revealed diffuse pseudomembranous colitis. The patient was then appropriately treated with oral vancomycin. We aim to shed light on the different testing modalities available to clinicians and the indications for doing a colonoscopy to delineate between false positive testing and active CDI.
Substance Abuse, Depression, and Social Anxiety: Case Study and Application of Cognitive Psychotherapy
Authors: Feda Abu Al-Khair
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

A 20-year-old male was referred by a psychiatrist to the clinic for treatment. He was diagnosed with social anxiety disorder (SAD), depression, and substances abuse. He complained of depressive mood and severe anxiety symptoms. These symptoms are triggered in social situations, as well as when talking to others, being in public areas, and going to malls or any crowded places. Because of his symptoms, he avoided getting into the situation, which affected his daily life. The patient was diagnosed with SAD, major depression, and substance abuse and underwent 20 separate sessions of cognitive behavioral therapy (CBT). The application of CBT led to a decrease in the number of anxiety attacks and angry outbursts that the patient suffers from. It also helped him learn some techniques to use in his interactions within the society, as well as other techniques, such as cognitive reorganization of dysfunctional thoughts, and gradually exposed him to the social situations. He also learned to practice some relaxation techniques, to teach him integration in social situations and confrontation instead of avoidance.
Transcranial alternating current stimulation combined with sound stimulation improves the cognitive function of patients with Alzheimer's disease: A case report and literature review
Authors: Yang Liu, Can Tang, Kailun Wei, Di Liu, Keke Tang, Meilian Chen, Xuewei Xia, Zhiqi Mao
Journal: Front Neurol (2022)
Keywords: alzheimer's disease, cognition, gamma rhythm, sound, transcranial alternating current stimulation
MeSH terms: Case Reports

Transcranial alternating current stimulation (tACS) is a relatively new non-invasive brain electrical stimulation method for the treatment of patients with Alzheimer's disease (AD), but it has poor offline effects. Therefore, we applied a new combined stimulation method to observe the offline effect on the cognitive function of patients with AD. Here, we describe the clinical results of a case in which tACS combined with sound stimulation was applied to treat moderate AD. The patient was a 73-year-old woman with a 2-year history of persistent cognitive deterioration despite the administration of Aricept and Sodium Oligomannate. Therefore, the patient received tACS combined with sound stimulation. Her cognitive scale scores improved after 15 sessions and continued to improve at 4 months of follow-up. Although the current report may provide a new alternative therapy for patients with AD, more clinical data are needed to support its efficacy.
Trial registration:
Clinicaltrials.gov, NCT05251649.
Hyper-Virulent Listeria monocytogenes Strains Associated With Respiratory Infections in Central Italy
Authors: Fabrizia Guidi, Alexandra Chiaverini, Antonella Repetto, Cinzia Lorenzetti, Gabriella Centorotola, Viviana Bazzucchi, Barbara Palombo, Antonietta Gattuso, Francesco Pomilio, Giuliana Blasi
Journal: Front Cell Infect Microbiol (2021)
Keywords: lipi-3, lipi-4, listeria monocytogenes, listeriosis, respiratory infection, whole genome sequencing
MeSH terms: COVID-19, Listeria monocytogenes / genetics, Listeriosis / epidemiology, Case Reports, Humans, Infant, Newborn, Multilocus Sequence Typing, RNA, Viral, SARS-CoV-2, RNA, Viral

Listeria monocytogenes (Lm) is a foodborne pathogen causing listeriosis. Invasive forms of the disease mainly manifest as septicaemia, meningitis and maternal-neonatal infections. Lm-associated respiratory infections are very rare and little known. We reported two Lm respiratory infection cases occurred in Central Italy during the summer of 2020, in the midst of the SARS-CoV2 pandemic. In addition to collect the epidemiological and clinical characteristics of the patients, we used Whole Genome Sequencing to study the genomes of the Lm isolates investigating their virulence and antimicrobial profiles and the presence of genetic mobile elements. Both the strains belonged to hypervirulent MLST clonal complexes (CC). In addition to the Listeria Pathogenicity Island 1 (LIPI-1), the CC1 strain also carried LIPI-3 and the CC4 both LIPI-3 and LIPI-4. Genetic determinants for antimicrobial and disinfectants resistance were found. The CC1 genome presented prophage sequences but they did not interrupt the comK gene, involved in the phagosomal escape of Lm. None of the strains carried plasmids. Lm is an important, although rare, opportunistic pathogen for respiratory tract and lung infections. To avoid dangerous diagnostic delays of these severe clinical forms, it is important to sensitize hospital laboratories to this rare manifestation of listeriosis considering Lm in the differential diagnosis of respiratory infections.
Periodontal regeneration using platelet-derived growth factor in infrabony defects: a series of three cases
Authors: Kaustubh Thakare, M L Bhongade, Preeti Charde, Priyanka Jaiswal, Nachiket Shah, Aniruddha Deshpande
Journal: Case Rep Dent (2013)

The periodontal researchers and clinicians, in an effort to develop effective regenerative therapies, have sought to understand key events involved in the regeneration of periodontium. Polypeptide growth factors are a class of natural biological mediators which regulate key cellular events in tissue repair. Platelet-derived growth factor (PDGF) is the most thoroughly studied growth factor in periodontal regeneration. The present case series evaluate the effectiveness of platelet-derived growth factor (rh-PDGF-BB) in combination with beta-tricalcium phosphate ( β -TCP) to achieve periodontal regeneration in 3 infrabony defects.
Idiopathic low-flow priapism in prepuberty: a case report and a review of literature
Authors: Ihab A Hekal, Eric J H Meuleman
Journal: Adv Urol (2008)

Introduction. The incidence of priapism in adults is higher than in children. Although approximately 50% of all episodes of priapism are thought to be idiopathic, there are a number of known specific causes of this disorder. In adults intracavernous therapy with papaverine, phentolamine, alprostadil or combinations of these agents is the most common cause of ischemic priapism. In children the most common etiology is sickle cell anemia for low-flow priapism or post-traumatic high-flow priapism. We present a 13-year-old boy, not sexually active presented to our outpatient clinic suffering from long standing (3.5 hours) sustained painful erection. To the best of our knowledge the idiopathic low-flow priapism in pre-pubertal boy was not reported before in literature. Our case is the first case to be reported in pre-pubertal age. Conclusion. In pre-pubertal boys idiopathic recurrent priapism is a rare condition. In the literature, several empirical therapies are described. Recently, it is postulated that a low dose of a PDE5 inhibitor. The early conservative management is the best treatment option to safe the corporeal smooth muscles from irreversible damage.