OpenMed/multicare-articles huggingface dataset:
Case Report: Macrophage Activation Syndrome and Widespread Neuroimaging Abnormality in Childhood-Onset Systemic Lupus Erythematosus
Authors: Nana Shi, Xiangying Wang, Lixia Zou, Xinghui Yang, Qian Ma, Meiping Lu
Journal: Front Pediatr (2021)
Keywords: central nervous system, macrophage activation syndrome, neuroimaging, pediatric, systemic lupus erythematosus
MeSH terms: Case Reports

Macrophage activation syndrome (MAS) and widespread brain lesions are rare and severe complications of childhood-onset systemic lupus erythematosus (SLE). We report an 11-year-old girl who presented with recurrent rashes for half a year and fever for 2 weeks. Clinical and laboratory features at admission pointed to the diagnosis of SLE and SLE-associated MAS. Cerebral magnetic resonance imaging taken on day 4 after admission showed abnormal signals. Glucocorticoid therapy was started on day 5. Two days later, the patient appeared weak and ill, then the next day she exhibited dizziness, drowsiness, apathia, and dysarthria. High-dose methylprednisolone, cyclophosphamide, and intravenous immunoglobulin were used to treat the patient, and intrathecal dexamethasone was given. The patient was discharged on day 30 after admission and showed complete clinical resolution and improved magnetic resonance imaging resolution.
Necrotizing fasciitis as a rare complication of osteonecrosis of the jaw in a patient with multiple myeloma treated with lenalidomide: case report and review of the literature
Authors: Patrizia Mondello, Vincenzo Pitini, Carmela Arrigo, Stefania Mondello, Michael Mian, Giuseppe Altavilla
Journal: Springerplus (2014)
Keywords: bronj, bisphosphonate, lenalidomide, multiple myeloma, necrotizing fasciitis

Bisphosphonates (BPs), potent inhibitors of osteoclast-mediated bone resorption, play a major role in the management of patients with multiple myeloma (MM). However, in the case of dental infections, they can lead to bisphosphonate related osteonecrosis of the jaw (BRONJ). This process can be worsened by concomitant antineoplastic therapy. Herein, we present a case of a life-threatening necrotizing fasciitis (NF) as a rare and severe complication of BRONJ after three cycles of lenalidomide and dexamethasone in an MM patient treated with corticosteroid therapy and Ibandronate for 5 years. The patient presented swelling on the right part of the neck, difficulty in swallowing and acute pain, so a magnetic resonance of the head and neck region was performed. It revealed the presence of an NF with a massive extension. Due to the large necrotic area and a rapid progression of the infection, the necrotic tissue had to be removed surgically. Furthermore, a specific antimicrobial treatment as well as 12 sessions of hyperbaric oxygen therapy were needed to cure the patient. Herein, we highlight the potential serious adverse events associated with the use of bisphosphonates and antiangiogenetic drugs in patients with MM. Future studies are needed to evaluate the potential synergistic effects of BPs, corticosteroids and antiangiogenetic drugs.
Alport's Syndrome in Pregnancy
Authors: Suchita Mehta, Chadi Saifan, Marie Abdellah, Rita Choueiry, Rabih Nasr, Suzanne El-Sayegh
Journal: Case Rep Med (2013)

Background. Alport's syndrome is an X-linked hereditary disorder affecting the glomerular basement membrane associated with ocular and hearing defects. In women, the disease is much less severe compared to that in men. However, women with Alport's syndrome can have an accelerated form of their disease during pregnancy with worsening of kidney function and can also develop preeclampsia. There are only four described cases of Alport's syndrome in pregnancy. Case Presentation. 20-year-old woman with a history of Alport's syndrome, which during pregnancy worsened resulting in hypertension, proteinuria, and acute kidney injury. Fortunately, there was complete resolution of the proteinuria and kidney injury with delivery, and the patient did not require any renal replacement therapy. Conclusion. One of the four reported cases had an accelerated form of the disease during pregnancy with rapid progression of kidney injury and end-stage renal disease. There are no definite guidelines to monitor these patients during pregnancy. Further studies are required to understand the exact pathophysiology of kidney damage that occurs in pregnant women with Alport's syndrome. This may give us some insight into the prognostic predictors, so that we can monitor these women more thoroughly and prevent adverse outcomes.
Allografting for Bosutinib, Imatinib, Nilotinib, Dasatinib, and Interferon Resistant Chronic Myeloid Leukemia without ABL Kinase Mutation
Authors: B Uz, O Bektas, E Eliacık, H Goker, Y Erbilgin, M Sayitoglu, N Sayinalp, S Aksu, Y Buyukasik, O Ozcebe, I C Haznedaroglu
Journal: Case Rep Hematol (2011)
MeSH terms: Case Reports

The current treatment of chronic phase chronic myeloid leukemia (CML) consists of oral tyrosine kinase inhibitors (TKIs). However, high-risk CML may present with an aggressive course which may result in blastic crisis or a "difficult-to-manage" state with available treatments. The aim of this paper is to report a patient with complicated CML resistant to treatment and progressed despite the administration of bosutinib, imatinib mesylate, nilotinib, dasatinib, interferon alpha 2a, cytotoxic chemotherapy, and allogeneic hematopoietic stem cell transplantation. The striking point of this case story is that no Abl kinase domain mutation against TKIs has been detected during this very complicated disease course of CML. Meanwhile, challenging cases will always be present despite the hope and progress in CML in the TKI era.
Takayasu's Arteritis in Pregnancy: A Rare Case Report from a Tertiary Care Infirmary in India
Authors: Sheeba Marwah, Monika Rajput, Ritin Mohindra, Harsha S Gaikwad, Manjula Sharma, Sonam R Topden
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Background. Takayasu's arteritis (TA) is a rare, chronic, inflammatory, progressive, idiopathic arteriopathy, afflicting young women of reproductive age group, causing narrowing, occlusion, and aneurysms of systemic and pulmonary arteries, especially the aorta and its branches. During pregnancy, such patients warrant special attention. An interdisciplinary collaboration of obstetricians, cardiologists, and neurologists is necessary to improve maternal and fetal prognosis. Here a case is reported where a patient with diagnosis of TA, complicated by neurological sequelae, successfully fought the vagaries of the condition twice to deliver uneventfully. Case. 25-year-old G2P1L1 presented at 34 weeks of gestation, with chronic hypertension, with TA, with epilepsy, and with late-onset severe IUGR. Following a multidisciplinary approach, she delivered an alive born low birth weight baby (following induction). Her postpartum course remained uneventful. Conclusion. Pregnancy with TA poses a stringent challenge to an obstetrician. Despite advancements in cardiovascular management and advent of new-fangled drugs, the optimal management for pregnant patients with this disease still remains elusive.
Primary Appendiceal Adenocarcinoma Presenting with Hematochezia due to the Invading Tumor in the Sigmoid Colon
Authors: Tatsuya Suzuki, Yasuhiro Yamamoto, Toshihiko Torigoe, Shoichiro Mizukami, Kengo Shigehara
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Primary appendiceal tumors are rare malignancies; some cases have been described to invade other organs, and this represents a very rare clinical condition. We report a case of appendiceal adenocarcinoma invading the sigmoid colon and a review of similar cases. A 69-year-old woman with complaints of hematochezia was admitted to the hospital. Colonoscopy revealed a tumor in the sigmoid colon, which was a well-differentiated tubular adenocarcinoma. A computed tomography scan showed an appendiceal mass that involved the sigmoid colon, suggesting an appendiceal cancer invading the sigmoid colon. Ileocecal resection with extended lymphadenectomy and en bloc resection of the sigmoid colon was performed. The appendiceal tumor involved the sigmoid colon and the terminal ileum. The ileocecal part which included the tumor and the involved sigmoid colon was resected in total. Macroscopic findings showed that the appendiceal tumor made a fistula with the sigmoid colon. Pathological examination revealed that the tumor was a well-differentiated tubular adenocarcinoma that invaded the sigmoid colon. The final pathological stage was T4bN0M0, stage IIC. The patient was discharged from the hospital uneventfully. She was alive without relapse after a 20-month follow-up. Although an appendiceal tumor invading the rectosigmoid region is rare, a preoperative diagnosis can be obtained that facilitates the planning of a suitable surgical procedure: en bloc resection of the ileocecal part and the rectosigmoid part.
Yellow papules: the iceberg of systemic elastorrhexis
Authors: Asmae Elhatimi, Amal Elbakkal, Soraya Iguermia, Maryame Meziane, Ouafae Mikou, Fatima Zahra Mernissi
Journal: Pan Afr Med J (2013)
Keywords: gronblad-strandberg-touraine, systemic elastorrhexis, pseudoxanthoma elasticum
MeSH terms: Pseudoxanthoma Elasticum / pathology, Case Reports, Humans, Male, Middle Aged

Systemic elastorrhexis is a multisystem genetic disorder characterised by dystrophic mineralization of soft connective tissues in a number of organs, including the skin, the eyes and the arterial blood vessels. Although the eye and skin findings have for years attracted the attention of ophthalmologists and dermatologists, the systemic nature of the disorder has not received sufficient attention among internists and many patients with this disorder have undoubtedly been unrecognized. We reported a case of systemic elastorrhexis redressing the diagnosis of vascular leucoencephalopathy of an unknown aetiology for many years.
Acute-on-Chronic Subdural Hemorrhage Due to Late Vitamin K Deficiency
Authors: Niraj K Choudhary, Jeevesh Mallik, Kumar Diwakar
Journal: Cureus (2023)
Keywords: bleeding disorder, breastfed, craniotomy, intracranial bleed, newborn
MeSH terms: Case Reports

Vitamin K deficiency bleeding (VKDB) is closely associated with the hemorrhagic disease of the newborn (HDN) and can have a late onset, after one week of birth up to six months of age. It is a major concern in developing countries where vitamin K prophylaxis is not often given to newborns and can lead to significant mortality and morbidity. We report a case of a three-month-old child who was exclusively breastfed. He presented with repeated vomiting and was eventually diagnosed as a case of acute-on-chronic subdural hemorrhage. Timely diagnosis and surgical intervention played a key role in ensuring a favorable outcome for the child.
Neuroendocrine neoplasm with metastasis to the thyroid: a case report and literature review
Authors: Yu Zhang, Bei Lin, Kai-Ning Lu, Yue-Ping Teng, Tian-Han Zhou, Jia-Yang Da, Fan Wu, Gang Pan, Ding-Cun Luo
Journal: Front Oncol (2023)
Keywords: fna, neoplasm metastasis, neuroendocrine tumor, rectal cancer, thyroid gland
MeSH terms: Case Reports

Thyroid cancer can be divided into two types according to its cellular origin, i.e., malignant tumors originating from thyroid cells and cancers that metastasize to the thyroid from other sites, the latter of which are, clinically rare. This article reports the diagnosis and treatment of a rectal neuroendocrine neoplasm metastasis to the thyroid. No similar cases have been reported before. This case suggests that when evaluating thyroid tumors, clinicians should not only carefully identify the clinical features of the tumor but also pay special attention to the patient's history of tumors, especially neuroendocrine neoplasms. For definite secondary thyroid malignancies, neck surgery is feasible if the thyroid is the only site of metastasis; otherwise, the subsequent diagnosis and treatment plan should be determined after a comprehensive evaluation of the primary tumor and patient's general condition.
Application of Indocyanine Green During Arteriovenous Malformation Surgery: Evidence, Techniques, and Practical Pearls
Authors: Chase H Foster, Peter J Morone, Samuel B Tomlinson, Aaron A Cohen-Gadol
Journal: Front Surg (2019)
Keywords: avm, fluorescence, indocyanine green, neurosurgery, resection, videoangiography
MeSH terms: Review

Indocyanine green (ICG) is a fluorescent molecule that enables visualization of hemodynamic flow through blood vessels. The first description of its application to the resection of arteriovenous malformations (AVMs) did not occur until 2007. Since then, industry leaders have rapidly integrated this optical technology into the intraoperative microscope, and the use of ICG videoangiography (VA) has since become routine in AVM surgery among some academic centers. A number of case series have been published since the introduction of ICG VA to AVM neurosurgery. These early reports with small sample sizes were largely qualitative, assigning to the technology "usefulness" and "benefit" scores as perceived by the operators. This lack of objectivity prompted the development of FLOW 800 software, a proprietary technology of Carl Zeiss Meditec AG (Oberkochen, Germany) that can quantify relative fluorescence intensity under the microscope to generate color maps and intensity curves for ad hoc and post hoc analyses, respectively. However, subsequent case series have done little to quantify the effect of ICG VA on outcomes. The available literature predominately concludes that ICG VA, although intuitive to deploy and interpret, is limited by its dependence on direct illumination and visualization. The subcortical components of AVMs represent a natural challenge to ICG-based flow analysis, and the scope of ICG VA has therefore been limited to AVMs with a high proportion of superficial angioarchitecture. As a result, digital subtraction angiography has remained the gold standard for confirming AVM obliteration. In this review, we provide an overview of the existing literature on ICG VA in AVM resection surgery. In addition, we describe our own experiences with ICG VA and AVMs and offer the senior author's surgical pearls for optimizing the marriage of fluorescence flow technology and AVM resection surgery.
Leptospirosis: An Unusual Cause of ARDS
Authors: Marc Clavel, Gwenaelle Lhéritier, Nicolas Weinbreck, Antoine Guerlin, Anthony Dugard, Eric Denes, Philippe Vignon
Journal: Crit Care Res Pract (2010)
MeSH terms: Case Reports

Severe leptospirosis usually associates shock, jaundice, renal failure, and thrombocytopenia. Massive hemoptysis due to diffuse alveolar haemorrhage may rarely occur leading to an acute respiratory failure and multiple organ failure. We present the case of an acute respiratory distress syndrome caused by a severe leptospirosis. The severity of the respiratory failure contrasted with the absence of significant liver or renal dysfunction. Bedside open lung biopsy was only consistent with a postinfectious BOOP. The diagnosis was retrospective when the niece of the patient presented with similar inaugural symptoms ten days later after being scratched by a wild rat which was considered by our patient as a pet.
Epithelial-myoepithelial parotid carcinoma after kidney transplantation
Authors: R Horta, F Barreto, M Marques, M Rebelo, J C Reis, J M Lopes, J M Amarante
Journal: Ecancermedicalscience (2008)
MeSH terms: Case Reports

The occurrence of a second malignant neoplasm (SMN) in patients who have been submitted to kidney transplantation is increasing and causes concern; parotid carcinoma is rarely reported after transplantation and may be related to long-term chemotherapy.Salivary gland carcinomas displaying exclusively myoepithelial differentiation-myoepithelial carcinomas (EMC) are rare, being less than 1% of all salivary gland tumours. EMC arises most commonly in the parotid gland and usually occurs in women. Their histopathologic features, immunohistochemical profile and clinical behaviour remain controversial.
Deconstructing Dissections: A Case Report and Review of Blunt Cerebrovascular Injury of the Neck
Authors: Brittany A Walsh, W Douglas Gregorie, Jessica S Whittle
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

Blunt cerebrovascular injury (BCVI) is a term encompassing traumatic carotid and vertebral artery dissection or disruption. While the reported incidence appears to be increasing as diagnostic modalities improve, these injuries are often diagnosed only after patients have developed acute neurologic symptoms. These injuries often result in severe permanent neurologic disability or death. The gold standard for diagnosis has historically been a 4-vessel arteriogram. However, newer data are suggesting that computed tomographic angiography may be more appropriate for most patients and new criteria for its utilization have been developed. We report a case of bilateral carotid dissection in a 23-year-old woman involved in a motor vehicle collision (MVC). She initially presents with a normal neurologic exam and two hours later develops hemiparesis. She is treated with antiplatelet therapy and given intravascular catheter directed tissue plasminogen activator with carotid stent placement. Nonetheless, the patient goes on to require intubation and, ultimately, a tracheostomy and transfer to an inpatient rehabilitation setting due to continued hemiparesis. This case highlights the need for increased awareness of a potentially debilitating, life-threatening disease process. A high index of suspicion is required among emergency medicine physicians for early diagnosis and treatment of trauma patients with BCVI.
Elderly onset of MELAS in a male: A case report
Authors: Sheng-Peng Diao, Song-Fa Chen, Ai-Qun Liu, Zhi-Hua Zhou, Zhong-Xing Peng, Ming-Fan Hong
Journal: Front Neurol (2022)
Keywords: melas, magnetic resonance angiography (mra), magnetic resonance imaging (mri), migraine, stroke-like episodes
MeSH terms: Case Reports

Background:
Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) is one of the most common maternally inherited mitochondrial diseases which rarely affects elderly people.
Case presentation:
We reported the case of a 61-year-old male patient with MELAS. He was experiencing acute migraine-like headaches as the first symptoms. Laboratory data showed elevated lactate and creatine kinase levels. Brain magnetic resonance imaging (MRI) found a high signal intensity lesion in the left occipital-temporal-parietal lobe on diffusion-weighted imaging (DWI). Magnetic resonance angiography (MRA) revealed reversible vasoconstriction of the middle cerebral arteries and superficial temporal arteries. A muscle biopsy suggested minor muscle damage. A genetic study revealed a mitochondrial DNA A3243G mutation.
Conclusion:
Elderly onset of MELAS is rare and easily misdiagnosed as an ischemic stroke. MELAS with the onset of stroke-like episodes should be considered in adult or elderly patients with imaging findings that are atypical for cerebral infarction. The use of multimodal MRI in the clinical diagnosis of MELAS could be extremely beneficial.
Dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release: technical innovation and case study
Authors: Chien-Hua Chen, Fu-Shan Jaw, Jia-Zhen Hu, Wei-Ting Wu, Ke-Vin Chang
Journal: Heliyon (2023)
Keywords: cts, carpal tunnel syndrome, carpal tunnel syndrome, median nerve, sonography, surgery, ultrasound
MeSH terms: Case Reports

Background:
Minimally invasive carpal tunnel release has recently emerged as the primary surgical approach for recalcitrant carpal tunnel syndrome. A major concern related to surgical failure with this technique is the incomplete release of the flexor retinaculum.
Case presentation:
We developed a technique using dynamic ultrasound for evaluating the adequacy of median nerve decompression following minimally invasive carpal tunnel release. This novel imaging method was applied to two patients who showed significant symptom relief after the intervention. This case study also provides details of the dynamic ultrasound protocol and highlights the advantages of this technique.
Conclusion:
Dynamic ultrasound imaging can be used to confirm the completeness of carpal tunnel decompression. A large-scale prospective trial should be conducted to validate whether additional dynamic ultrasound examination can improve the outcome of minimally invasive carpal tunnel release.
Rapid Glomerulotubular Nephritis as an Initial Presentation of a Lethal Diquat Ingestion
Authors: Daniel Guck, Reynaldo Hernandez, Steven Moore, Andry Van de Louw, Philippe Haouzi
Journal: Case Rep Nephrol (2021)
MeSH terms: Case Reports

Introduction:
Diquat is an herbicide that can lead to rapid multiorgan system failure upon toxic ingestion. Although Diquat shares a similar chemical structure with paraquat, diquat is still readily available to the general population, and in contrast to paraquat, it is not regulated. We present a case of an intentional diquat poisoning which emphasizes the necessity of the early recognition due to atypical symptoms within the first 24 hours and certainly enhanced regulatory restrictions on this very toxic compound.
Case:
A 60-year-old male with a history of severe depression presented to the emergency department after intentional ingestion of a commercial herbicide containing diquat dibromide 2.30%. The earliest manifestations of this acute diquat intoxication comprised a glomerulonephritis and proximal tubular dysfunction. Progressive multiorgan system failure then developed with a significant delay (24-38 hours) including acute renal, liver failure, and then respiratory failure with refractory hypoxemia. Despite maximal supportive care, the end organ failure was lethal. Discussion. Diquat intoxication should be suspected in patient presenting an acute glomerulonephritis with coma. Diquat should undergo the same regulatory restrictions as paraquat-containing compounds.
Septic arthritis of the hip, an unreported complication of perforated appendicitis: A case report
Authors: Mahnoor Zia, Nima Maghami
Journal: Int J Surg Case Rep (2020)
Keywords: appendicitis, arthrocentesis, arthropathy, case report, interval appendectomy, septic arthritis
MeSH terms: Case Reports

Introduction:
Progression of inflammation in acute appendicitis can lead to appendiceal perforation, which is associated with higher morbidity and mortality. Bacteremia due to a perforated appendicitis can lead to distal bacterial seeding, resulting in further complications.
Presentation of case:
We present here a case of appendiceal perforation in a 32-year-old previously healthy male. Patient was conservatively managed with intravenous (IV) antibiotics and was discharged on hospitalization day-6. Prior to scheduled interval appendectomy, he developed right sided hip pain with decreased range of motion. Computed tomography (CT) scan with contrast showed right hip abscess and enlarged pelvic lymph nodes. Arthrocentesis yielded purulent fluid with leukocytosis (84.8 k/CMM) and neutrophilia (89%). Patient underwent emergent incision and drainage of the hip abscess followed with 42-days of IV antibiotics for septic arthritis.
Conclusion:
This case presents a unique occurrence of a complication from appendiceal perforation in patients who are initially managed non-operatively. Clinicians should be mindful of rare complications associated with non-operative management of appendicitis.
Two Case Reports on Thalamic and Basal Ganglia Involvement in Children with Dengue Fever
Authors: Guwani Liyanage, Lihini Adhikari, Saraji Wijesekera, Maheshaka Wijayawardena, Suchithra Chandrasiri
Journal: Case Rep Infect Dis (2016)

There have been increasing numbers of case reports of dengue infection with unusual manifestations. Such unusual manifestations including acute liver failure and encephalopathy could be manifested even in the absence of significant plasma leakage. Further, severe organ involvement including nervous system involvement indicates severe dengue infection. However, neurological manifestations of dengue fever are rare. This is the first case report of dengue infection with thalamic and basal ganglia involvement in Sri Lanka.