OpenMed/multicare-articles huggingface dataset:
The management of catatonia in bipolar disorder with stimulants
Authors: Waheed K Bajwa, Ali Rastegarpour, Omar A Bajwa, Jessica Babbitt
Journal: Case Rep Psychiatry (2015)

Catatonia, while not a rare occurrence in bipolar disorder, has not been widely discussed in the literature. We present a case of a married Caucasian male with a history of bipolar disorder, exhibiting catatonia and experiencing difficulty in day-to-day functioning. He demonstrated impairment in cognition and an inability to organize simple activities of daily life. After exhausting a number of options for medical management, including benzodiazepines, atypical antipsychotics, and amantadine, he only displayed significant clinical improvement with the addition of a stimulant, methylphenidate. In time, the patient saw a complete return to normal functioning. The use of stimulants for catatonia in bipolar disorder may be an interesting and effective option for treatment. While this is not the first time this treatment has been suggested, there is very little data in support of it; our case confirms the discoveries of previous case reports.
Advantages of FDM and gamma irradiation to manufacture personalized medical devices for airway obstructions
Authors: Beatriz Aráoz, Gastón Bellía-Munzón, Juan I Bousquet, Élida B Hermida
Journal: Front Bioeng Biotechnol (2023)
Keywords: additive manufacturing, airway, bronchomalacia, case report, polycaprolactone, splint

In the early childhood population, congenital airway conditions like bronchomalacia (BM) can pose a life-threatening threat. A breakthrough technology called additive manufacturing, or 3D printing, makes it feasible to create a biomedical device that aids in the treatment of airway obstruction. This article describes how a polycaprolactone (PCL) splint for the upper airways can be created using the fusion deposition technique (FDM) and sterilized using gamma radiation. It is presented as a simple, accessible, and cost-reduced alternative that complements other techniques using more expensive and sophisticated printing methods. Thermomechanical and morphological analysis proved that FDM and sterilizing by gamma irradiation are both appropriate methods for producing splints to treat life-threatening airway blockages. Additionally, the 3D-printed splints' effectiveness in treating a young patient with BM that was life-threatening was assessed by medical professionals. In this regard, the case report of a patient with 34 months of follow-up is presented. Splints manufactured by this affordable 3D printing method successfully surpass breathing arrest in life-threatening airway obstruction in pediatric patients. The success of this procedure represents a fundamental contribution to the treatment of the population in countries where access to expensive and complex technologies is not available.
Case Report: Prenatal Genetic Counseling to Parents of Fetuses Suspected of Having Ambiguous Genitalia
Authors: Takeshi Sato, Tomohiro Ishii, Yu Yamaguchi, Yosuke Ichihashi, Daigo Ochiai, Hiroshi Asanuma, Tatsuo Kuroda, Tomonobu Hasegawa
Journal: Front Pediatr (2021)
Keywords: ambiguous genitalia, case report, differences in sex development, prenatal genetic counseling, sex assignment
MeSH terms: Case Reports

The occurrence of fetuses suspected of having ambiguous genitalia will likely increase in the future. Currently, the impact of prenatal genetic counseling on parents' understanding and psychological preparedness has not been addressed. We provided prenatal genetic counseling to parents of two fetuses suspected of ambiguous genitalia. Case 1: At 22 weeks of gestation, swelling of the labia majora, and a clitoris-like structure were noted despite 46,XY detected in amniotic fluid cells. Case 2: At 28 weeks of gestation, bladder exstrophy and a scrotum-like structure were noted. At 32 weeks (Case 1) and 37 weeks (Case 2) of gestation, we shared information with parents regarding the possible difficulty of legal sex assignment at birth, and a scenario for registration of the birth certificate. At birth, both babies presented with ambiguous genitalia. For both cases, the parents remained calm on seeing their baby's genitalia for the first time. After a month, we shared medical information with parents, including karyotype, testosterone production capacity, and surgical schedule. In both cases parents assigned their respective baby's legal sex as male. Several months later, parents were questioned on prenatal genetic counseling. Case 1: Mother, "I was prepared to address our baby's genitalia calmly." Father, "I understood the procedure of legal sex assignment." Case 2: Mother, "Without counseling, I would have been more upset and worried." Father, "We were assured that multidisciplinary experts would support us." Prenatal genetic counseling provides reassurance to parents, who remain informed and emotionally secure throughout the legal sex assignment of their child.
STK11 loss and SMARCB1 deficiency mutation in a dedifferentiated lung cancer patient present response to neo-adjuvant treatment with pembrolizumab and platinum doublet: A case report
Authors: Jianxin Chen, Junhui Wang
Journal: Front Oncol (2023)
Keywords: smarcb1, stk11, efficacy, lung cancer, pembrolizumab
MeSH terms: Case Reports

Cancers harboring serine threonine kinase (STK11) alteration or SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily B, member 1 (SMARCB1) mutation are conventionally considered as treatment-refractory to immune checkpoint inhibitors or chemotherapy, respectively. However in the present report, we demonstrated a case of dedifferentiated non-small cell lung cancer, characterized by STK11 loss (due to promoter loss) mutation co-mutated with SMARCB1 deficiency mutation, has achieved significantly partial response to neo-adjuvant treatment with pembrolizumab and platinum doublet regimen. Our case highlighted that either STK11 loss, or SMARCB1 deficiency mutation, might not be used to select patients for PD-(L)1 blockade therapy or chemotherapy, respectively. SKT11 loss accompanied with SMARCB1 deficiency mutation may benefit from immunotherapy combined with chemotherapy.
Chronic recanalization of dissection of the distal anterior cerebral artery: case report and review of the literature
Authors: Shuichiro Asano, Tetsuo Hara
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

The natural history of atraumatic idiopathic dissection of the distal anterior cerebral artery is still unclear. We present a 38-year-old man who had dissection of the left A(2) segment of this vessel associated with subintimal hematoma and infarction. Because of complete stroke in acute stage, he did not undergo surgery. About three months later, administration of aspirin (100 mg/day) was started. At nine months, magnetic resonance angiography revealed complete recanalization of the A(2) dissection. To assess the outcome of dissection, we should observe the patient for at least one year.
Case report: Plasmablastic neoplasm with multinucleated giant cells-Analysis of stemness of the neoplastic multinucleated giant cells
Authors: Narumi Otsuka-Kamakura, Yoshiya Sugiura, Toshiki Yamazaki, Naomi Shimizu, Nobuyuki Hiruta
Journal: Front Oncol (2022)
Keywords: mib1/ki67 index, yamanaka factors, cancer stem cell, multinucleated giant cell, plasmablastic neoplasm
MeSH terms: Case Reports

Cancer stem cells have the capability of self-renewal and multipotency and are, therefore, associated with tumor heterogeneity, resistance to chemoradiation therapy, and metastasis. The hypothesis that multinucleated giant cells, which often emerge following chemo- and/or radiotherapy, serve as cancer stem cells has not been fully evaluated. Although a previous study demonstrated that these cells functioned as stem cells, only low levels of Yamanaka factors were expressed, contrasting with the high expression seen from their gestated first-generation mononuclear cells. Herein, we report a case of a plasmablastic neoplasm with multinucleated giant cells that were analyzed for stemness to test the above hypothesis. The patient was a male in his 80s who had a plasmablastic neoplasm that was not easily distinguishable as plasmablastic lymphoma versus plasma cell myeloma of plasmablastic type. Lymph node biopsy showed predominant mononuclear cell proliferation with admixed multinucleated giant cells. Immunohistochemistry and in situ hybridization showed that both multinucleated and mononuclear cells had the same profile: CD138(+), light chain restriction of κ>λ, cyclin D1(+), CD68(-), EBER-ISH (+). These results suggested that both cell types were neoplastic. In accordance with the previous study, the multinucleated giant cells showed low expression of Yamanaka factors, which were highly expressed in some of the mononuclear cells. Furthermore, the multinucleated giant cells showed a much lower proliferative activity (Mib1/Ki67 index) than the mononuclear cells. Based on these results, the multinucleated giant cells were compatible with cancer stem cells. This case is expected to expand the knowledge base regarding biology of cancer stem cells.
A Rare Presentation of Clozapine-Induced DRESS Syndrome
Authors: Carmel Moazez, Yasir Rudha, Natasha Narang, Tina Younger
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) is an uncommon side effect of certain medications. It causes a skin reaction, with eosinophilia and other organ involvement. This case describes a presentation of a 32-year-old female with a past medical history significant for schizophrenia and bipolar disorder who presented for a rash. She had been started on clozapine 10 days prior to admission. After extensive workup she was found to have DRESS syndrome secondary to clozapine use. This is the second reported case in the literature of clozapine-induced DRESS syndrome. This case is unique because it is the first case to present with the common manifestations of DRESS syndrome including eosinophilia, rash, lymphadenopathy, and organ involvement after clozapine use.
Tigecycline in the treatment of severe pneumonia caused by Chlamydia psittaci: A case report and literature review
Authors: Jiaming Liu, Yuan Gao
Journal: Front Med (Lausanne) (2022)
Keywords: chlamydia psittaci pneumonia, metagenomic nextgeneration sequencing (mngs), psittaci, severe pneumonia, tigecycline
MeSH terms: Review

Psittacosis is a zoonotic disease caused by Chlamydia psittaci. Systemic infections are mainly transmitted through the respiratory tract. The most common related disease is human atypical pneumonia, which is a rare pathogen of community-acquired pneumonia. Due to the difficulty of diagnosis, there have been few reports of C. psittaci pneumonia in the past. In recent years, with the widespread application of metagenomic next-generation sequencing (mNGS), the number of reported cases of C. psittaci has increased year by year. However, at present, most hospitals have little understanding of C. psittaci, especially for severe patients, and lack experience in diagnosis and treatment. Herein, we report the case of a 71-year-old woman with severe pneumonia that caused by C. psittaci. This patient was diagnosed through mNGS and was treated with tigecycline successfully. The level of IL-6 in the BALF was significantly increased. We discontinued tigecycline after mNGS of the blood was negative. In this review, we analyzed 53 cases to summarize the etiology, clinical manifestations, diagnosis and treatment strategies of severe C. psittaci pneumonia and hope to raise clinicians' awareness of this disease.
Bilateral Facial Diplegia: A Rare Presenting Symptom of Lyme
Authors: John Ashurst, Matthew Perry
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Lyme disease is a common disease that is faced by the physician but also acts a mimicker of many other disease processes. Facial palsies, especially bilateral, are a relatively rare presenting symptom of Lyme disease and may warrant further investigation. A thorough history and physical examination coupled with precision testing may aid the physician when faced with a patient with the diagnostic dilemma of facial diplegia.
Case Report: Progression of a Silent Corticotroph Tumor to an Aggressive Secreting Corticotroph Tumor, Treated by Temozolomide. Changes in the Clinic, the Pathology, and the β-Catenin and α-SMA Expression
Authors: Gianina Demarchi, Sofía Perrone, Gaela Esper Romero, Cristian De Bonis, Juan Pablo Casasco, Gustavo Sevlever, Silvia Ines Berner, Carolina Cristina
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: acth, corticotroph tumor, temozolomide, tumor transformation, vasculature, β-catenin
MeSH terms: Adenoma / pathology, Pituitary Neoplasms / pathology, Case Reports, Research Support, Non-U.S. Gov't, Adrenocorticotropic Hormone / metabolism, Corticotrophs / metabolism, Corticotrophs / pathology, Humans, Temozolomide / therapeutic use, beta Catenin / metabolism, beta Catenin, Adrenocorticotropic Hormone, Temozolomide

Clinically silent corticotroph tumors are usually macroadenomas that comprise 20% of ACTH tumors. They frequently progress to aggressive tumors with high recurrence, invasiveness, and on rare occasions, they may become hormonally active causing Cushing's disease. Trustable biomarkers that can predict their aggressive course, as well as their response to traditional or new therapies, are paramount. Aberrant β-Catenin expression and localization have been proposed as responsible for several malignancies including pituitary tumors. Nevertheless, the role of β-Catenin in the aggressive transformation of silent corticotropinomas and their response to Temozolomide salvage treatment have not been explored yet. In this work, we present a case of a silent corticotroph tumor that invaded cavernous sinus and compressed optic chiasm and, after a first total resection and tumor remission it recurred six years later as an aggressive ACTH-secreting tumor. This lesion grew with carotid compromise and caused Cushing's signs. It required multiple medical treatments including Cabergoline, Ketoconazole, TMZ, and radiotherapy. Besides, other two surgeries were needed until it could be controlled. Interestingly, we found α-SMA vascular area reduction and differential β-Catenin cell localization in the more aggressive tumor stages characterized by high Ki-67 indexes and p53 expression. Our results may indicate a role of angiogenesis and β-Catenin trigged events in the pituitary tumor progression, which could in turn affect the response to TMZ and/or conventional treatments. These molecular findings in this unusual case could be useful for future management of aggressive pituitary tumors.
A Case Report of Graves' Disease Induced by the Anti-Human Programmed Cell Death-1 Monoclonal Antibody Pembrolizumab in a Bladder Cancer Patient
Authors: Ken Yajima, Yushi Akise
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Immune checkpoint inhibitors, such as anti-programmed cell death-1 (anti-PD-1), have been widely used in the treatment of malignancies. However, these drugs can cause immune-related adverse events resembling autoimmune diseases. There are some reports of Graves' disease (GD) induced by anti-cytotoxic T-lymphocyte-associated antigen 4 antibodies, but reports which discussed GD induced by anti-PD-1 antibodies are very rare. We report the case of a 61-year-old man with bladder cancer who presented with severe diarrhea, fatigue, palpitation, body weight loss, and hyperthyroidism after the fifth treatment with the anti-PD-1 monoclonal antibody pembrolizumab. His thyroid function prior to pembrolizumab administration had been subclinical hyperthyroidism, despite a negative thyroid-stimulating hormone receptor antibody (TRAb) level. On admission, pembrolizumab administration was discontinued. Graves' disease was diagnosed based on a positive TRAb test result and the ultrasonographic finding of increased blood flow in the superior thyroid artery. Based on colonoscopy findings, the cause of diarrhea was diagnosed as active colitis. His diarrhea was improved with prednisolone, and thyroid function was treated with potassium iodide and thiamazole. This case report of GD with positive TRAb induced by the anti-PD-1 antibody pembrolizumab may contribute to the understanding of the mechanism underlying the association between GD and autoimmune activation via PD-1.
Gut microeukaryotes during anorexia nervosa: a case report
Authors: Nina Gouba, Didier Raoult, Michel Drancourt
Journal: BMC Res Notes (2014)
MeSH terms: Anorexia Nervosa / microbiology, Anorexia Nervosa / parasitology, Fungi / isolation & purification, Intestines / microbiology, Intestines / parasitology, Microbiota, Trichomonadida / isolation & purification, Case Reports, Research Support, Non-U.S. Gov't, Anorexia Nervosa / complications, Aspergillus / genetics, Aspergillus / growth & development, Aspergillus / isolation & purification, Beverages / microbiology, Cladosporium / genetics, Cladosporium / growth & development, Cladosporium / isolation & purification, Diet, Feces / microbiology, Feces / parasitology, Female, Food Microbiology, Fruit / microbiology, Fungi / genetics, Fungi / growth & development, Humans, Malnutrition / etiology, Malnutrition / microbiology, Malnutrition / parasitology, Nuts / genetics, Nuts / microbiology, Penicillium / genetics, Penicillium / growth & development, Penicillium / isolation & purification, Polymerase Chain Reaction, Trichomonadida / genetics, Trichomonadida / growth & development, Vegetables / microbiology, Young Adult

Background:
Few studies have focused on eukaryote community in the human gut. Here, the diversity of microeukaryotes in the gut microbiota of an anorexic patient was investigated using molecular and culture approaches.
Case presentation:
A 21-year-old Caucasian woman was admitted in an intensive care unit for severe malnutrition in anorexia nervosa. One stool specimen was collected from the anorexic patient, culture and polymerase chain reaction-based explorations yielded a restricted diversity of fungi but four microeukaryotes Tetratrichomonas sp., Aspergillus ruber, Penicillium solitum and Cladosporium bruhnei previously undescribed in the human gut.
Conclusions:
Establishing microeukaryote repertoire in gut microbiota contributes to the understanding of its role in human health.
Calcified Leiomyoma of the Distal Forearm in a Child: A Case Report and Review of Literature
Authors: Nadeeke Nidhan Perera, Sunil Ranjith Wijayasinghe, Karuna Dissanayake, Jerard Fernando, Ethige Tharushi De Silva
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Background:
Deep somatic leiomyomas arising in skeletal muscle are extremely rare in children, especially in the extremities. Around half of them show calcifications. We present a rare case of a calcified leiomyoma of the distal forearm in a child. Case Summary. A seven-year-old boy presented with right distal forearm and wrist pain with restricted supination for 4 years. X-ray showed ring and arc calcifications in the distal forearm at the interosseous area. MRI also confirmed a well-defined soft tissue lesion with areas of calcifications. A diagnosis of a cartilage-forming lesion or a peripheral nerve sheath tumour was suggested. The lesion was completely excised. Histology showed a lesion composed of intersecting fascicles of spindle cells with stromal calcification having immunohistochemical features of a leiomyoma.
Conclusion:
Although soft tissue calcifications can be seen in a plethora of conditions seen in daily orthopaedic practise, a high index of suspicion should be maintained for rare conditions like deep somatic leiomyoma.
Infectious crystalline keratitis induced by Citrobacter
Authors: Zeba Khanam, Gaganjeet Singh Gujral, Shariq Wadood Khan
Journal: GMS Ophthalmol Cases (2021)
Keywords: citrobacter, crystalline keratopathy, levofloxacin, microbial keratitis
MeSH terms: Case Reports

Background: Microbial keratitis is an important cause of ocular morbidity, with emerging organisms and drug resistance posing a real threat to vision of patients. Case presentation: A 30-year-old female presented with infective keratitis in the left eye. She had been using rose nectar as home remedy for her ailment. With no improvement in her symptoms, she presented to the eye emergency department, where she was started on empirical therapy with moxifloxacin, which was shifted to levofloxacin eye drops after the antimicrobial susceptibility test results came in. Microbiological examination revealed infection with rare gram-negative bacilli Citrobacter koseri. The patient responded well to the treatment with 1.5% levofloxacin eye drops and her vision improved from 20/120 to 20/30 over a course of 3 months. Conclusion: Treatment of microbial keratitis with those antibiotics that the organism is most sensitive to is of paramount importance today, where we often find patients on a cocktail of eye drops, which leads to further resistance and vision deterioration. Culturing of cornea scrapings and antimicrobial susceptibility testing of the isolated organism is now the standard guideline to be followed in the investigation of microbial keratitis.
76-year-old gentlemen with primary cardiac lymphoma presenting as acute coronary syndrome and atrioventricular block
Authors: Baskar Sekar, Gagan Swami, Amin Ibrahim, Azad Hanna, Mark N Payne, James Rc Seale, Abdul Azzu
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

We report the case of an immunocompetent patient who presented with symptoms suggestive of acute coronary syndrome and was found to be in complete heart block. He re-presented within 2 months with worsening breathlessness and investigations confirmed infiltrative cardiac disease. We describe here an uncommon presentation of primary cardiac lymphoma as acute coronary syndrome and atrioventricular block.
Deep sustained response to daratumumab monotherapy associated with T-cell expansion in triple refractory myeloma
Authors: Saad Z Usmani, Imran Khan, Christopher Chiu, David Foureau, Lawrence J Druhan, Katherine Rigby, Tineke Casneuf, A Kate Sasser
Journal: Exp Hematol Oncol (2018)
Keywords: daratumumab, immune response, minimal residual disease, multiple myeloma, stringent complete response, sustained response, t-cell expansion, triple refractory
MeSH terms: Case Reports

Background:
Daratumumab, a human CD38 monoclonal antibody that has direct on-tumor and immunomodulatory mechanisms of action, demonstrated clinical benefit as monotherapy or in combination with established regimens in patients with multiple myeloma with one or more prior lines of therapy.
Case presentation:
A male patient, who was 70 years of age at the time of diagnosis of multiple myeloma in 2011, relapsed after five lines of therapy, including autologous stem cell transplantation. The patient's disease, which was considered high risk with a deletion of chromosome 17p, advanced quickly and was triple refractory 2 years after diagnosis leaving few treatment options. He was treated with daratumumab monotherapy in the SIRIUS clinical trial resulting in a stringent complete response and clearance of minimal residual disease. The duration of the patient's clinical response is now over 3.5 years without relapse, compared with a median of 7.6 months for similarly treated patients. The patient's immunophenotype revealed CD8+ T-cell expansion, clonal expansion of the T-cell receptor repertoire, and decreases in regulatory T cells during daratumumab therapy, suggesting a robust adaptive immune response. This immune response was still present 32 months into daratumumab therapy.
Conclusions:
The results from this case report showed that a patient with advanced multiple myeloma, who had exhausted all treatment options with existing regimens, mounted an ongoing, deep, and durable response to daratumumab monotherapy. Further investigation of the immunologic profile provided additional patient-level evidence of an immunomodulatory mechanism of action of daratumumab.Trial registration ClinicalTrials.gov Identifier number NCT01985126. Submitted 22 July 2013.