OpenMed/multicare-articles huggingface dataset:
Persistent response of furmonertinib plus anlotinib in a lung adenocarcinoma patient with an EGFR exon 20 insertion mutation: A case report
Authors: Xuesong Chen, Wangjian Zha, Mei Su, Nan Meng, Shuliang Cao, Beifang Niu, Xu Qi
Journal: Front Pharmacol (2023)
Keywords: egfr exon 20 insertions, anlotinib, case report, furmonertinib, lung adenocarcinoma
MeSH terms: Case Reports

Insertions in exon 20 represent the third most common type of EGFR mutation following in-frame deletions in exon 19 and the point mutation L858R in exon 21. They are generally associated with primary resistance to EGFR-TKIs. Although mobocertinib and amivantamab were approved for adult patients with non-small cell lung cancer (NSCLC) harboring EGFR exon 20 insertion mutations, the efficacy of these two agents was rather moderate. Therefore, other more potent targeted agents are urgently needed. Here, we report a patient with advanced lung adenocarcinoma harboring an EGFR exon 20 insertion mutation (NM_005228: exon 20: c.2316_2321dup: p.773_774dup). After experiencing platinum-based chemotherapy, this patient received a combination of furmonertinib and anlotinib and achieved lasting stable disease (SD). The treatment was well tolerated, and only mild hand-foot syndrome was reported from the patient. To the best of our knowledge, this case firstly reported the encouraging efficacy of combined furmonertinib and anlotinib in an advanced lung adenocarcinoma patient with an EGFR exon 20 insertion mutation who was previously treated with platinum-based chemotherapy. In addition, we summarize the recent literature on therapies against NSCLC with EGFR exon 20 insertion mutations. This case might provide an alternative approach for clinical oncologists.
Case Report: An Undefined Liver Lesion in a Young Man With Severe Aplastic Anemia: A Teachable Moment
Authors: Jin Liu, Jidong Sui, Deguang Sun, Kun Guo, Zhenming Gao, Jie Bian, Jinsong Yan, Liming Wang
Journal: Front Surg (2021)
Keywords: a teachable moment, androgen-related hepatic adenoma, clinical challenges, extramedullary hematopoiesis, less is more
MeSH terms: Case Reports

In this work, we reported a young man complaining of asthenia and intermittent fever for 10 days, and an ultrasound showed an undefined lesion on his liver. Facing the patient's situation with severe agranulocytosis, anemia, and thrombocytopenia, we passed through a tough diagnostic process for choosing an appropriate treatment for him with an ambiguous result of pathological biopsy. The undefined liver lesion was successfully solved by withdrawing the androgen for observation, without lobectomy. The lesion gradually diminished over 2 years of follow-up.
Monochorionic Diamniotic Vasa Previa Pregnancy: A Medical Student Perspective
Authors: Joshua M Samuel, Fatima Ali, Jonathan Faro, Jonathan D Baum
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Monochorionic diamniotic twins and vasa previa are uncommon. We present a case that was followed from ultrasound diagnosis to delivery.
Artesunate-induced hemolysis in severe complicated malaria - A diagnostic challenge: A case report and literature review of anemia in malaria
Authors: Sundus Sardar, Mohammed Abdurabu, Ahmed Abdelhadi, Mhd Baraa Habib, Muhammad Bilal Jamshaid, Adnan Humam Hajjar, Munir Abu Ageila, Tasnim Abdalla, Anand Kartha, Khalid Farooqui
Journal: IDCases (2021)
Keywords: anemia, malaria, padh, plasmodium falciparum, post-artemisinin delayed hemolysis
MeSH terms: Case Reports

Malaria infection, which results due to the parasitic protozoan Plasmodium, has several known etiologies of hemolytic anemia as a possible complication in cases such as concurrent G6PD deficiency, severe parasitemia, or use of parenteral antimalarials. Although artemisinin-based antimalarial therapies are generally well-tolerated, several cases of severe post-artemisinin delayed hemolysis (PADH) have been recently reported, which present a diagnostic challenge, and affect morbidity and mortality in patients with malarial infection. We highlight the case of a young lady with Plasmodium falciparum severe parasitemia who developed hemolytic anemia after parenteral artesunate therapy.
Congenital transpositions of stomach and spleens with partial pyloric stenosis
Authors: Benard Ohene Botwe, Benjamin Dabo Sarkodie, Yaw Boateng Mensah, William Kwadwo Antwi
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

The occurrence of chromosomal aberrations resulting in congenital transposition of internal organs is rare. Isolated congenital stomach and spleen (multiple) transposition with partial pyloric stenosis, where the rest of the internal organs remain in their normal positions, to the best of our knowledge has not been reported before. Attention to, knowledge and records of this case should be considered vital for understanding future symptoms and occurrences and also for prevention of surgical mistakes.
Endoscopic Image 2 Hours after PuraStat® Application: A Case of Achieving Hemostasis Using PuraStat® for Postgastric Lesion Biopsy Bleeding after Hemostatic Clips Failed
Authors: Yoshitsugu Misumi, Kouichi Nonaka, Maiko Kishino
Journal: Case Rep Gastrointest Med (2023)
MeSH terms: Case Reports

PuraStat® (3D Matrix, Tokyo, Japan) is a novel, self-assembling peptide hemostatic hydrogel that can be used endoscopically. Hemostasis can be physically obtained by covering bleeding points; however, there are no reports of how long PuraStat remains in the upper gastrointestinal tract. Herein, we report a case wherein esophagogastroduodenoscopy (EGD) was performed 2 hours after PuraStat application. A 73-year-old man underwent EGD for evaluation of lesions in the posterior wall of the stomach. A biopsy was then performed on the gastric lesions; however, massive bleeding occurred. A hemostatic clip was used to stop bleeding but failed; primary hemostasis was obtained by applying PuraStat. EGD performed 2 hours later to determine whether the patient could be discharged revealed that the white-turning PuraStat gel remained firmly in the applied area, confirming complete hemostasis. PuraStat is a hemostatic agent capable of physical hemostasis that reliably remains in the stomach even after a few hours of use and, thus, may replace some conventional hemostasis methods.
Pediatric robotic assisted laparoscopic nephropexy: case study
Authors: Danesh Bansal, W Robert Defoor Jr, Paul H Noh
Journal: Springerplus (2013)
Keywords: nephropexy, nephroptosis, partial nephroureterectomy, pediatrics, robotic assisted laparoscopic

We describe pediatric robotic assisted laparoscopic left nephropexy in a 12-year-old female for symptomatic nephroptosis after partial nephroureterectomy.
Breast metastasis from esophagogastric junction cancer: a case report
Authors: Sanghamitra Jena, Samir Bhattacharya, Arnab Gupta, Shravasti Roy, Neetesh Kumar Sinha
Journal: Case Rep Surg (2014)

Metastasis to breast from nonmammary malignancy is only about 1.3-2.7%. A few cases of squamous cell carcinoma of esophagus and adenocarcinoma of stomach metastasizing to breast have been reported, but this is probably the first report of breast metastasis from esophagogastric junction (EGJ) cancer in the English literature. Herein we report a case of a 32-year-old patient diagnosed as adenocarcinoma of gastroesophageal junction, presenting with left breast metastasis two years after treatment. Given unusual site of metastasis in a follow-up case of EGJ cancer, not only it is challenging to differentiate it from primary carcinoma of breast but also it is important from treatment point of view. In our case, clinical data, radiology, histopathology, and immunohistochemistry (IHC) led us to reach the diagnosis.
Sacral Rheumatoid Nodule: An Unusual Indication for Coccygectomy
Authors: Zachary R Porter, Juan C Mejia-Munne, Bryan M Krueger, Jennifer A Kosty, Laura B Ngwenya
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Here, we present a case report of a woman who presented with a large sacral rheumatoid nodule. This patient failed conservative treatment and presented in search of a surgical solution. We successfully removed her rheumatoid nodule using a surgical approach typically reserved for traumatic coccydynia. We show how coccygectomy, although a rare surgical procedure, was effective in treatment of a large rheumatoid nodule.
Progression of Hepatic Adenoma to Carcinoma in the Setting of Hepatoportal Sclerosis in HIV Patient: Case Report and Review of the Literature
Authors: M I Montenovo, F G Jalikis, M Yeh, J D Reyes
Journal: Case Reports Hepatol (2016)

We report a case of hepatic adenoma progression to carcinoma in the setting of hepatoportal sclerosis in an HIV+ patient and provide a review of the scarce literature regarding hepatoportal sclerosis in HIV patients. We describe the clinical presentation, diagnostic workup, and management. This is the first case report in the literature of progression of hepatic adenoma to carcinoma in hepatoportal sclerosis in an HIV patient. This case also highlights the broad differential diagnosis that should always be included in the study of any liver disease in this patient population, including the performance of invasive and aggressive tests to arrive at the final diagnosis.
Embolic Stroke and Meningitis Secondary to Staphylococcus lugdunensis Native Valve Endocarditis
Authors: Wafa Ali AlDhaleei, Akshaya Srikanth Bhagavathula, Rabia Aldoghaither
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Staphylococcus lugdunensis is a coagulase-negative staphylococcus that leads to destructive infective endocarditis. The clinical course of S. lugdunensis endocarditis is usually aggressive with a high mortality rate compared to endocarditis caused by other coagulase-negative staphylococcal species. Despite that, it is usually sensitive to Penicillin G, and surgical intervention is sometimes warranted. Here, we report a case of S. lugdunensis endocarditis complicated by both embolic stroke and meningitis.
Improvement of Severe COVID-19 in an Elderly Man by Sequential Use of Antiviral Drugs
Authors: Masakiyo Yatomi, Tomonori Takazawa, Kunio Yanagisawa, Masafumi Kanamoto, Yusuke Matsui, Hiroyuki Tsukagoshi, Nobuhiro Saruki, Shigeru Saito, Yutaka Tokue, Toshitaka Maeno
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Although a variety of existing drugs are being tested for patients with coronavirus disease 2019 (COVID-19), no efficacious treatment has been found so far, particularly for severe cases. We report successful recovery in an elderly patient with severe pneumonia requiring mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Despite administration of multiple antiviral drugs, including lopinavir/ritonavir, chloroquine, and favipiravir, the patient's condition did not improve. However, after administration of another antiviral drug, remdesivir, we were able to terminate invasive interventions, including ECMO, and subsequently obtained negative polymerase chain reaction results. Although further validation is needed, remdesivir might be effective in treating COVID-19.
The rise of tunnel endoscopic surgery: a case report and literature review
Authors: Mingyan Cai, Jinzhong Chen, Pinghong Zhou, Liqing Yao
Journal: Case Rep Gastrointest Med (2012)

There has been booming interest in natural orifice transluminal surgery since it was first described. Several techniques first developed for the safe transluminal access now derive into independent endoscopic surgical procedures. In this paper, we describe a case treated by a novel procedure by submucosal tunnelling technique and provide a literature review of the rise of tunnel endoscopic surgery.
A rare coincidence of different types of driver mutations among uterine leiomyomas (UL)
Authors: Carsten Holzmann, Dominique Nadine Markowski, Sabine Bartnitzke, Dirk Koczan, Burkhard Maria Helmke, Jörn Bullerdiek
Journal: Mol Cytogenet (2015)
Keywords: genetic types, hmga2, med12, med12l, uterine leiomyoma
MeSH terms: Case Reports

Mutations of mediator subcomplex 12 (MED12) and of high mobility group protein AT-hook 2 (HMGA2) are driver mutations in uterine leiomyomas (UL) that have not been observed to coexist in one tumor and even rarely coexist in different UL tumors of one patient. Here we describe a patient who underwent hysterectomy because of multiple leiomyomas which were studied by cytogenetics, MED12 hotspot sequencing, and copy number variation arrays. Two of the UL tumors had different HMGA2 rearrangements not detected by G-banding. Two UL tumors had deletions of the long arm of chromosome 3, in one case associated with a MED12 mutation. Both deletions lead to the loss of MED12L showing strong similarity with MED12. It remains to be determined if this gene can play a role in leiomyomagenesis independent of MED12. In summary, the patient presented exhibits an unusual coincidence of different driver mutations among her leiomyomas.
Post-COVID Opsoclonus Myoclonus Syndrome: A Case Report From Pakistan
Authors: Hira Ishaq, Talha Durrani, Zainab Umar, Nemat Khan, Pamela McCombe, Mian Ayaz Ul Haq
Journal: Front Neurol (2021)
Keywords: covid-19, ataxia, autoimmue disease, movement disorder, neurological disorder, opsoclonus myoclonus syndrome
MeSH terms: Case Reports

Background: Coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory distress syndrome-coronavirus-2 (SARS-CoV-2), is primarily a respiratory infection but has been recently associated with a variety of neurological symptoms. We present herewith a COVID-19 case manifesting as opsoclonus-myoclonus syndrome (OMS), a rare neurological disorder. Case Presentation: A 63-year-old male diagnosed with COVID-19 infection developed behavioral changes, confusion, and insomnia followed by reduced mobility and abnormal eye movements within 48 h of recovery from respiratory symptoms associated with COVID-19. On examination, he had rapid, chaotic, involuntary saccadic, multidirectional eye movements (opsoclonus), and limb myoclonus together with truncal ataxia. CSF analysis, MRI of the brain, and screening for anti-neuronal and encephalitis related antibodies were negative. Extensive testing revealed no underlying malignancy. The patient was successfully treated with intravenous immunoglobulin (IVIG) with complete resolution of symptoms within 4 weeks of treatment. Conclusion: COVID-19 infection can be associated with the manifestation of opsoclonus myoclonus syndrome, a rare neurological disorder that can be treated with IVIG if not responsive to corticosteroids.
Superficial siderosis due to filum terminale tumor: An uncommon cause of cranial nerve dysfunction
Authors: Tom Campion, Farrukh Arfeen, Ashok Adams
Journal: Clin Case Rep (2018)
Keywords: haemosiderosis, sensorineural hearing loss
MeSH terms: Case Reports

If superficial siderosis is suspected based on clinical presentation, susceptibility weighted imaging should be undertaken in addition to standard MRI sequences as it is more sensitive than T2 weighted imaging. Once diagnosed, imaging of the entire brain and spine must be undertaken to assess for an underlying cause.
A Novel Case of Acquired Isolated Left Ventricular Non-compaction in a Primigravida: Revisiting the Diagnostic Criteria of Left Ventricular Non-compaction
Authors: Esiemoghie J Akhigbe, Ebubechukwu Ezeh, Nadew Sebro, Olalekan Olanipekun, Carlos Rueda Rios
Journal: Cureus (2023)
Keywords: acquired heart disease, cardiomyopathy, genetics, heart disease in pregnancy, heart failure, left ventricular non-compaction
MeSH terms: Case Reports

Left ventricular non-compaction (LVNC) is rare cardiomyopathy characterized by the presence of a two-layered myocardium with prominent trabeculations. It has high rates of mortality and morbidity. Clinical presentation could vary from asymptomatic patients to developing ventricular arrhythmias, thromboembolism, heart failure, and even sudden cardiac death. We present a 23-year-old primigravida with a childhood history of dilated cardiomyopathy secondary to post-viral myocarditis presenting at 32 weeks gestation with dyspnea on exertion. Initial 2-D echocardiogram revealed a mildly dilated left ventricle with apical trabeculation and a 2-layer distinction between compacted and noncompacted myocardium indicating non-compaction of the left ventricle. This case presents a peculiar confluence of cardiac genetics, normal physiology, and infection. We describe a rare form of acquired LVNC that transformed from another type of cardiomyopathy to LVNC during pregnancy drawing attention to the causality pathways of LVNC.
Immunotherapy responsive autoimmune subacute encephalitis: a report of two cases
Authors: Manoj Mittal, Nancy Hammond, Sharon G Lynch
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Objective. To describe the clinical characteristics and radiological findings in two patients with subacute encephalitis associated with elevated serum voltage-gated potassium channel antibody (VGKCAb) and antithyroperoxidase (TPO) antibody. Case Reports. Case 1: 63-year-old woman was admitted for altered mental status and possible seizure activity. MRI brain showed hyperintensity in the bilateral hippocampal areas. She was positive for VGKCAb and anti-TPO antibodies. She was treated with steroids, IVIG, plasma exchange and azathioprine. After 8 months, she had marked improvement in her memory and seizures. Case 2: 61-year-old woman was admitted for video EEG monitoring of unclassified seizure and cognitive function decline. MRI of the brain showed mild hyperintensity in bilateral hippocampal areas and significant atrophy in the frontotemporal lesion. Anti-TPO antibody and VGKCAb were positive. She was treated with steroids, plasma exchange and azathioprine. After 9 months, she had marked improvement in her memory and seizures. Conclusion. Autoimmune subacute encephalitis appears to be an underdiagnosed entity. It is important to screen patients with subacute encephalitis for anti-TPO antibody and VGKCAb, particularly in the presence of seizures. Immunosuppressive therapy appears to be effective in treating this entity.
Isolated low high density lipoprotein-cholesterol (HDL-C): implications of global risk reduction. Case report and systematic scientific review
Authors: Melvin R Hayden, Suresh C Tyagi
Journal: Cardiovasc Diabetol (2005)
MeSH terms: Cholesterol, HDL / blood, Coronary Artery Disease / physiopathology, Risk Reduction Behavior, Case Reports, Review, Angioplasty, Balloon, Coronary, Anti-Inflammatory Agents, Antioxidants / physiology, Cholesterol, HDL / physiology, Coronary Artery Disease / blood, Coronary Artery Disease / complications, Coronary Vessels / pathology, Coronary Vessels / physiopathology, Disease Progression, Humans, Male, Middle Aged, Myocardial Infarction / etiology, Myocardial Infarction / physiopathology, Odds Ratio, Risk Factors, Stents, Uric Acid / blood, Anti-Inflammatory Agents, Antioxidants, Cholesterol, HDL, Uric Acid

Background:
The importance of low high-density lipoprotein cholesterol (HDL-C), elevated non HDL-C (as part of the metabolic syndrome, prediabetes, and type 2 diabetes mellitus), and an isolated low HDL-C is rapidly emerging. The antiatherosclerotic roles of reverse cholesterol transport and the pleiotropic antioxidant--anti-inflammatory mechanistic effects of HDL-C are undergoing rapid exponential growth.
Case presentation:
In 1997 a 53-year-old Caucasian male presented with a lipoprotein profile of many years duration with an isolated low HDL-C and uric acid levels in the upper quintile of normal. He developed an acute myocardial infarction involving the right coronary artery and had percutaneous transluminal coronary angioplasty with stenting of this lesion. He also demonstrated a non-critical non-flow limiting lesion of the proximal left anterior descending coronary artery at the time of this evaluation. Following a program of global risk reduction this patient has done well over the past 7 years and remains free of any clinical signs and symptoms of atherosclerosis. His HDL-C and uric acid levels are currently in the normal physiological range.
Conclusion:
Low HDL-C and isolated low HDL-C constitute an important risk factor for atherosclerosis. Therapies that lead to a return to normal physiologic range of HDL-C may result in the delay of atherosclerotic progression.
Rapidly progressive Guillain-Barré syndrome following amitriptyline overdose and severe Klebsiella pneumoniae infection: A case report and literature review
Authors: Boyu Zhang, Liwei Duan, Linhao Ma, Qingqing Cai, Hao Wu, Liang Chang, Wenfang Li, Zhaofen Lin
Journal: Front Med (Lausanne) (2022)
Keywords: guillain–barré syndrome (gbs), klebsiella pneumoniae infection, amitriptyline overdose, bilateral weakness, case report
MeSH terms: Case Reports

Guillain-Barré syndrome (GBS) is a potentially life-threatening post-infectious autoimmune disease characterized by rapidly progressive symmetrical weakness of the extremities. Herein, we report a case of GBS associated with drug poisoning complicated by Klebsiella pneumoniae infection. A 38-year-old woman was admitted to the intensive care unit after taking an overdose of amitriptyline and was later diagnosed with coma, Klebsiella pneumoniae infection, and septic shock. Thirteen days after admission, she was diagnosed with GBS based on acute muscle pain, flaccid paralysis, hyporeflexia, reduced amplitude of compound muscle action potential, and albuminocytologic dissociation in the cerebrospinal fluid. GBS rarely occurs after a drug overdose and septic shock, and this is the first report of a rapidly progressive GBS following amitriptyline overdose and severe Klebsiella pneumoniae infection.
A rare case of popliteal venous aneurysm
Authors: Roberto Fiori, Roberto Chiappa, Eleonora Gaspari, Giovanni Simonetti
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

We report a case of a 21-year-old man with a popliteal venous aneurysm of the left popliteal fossa, with local symptoms and pain during palpation. Early diagnosis is fundamental in order to prevent the thromboembolic events or other major complications. Duplex scanning, Computed Tomography scanning, and Magnetic Resonance imaging are considered to be important non-invasive diagnostic methods for the diagnosis of PVA. The Angio Computed Tomography acquisition confirmed a 36 mm x 17 mm oval mass in the left popliteal fossa continuous with the popliteal veins. This lesion had presented contrast enhancement only in delayed acquisition (180 sec) and so appeared to be a true venous aneurysm and no arterial. The PVA was repaired surgically via a posterior approach to the popliteal fossa. A 4 x 2 aneurysm was identified. In the same time open tangential aneurysmectomy and lateral vein reconstruction were realised. This case is interesting because the Angio Computed Tomography study, in delayed acquisition, has allowed a correct diagnostic assessment of PVA and the surgical treatment.
Case report: A new pathogenic variant of LRBA deficiency with a complex phenotype and Rosai-Dorfman disease
Authors: Francesco Fabozzi, Rita De Vito, Stefania Gaspari, Fabrizio Leone, Maurizio Delvecchio, Emanuele Agolini, Federica Galaverna, Angela Mastronuzzi, Daria Pagliara, Maria Antonietta De Ioris
Journal: Front Immunol (2022)
Keywords: lrba deficiency, rosai-dorfman’s disease, autoimmunity, neonatal diabetes, primary immunodeficiencies
MeSH terms: Arthritis, Histiocytosis, Sinus / diagnosis, Histiocytosis, Sinus / genetics, Histiocytosis, Sinus / pathology, Lymphadenopathy, Case Reports, Adaptor Proteins, Signal Transducing, Humans, LRBA protein, human, Adaptor Proteins, Signal Transducing

We reported a new pathogenic variant of LRBA deficiency with a complex phenotype-neonatal diabetes, very early-onset inflammatory bowel disease, and polyarthritis-who presented with lymph node enlargement. A case of Rosai-Dorfman's disease (RDD) was confirmed. The occurrence of an RDD lesion in LRBA-deficiency has never been reported so far.