OpenMed/multicare-articles huggingface dataset:
Case Report: A case of Kounis syndrome induced by iodine contrast agent during coronary angiography
Authors: Yangliu Sun, Jian Zhang
Journal: Front Cardiovasc Med (2024)
Keywords: kounis syndrome, allergy, cardiovascular system, coronary spasm, ioversol
MeSH terms: Case Reports

Kounis Syndrome (KS), a seldom-seen adverse reaction to iodine contrast agents, has an incidence that remains unclear. At present, there are no unified guidelines for managing KS either nationally or internationally. Ioversol, a new triiodinated hypotonic nonionic contrast agent, is commonly used in cardiovascular Computed Tomography (CT) and vascular imaging for diagnostic purposes. Its principal adverse reactions encompass fever, dermatological responses, convulsions, respiratory distress, hypersensitivity reactions including KS, and acute renal injury. This paper documents a case of KS induced by an iodine contrast agent during coronary angiography and, at the same time, searches for related literature and carries out a summary analysis in an attempt to provide a dependable reference for clinicians to make accurate diagnoses and treatments.
Long-term outcome of progressive multifocal leukoencephalopathy with recombinant interleukin-2 treatment and an associated increase in the number of HPyV-2-specific T-cells: a case report
Authors: Fieke W Hoff, John Rolwes, Paula A Hardeman, Molly Perkins, Eugene O Major, Daniel Douek, Robert H Collins Jr, Benjamin M Greenberg
Journal: Ther Adv Hematol (2023)
Keywords: il-2, case report, follicular lymphoma, non-hodgkin lymphoma, progressive multifocal leukoencephalopathy
MeSH terms: Case Reports

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by reactivation of the human polyomavirus 2 (HPyV-2). PML is associated with a high morbidity and mortality rate and there is currently no standard curative therapy. We report short-term immunologic response and long-term clinical outcomes in a patient diagnosed with follicular lymphoma (FL) who developed PML. Diagnosis of PML was established conclusively based on findings from a brain biopsy. The patient was treated with recombinant interleukin 2 (IL-2) and showed rapid clinical improvement. HPyV-2-specific T-cells were tracked longitudinally and correlation with clinical status, viral load, and radiographic imaging was documented. After the progression of the patient's FL, which required an allogeneic bone marrow transplant, the patient prophylactically received human leukocyte antigen-matched donor-derived HPyV-2 T-cells to prevent the recurrence of the PML as part of a clinical trial. Twelve years after the initial diagnosis of PML, he did not develop a relapse of his PML, supporting data that therapies that increase HPyV-2-specific T-cells, including IL-2, may be effective in the management of PML.
Long-term survival with a combination of immunotherapy, anti-angiogenesis, and traditional radiotherapy in brain metastatic small cell lung cancer: a case report
Authors: Yan-Yan Long, Jing Chen, Yue Xie, Ying Wang, Yong-Zhong Wu, Ying Xv, Ke-Gui Weng, Wei Zhou
Journal: Front Oncol (2023)
Keywords: anti-angiogenesis, case report, immune checkpoint inhibitor (icis), radiation therapy, small cell lung cancer (sclc)
MeSH terms: Case Reports

Purpose:
Brain metastases (BMs) are common in Small Cell Lung Cancer (SCLC), but the prognosis is very poor. Currently, there is no standard of care on what constitutes optimal treatment, and there is no consensus regarding maintenance therapy in SCLC.
Case description:
We report the case of a 55-year-old man with advanced SCLC. After the initial diagnosis, he received routine chemotherapy and chest radiotherapy but developed brain metastases with 2 lesions seven months later. We used an effective combination therapy consisting of the antiangiogenic inhibitor, Anlotinib and whole-brain radiotherapy. We then administered anti-PD-L1 immunotherapy Atezolizumab in combination with Anlotinib as long-term maintenance therapy. Twelve months later, there was a progression in one of the brain metastases. The patient underwent further stereotactic radiotherapy (SRT) for the lesion. However, after four months of treatment with SRT, the lesion began to gradually grow in size. The patient underwent surgical resection of the lesion, which confirmed radioactive brain necrosis. After a full 3-year course of anti-PD-L1 therapy, the patient discontinued immunotherapy and was administered only Anlotinib as maintenance. At the time of writing up this report, the patient was alive and the overall survival reached 41 months after the onset of BM.
Conclusion:
This indicated a potential synergistic effect of combined immunotherapy and antiangiogenic targeted therapy with local radiotherapy in patients with BM-SCLC and can provide directions for future clinical decisions.
A Classic Presentation of Roseola Infantum
Authors: Micah Pippin, Gloria Laws
Journal: Cureus (2024)
Keywords: exanthema subitum, rash in children, roseola infantum, sixth disease, viral exanthem, viral febrile illness
MeSH terms: Case Reports

Roseola is a common viral exanthem of childhood, most frequently affecting infants and toddlers before age three. The syndrome is characterized by an abrupt onset of high fever, which, upon resolution, yields to a centrally located maculopapular rash that spreads peripherally. This report describes the case of an 18-month-old child whose fever and defervescence rash provide insight into the typical presentation and progression of this pervasive yet mostly benign condition.
Identification of a rare copy number polymorphic gain at 3q12.2 with candidate genes for familial endometriosis
Authors: Flávia Gaona Oliveira, Júlio Cesar Rosa-E-Silva, Alexandra Galvão Gomes, Juliana Dourado Grzesiuk, Thiago Vidotto, Jeremy Andrew Squire, Rodrigo Alexandre Panepucci, Juliana Meola, Lúcia Martelli
Journal: Rev Bras Ginecol Obstet (2024)
Keywords: array-cgh, dna copy number variations, endometriosis, endometrium, genomic structural variation, heredity, polymorphism, genetic
MeSH terms: DNA Copy Number Variations, Endometriosis / genetics, Case Reports, Adult, Chromosomes, Human, Pair 3 / genetics, Female, Genetic Predisposition to Disease, Humans, Polymorphism, Genetic

Endometriosis is a complex disease that affects 10-15% of women of reproductive age. Familial studies show that relatives of affected patients have a higher risk of developing the disease, implicating a genetic role for this disorder. Little is known about the impact of germline genomic copy number variant (CNV) polymorphisms on the heredity of the disease. In this study, we describe a rare CNV identified in two sisters with familial endometriosis, which contain genes that may increase the susceptibility and progression of this disease. We investigated the presence of CNVs from the endometrium and blood of the sisters with endometriosis and normal endometrium of five women as controls without the disease using array-CGH through the Agilent 2x400K platform. We excluded common CNVs that were present in the database of genomic variation. We identified, in both sisters, a rare CNV gain affecting 113kb at band 3q12.2 involving two candidate genes: ADGRG7 and TFG. The CNV gain was validated by qPCR. ADGRG7 is located at 3q12.2 and encodes a G protein-coupled receptor influencing the NF-kappaβ pathway. TFG participates in chromosomal translocations associated with hematologic tumor and soft tissue sarcomas, and is also involved in the NF-kappa B pathway. The CNV gain in this family provides a new candidate genetic marker for future familial endometriosis studies. Additional longitudinal studies of affected families must confirm any associations between this rare CNV gain and genes involved in the NF-kappaβ pathway in predisposition to endometriosis.
Rhabdomyolysis Induced by Levetiracetam: A Case Report in Kuwait
Authors: Moaz Qureshi, Prakash A Abraham, Abdullah Al-Faras, Omar M Bamasood, Kamal M Matar
Journal: Case Rep Neurol Med (2024)
MeSH terms: Case Reports

Epilepsy is a common disorder caused by a myriad of drugs, of that levetiracetam is being commonly used late because of its strong safety profile and efficacy. With the increasing usage of drugs, some rare side effects may sometimes appear that can escape the most stringent checks, possibly due to the rarity of their occurrence. Rhabdomyolysis is known to occur in some patients owing to a variety of causes, even leading to kidney injury. When a drug has a side effect that is not well recognized in the literature, especially when the side effect can mimic an adverse effect of an uncommon primary illness, identifying the causal factor can be doubly difficult. To date, only limited studies have been published suggesting rhabdomyolysis linked to levetiracetam use. We report the first case of levetiracetam-induced rhabdomyolysis in Kuwait.
Lichenoid drug reaction after ipilimumab/nivolumab combination therapy: A case report
Authors: Zonía Robenne Moore, Dalit Zajdman-Faitelson, Arely Tamariz Campillo, Diana Karen Brito Bustillos, Sonia Toussaint-Caire, Cristina Berumen-Glinz
Journal: SAGE Open Med Case Rep (2023)
Keywords: bullous lichenoid drug reaction, combination therapy, ipilimumab, mesothelioma, nivolumab
MeSH terms: Case Reports

Nivolumab (PD-1 inhibitor) and ipilumumab (CTLA-4 inhibitor) are recently approved checkpoint inhibitors for treatment of non-small cell lung cancer. Immune-related adverse events related to the usage of checkpoint inhibitors are growing with their popularity. We present the case of a patient in combination treatment of nivolumab and ipilimumab who developed a lichenoid drug reaction, notable because it worsened to a bullous lichenoid drug reaction. Treatment with prednisone and withdrawal of checkpoint inhibitors aided in clinical resolution. Initial presentation of a lichenoid reaction that progressed to a bullous, desquamated presentation indicates the possibility of the prodromal rash progressing to a Stevens-Johnson Syndrome-like dermatosis. When dermatologists are consulted for rashes developed during checkpoint-inhibitor therapy, they should be aware that early treatment may prevent progression to bullae formation and desquamation and develop their treatment plans with this in mind.
A New Case of Granulomatosis with Polyangiitis Presented with Tolosa-Hunt Syndrome Manifestations
Authors: Maryam Mohebbi, Shahriar Nafissi, Majid Alikhani
Journal: Case Rep Rheumatol (2024)
MeSH terms: Case Reports

Background:
Tolosa-Hunt syndrome (THS) is a rare disorder involving the orbital and retro-orbital space. The typical symptoms include sensory loss in the trigeminal nerve's distribution, orbital pain, swelling, headaches, and cranial nerve palsies. Case Presentation. We report a 40-year-old female who initially presented with biparietal headache, unresponsive to medication, which then led to ophthalmoplegia and orbital pain. Serological findings demonstrated positive CANCA-PR3. She was initially treated with 1 g pulse methylprednisolone for three days. Based on the rheumatological evaluation and her positive lung nodule, hematuria, dysmorphic red blood cells, and positive antiproteinase 3 classic antineutrophil cytoplasm antibodies (CANCA-PR3) and also based on the diagnostic criteria for granulomatosis with polyangiitis criteria for Wegner disease, her treatment was continued with prednisolone 1 mg/kg and also rituximab at the first and 14th day of treatment.
Conclusion:
In our case of THS, we achieved satisfactory improvement in symptoms through the administration of high-dose steroids.
Case Report: Two cases of advanced primary cardiac angiosarcoma treated with anlotinib and a retrospective analysis of the literature
Authors: Pan Yang, Fu Xiong, Bingjing Zhu, Liang Gong, Chunlan Tang
Journal: Front Cardiovasc Med (2024)
Keywords: anlotinib, cardiac angiosarcoma, pericardial effusion, pleural effusion, vascular targeting agents
MeSH terms: Case Reports

Primary cardiac angiosarcoma is a rare malignant soft-tissue sarcoma derived from vascular endothelial cells or lymphatic endothelial cells, with a high malignancy, poor prognosis, and a lack of effective medical therapy. This article reports on two patients with primary cardiac angiosarcoma who received first-line treatment with multi-targeted anti-angiogenic agent, anlotinib monotherapy. The treatment rapidly controlled pleural and pericardial effusion, significantly reduced the tumor, improved symptoms, and showed satisfactory recent efficacy. This indicates that anlotinib offers a new first-line treatment option for advanced primary cardiac angiosarcoma.
Percutaneous coronary intervention for a healed erosion with excimer laser coronary angioplasty and drug-coated balloon angioplasty: a case report
Authors: Teruo Sekimoto, Shunya Sato, Hiroyoshi Mori, Hiroki Tanisawa, Hiroaki Tsujita, Seita Kondo, Hiroshi Suzuki, Toshiro Shinke
Journal: Front Cardiovasc Med (2023)
Keywords: acute coronary syndrome, drug-coated balloon, excimer laser, healed plaque, intravascular ultrasound, optical coherence tomography
MeSH terms: Case Reports

Background:
Healed plaque, characterized by distinct layers of organizing thrombus and collagen, is the hallmark of tissue self-repair. However, the efficacy of excimer laser coronary angioplasty (ELCA) followed by drug-coated balloon (DCB) angioplasty in patients with healed plaques is not fully understood.
Case summary:
A 42-year-old woman with a history of anxiety disorder was admitted to our institution with worsening chest pain and subsequently diagnosed with anterior non-ST-elevation myocardial infarction. Coronary angiography revealed severe stenosis in the proximal left anterior descending artery (LAD) despite Thrombolysis in Myocardial Infarction (TIMI) grade 3. Optical coherence tomography (OCT) showed healed plaques with partial macrophage accumulation and no fresh thrombus. Plaque disruption and thin-cap fibrous atheroma were not identified in the culprit lesions. Intravascular ultrasound (IVUS) confirmed high-intensity marginal irregular masses at the culprit site, suggesting that the thrombus was formed by plaque erosion rather than lipid plaque or necrotic tissue. With lesion modification using ELCA prior to DCB angioplasty, OCT examination of the LAD after ELCA showed a significant reduction in plaque burden and preserved lumen size. Post-percutaneous coronary intervention angiography revealed no stenosis with TIMI grade 3. A follow-up coronary computed tomography scan showed no angiographic restenosis, and the patient remained symptom-free.
Conclusions:
Here we describe a case in which OCT and IVUS evaluation suggested organizing thrombus due to erosion healing, and a favorable outcome was achieved with the combination of ELCA and DCB. The combination use of ELCA and DCB might be a potential strategy for acute coronary syndrome patients with organizing thrombus.
Case study: Evaluating deep-water start techniques and training demands in seated slalom waterskiing for an athlete with paraplegia
Authors: David Suárez-Iglesias, Carlos Ayán, Adrián García-Fresneda, José Gerardo Villa-Vicente, Juan Rodríguez-Medina, Jose A Rodríguez-Marroyo
Journal: Front Psychol (2024)
Keywords: disability impairment, heart rate, perceived exertion, training zones, water sports

Purpose:
Recreational and competitive slalom waterskiing is increasingly popular among individuals with spinal cord injuries (SCI), particularly for those with paraplegia using sit-skis. A key component of slalom skiing is the deep-water start (DWS), yet little is known about the physiological and physical demands of this activity when the athlete is seated. This study aims to fill this gap by focusing on the training requirements for a seated slalom athlete.
Materials and methods:
Focusing on a young male athlete with paraplegia, this case study evaluates the effectiveness and efficiency of traditional (TDWS) and alternative (ADWS) DWS techniques during seated slalom waterskiing sessions. It assesses internal training load (TL) through heart rate (HR) zones and session rating of perceived exertion (sRPE), alongside pre- and post-session handgrip strength measurements to gauge peripheral muscle fatigue.
Results and conclusions:
Performing the ADWS, achieving a full success rate, proved more effective but slightly more time-consuming than TDWS, which had limited success. HR during DWS maneuvers ranged from 63.2 to 81.3% of maximal HR, with most sessions occurring below the ventilatory threshold, thus perceived as hard effort. A moderate yet non-significant correlation was found between HR and sRPE-based TL. A significant reduction in handgrip strength post-session underscores the activity's demands. These insights illuminate the technical, physiological, and physical challenges in mastering DWS for seated slalom athletes with SCI, providing valuable guidance for the development of tailored training programs and techniques in this sport.
Case Report: Ribociclib-induced phototoxicity presented as dyschromia with subsequent bullae formation
Authors: Jyun-Yan Jhan, Wei-En Wang, Sung-Chao Chu, Chiu-Hsuan Cheng, Chung-Hsing Chang
Journal: Front Oncol (2023)
Keywords: breast cancer, bullae, case report, cyclin-dependent kinases 4/6 inhibitor, drug allergy, dyschromia, phototoxicity, ribociclib
MeSH terms: Case Reports

Ribociclib, a cyclin-dependent kinase 4/6 inhibitor, is a novel targeted therapy for advanced-stage breast cancer. Although ribociclib-induced cutaneous side effects have been previously noted, they have not been well documented. Herein, we present a case of ribociclib-induced phototoxicity, which manifested as dyschromia over sun-exposed forearms and neck initially and as bullae formation subsequently. A 71-year-old woman with metastatic breast cancer developed dyschromia after daily treatment with ribociclib (600 mg) for 7 months. Skin biopsy of the pigmented lesion revealed interface dermatitis with melanin incontinence and dyskeratotic cells and ballooning keratinocytes with loss of melanocytes in the basal layer. Further, clefting at the basal layer of epidermis was noted in a more hyperpigmented field. Fontana-Masson staining revealed melanophages in the dermis. Human Melanoma Black-45 staining revealed decreased melanocyte numbers in the epidermis above the cleft. Immunohistochemical analyses revealed activated CD1a+ epidermal Langerhans cells and infiltrating CD4+ and CD8+ T cells in the epidermis and dermis, thereby indicating type IV hypersensitivity that was associated with damage to keratinocytes and melanocytes. To prevent progression of bullous dermatitis, we advised the patient to discontinue ribociclib and prescribed oral and topical prednisolone. Due to the risk of phototoxicity, we educated the patient on sun-protection strategies. The patient's skin lesions subsided during the 2 months of treatment. Phototoxicity with dyschromia is a rare but significant ribociclib-induced cutaneous side effect. Early diagnosis, rapid ribociclib withdrawal, protection from sunlight, and prompt treatment are critical for preventing subsequent severe bullous dermatosis.
Individualized Physiotherapy of Upper Body Functional Movement Disorder - Two Illustrative Cases
Authors: Christof Degen-Plöger, Annemarie Reincke, Christina Bolte, Carl Alexander Gless, Kerstin Luedtke, Alexander Münchau, Kirsten E Zeuner, Anne Weissbach
Journal: Tremor Other Hyperkinet Mov (N Y) (2024)
Keywords: physiotherapy, attention training, functional movement disorder
MeSH terms: Physical Therapy Modalities, Case Reports, Adult, Female, Humans, Male, Middle Aged, Movement Disorders / physiopathology, Movement Disorders / rehabilitation, Movement Disorders / therapy, Upper Extremity / physiopathology

Background:
Information on specialist physiotherapeutic treatment for functional movement disorders is scarce. Previous studies focussed on functional gait disorders and availability of descriptions of the practical application especially for other body regions is very limited.
Cases:
We present two illustrative cases, demonstrating the key elements of physiotherapy for the treatment of functional movement disorders beyond gait difficulties. The individual applicability of the specific core elements of physiotherapy, adapted to the individual needs of each patient, are described. We also explain, how different sensory stimuli can be used to shift attention away from symptoms and thus reduce them. Moreover, we discuss how patients' agency can be encouraged and how this results in therapy key moments, contributing to a sustained improvement of symptoms.
Conclusion:
Thus, our case series are intended to guide clinicians and therapists alike, to promote disease-specific physiotherapy for this common and treatable neuropsychiatric disorder.
A case of chorea-acanthocytosis with significant improvement of symptoms at one year with deep brain stimulation: case report and literature review
Authors: Yan Xu, Jiabin Yu, Yimeng Gao, Qiaozhen Su, Haitao Xie, Hongfeng Liang, Chunye Zheng
Journal: Front Neurol (2024)
Keywords: abnormal vocalizations, chorea-acanthocytosis, deep brain stimulation, globus pallidus internal, involuntary movement
MeSH terms: Case Reports

Chorea-acanthocytosis (ChAc) is a rare, neurodegenerative disorder caused by mutations in the VPS13A gene. In this article, we report on a 32-year-old man diagnosed with ChAc, with involuntary movements of the mouth and trunk, drooling of the mouth, slurred speech, and abnormal vocalizations as the main clinical manifestations. Three weeks after implantation of globus pallidus internal (GPi)-deep brain stimulation (DBS), the patient's symptoms improved significantly. For example, articulation is clear, involuntary trunk movements and salivation have largely disappeared, and abnormal vocalizations have been significantly reduced. After 1 year of follow-up, the improvement in involuntary movement symptoms is essentially the same as before. As far as we know, we are the first to report the relief of involuntary vocalizations in a patient with GPi-DBS treatment, and that salivation and involuntary trunk movements have almost disappeared, and all other symptoms are significantly relieved, which is rare in previous cases. All of the above proves that the treatment of our case with DBS was very successful and that longer term follow-up is critical. We also hope that our case will provide new references and therapeutic ideas for the future treatment of patients with ChAc.
Case report: Bruton tyrosine kinase inhibitor as therapy for chronic lymphocytic leukemia infiltrating a kidney allograft
Authors: Louis Stavart, Matthieu Halfon, Natacha Dewarrat, Samuel Rotman, Dela Golshayan
Journal: Front Med (Lausanne) (2024)
Keywords: bruton tyrosine kinase inhibitor, acute cellular rejection, case report, chronic lymphocytic leukemia, kidney transplantation
MeSH terms: Case Reports

The burden of chronic lymphocytic leukemia (CLL) in the prognosis of solid organ transplant (SOT) recipients seems non-negligible. Whether transplanting a patient with previous CLL is safe or what is the optimal monitoring and treatment management after transplantation is still unclear and only based on few case series and reports. Therefore, we aimed to contribute to this understanding by reporting the first documented case of a clinically significant CLL with biopsy-proven infiltration of the kidney allograft and its successful management with a Bruton tyrosine kinase inhibitor (BTKi). We then reviewed the related literature, with a focus on CLL and kidney transplantation. Our main message is that BTKi may represent a safe and effective intervention to prevent the hazardous patient and graft outcomes of CLL in SOT patients.