OpenMed/multicare-articles huggingface dataset:
A Case of Lyme Carditis Presenting with Atrial Fibrillation
Authors: Peter J Kennel, Melvin Parasram, Daniel Lu, Diane Zisa, Samuel Chung, Samuel Freedman, Katherine Knorr, Timothy Donahoe, Steven M Markowitz, Hadi Halazun
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

We report a case of a 20-year-old man who presented to our institution with a new arrhythmia on a routine EKG. Serial EKG tracings revealed various abnormal rhythms such as episodes of atrial fibrillation, profound first degree AV block, and type I second degree AV block. He was found to have positive serologies for Borrelia burgdorferi. After initiation of antibiotic therapy, the atrial arrhythmias and AV block resolved. Here, we present a case of Lyme carditis presenting with atrial fibrillation, a highly unusual presentation of Lyme carditis.
Bilateral recurrent discloation of the patella associated with below knee amputation: a case report
Authors: Sumit Batra, Ratnesh Kumar, Prasanna Lenka
Journal: BMC Musculoskelet Disord (2005)
MeSH terms: Amputation, Surgical / adverse effects, Joint Dislocations / etiology, Joint Dislocations / prevention & control, Leg / surgery, Orthotic Devices, Patella, Case Reports, Adult, Amputation, Surgical / methods, Equipment Design, Humans, Male, Recurrence, Shoes, Walking

Background:
Recurrent dislocation of the patella in patients with below knee amputation is a known entity. Abnormally high-riding patella (patella alta) and medial patellofemoral ligament insufficiency in these patients predisposes them to patellar instability. The established treatment of this problem is surgical realignment.
Case presentation:
A 25 year old male patient with bilateral below knee amputation presented with bilateral recurrent dislocation of the patella while walking on knees on uneven ground. Clinical and radiographic studies showed patella alta. A simple shoe modification was used to treat this patient.
Conclusions:
A simple shoe modification can be used to treat such a condition which is otherwise treated surgically.
LIMITED JOINT MOBILITY IN A CHILD WITH TYPE 1 DIABETES MELLITUS
Authors: Mohammad H Al-Qahtani, Fai A AlQahtani
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Chronic uncontrolled type 1 diabetes mellitus (type 1DM) is a very major risk for chronic systemic complications; specifically, the microvascular and macrovascular ones. Limited joint mobility (LJM) is a rare disease that complicates all types of diabetes and might indicate the high-risk odd for the diabetic patients to develop microvascular complications. We are reporting a 13-year-old female child with chronic uncontrolled type 1DM presenting with full blown clinical picture of bilateral hand LJM associated with significant growth failure yet has no clinical or biochemical evidence of microvascular complications. Literature research studies have emphasized the rarity of this manifestation in pediatric type 1 diabetic patients; however, it is an important clue and warning sign for microvascular complication occurrence in these patients.
Case report: gastric carcinoma diagnosed at the second trimester of pregnancy
Authors: Tayfur Cift, Begüm Aydogan, Murat Akbaş, Burcu Aydın, Fuat Demirkiran, Dogu V Bakkaloglu, Sennur Ilvan
Journal: Case Rep Obstet Gynecol (2011)
MeSH terms: Case Reports

We report a rare case of gastric cancer in pregnancy. A 26-year-old woman presented at the 20th week of pregnancy complaining of nausea and vomiting. Although the patient considered the condition to be related with pregnancy and underestimated its importance, her complaints persisted over the following weeks and she was hospitalized for investigation. The diagnostic workup revealed a metastatic gastric cancer. Gastric cancer is very rare in pregnancy, and therefore it may be left out of differential diagnosis by physicians. Diagnosis may be further delayed because of overlapping symptoms occurring during normal pregnancy (nausea, vomiting, and fatigue). All these factors may contribute to a very high mortality of this malignancy during pregnancy.
Autoimmune Encephalitis With Multiple Auto-Antibodies With Concomitant Human Herpesvirus-7 and Ovarian Teratoma: A Case Report
Authors: Jianhua Yang, Pengcheng Wu, Xianghong Liu, Han Xia, Zhaohui Lai
Journal: Front Med (Lausanne) (2022)
Keywords: anti-n-methyl-d-aspartate receptor (nmdar) encephalitis, autoimmune encephalitis, human herpes virus 7, paraneoplastic syndrome, post viral encephalitis autoimmune encephalitis, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (ampar) encephalitis
MeSH terms: Case Reports

Infectious etiologies and tumors are common triggers of autoimmune encephalitis. We herein reported a rare case of autoimmune encephalitis with multiple autoantibodies in cerebrospinal fluid (CSF) and serum, with concomitant human herpesvirus 7 (HHV-7) infection and ovarian teratoma. A 36-year-old woman presented with mental and behavioral changes and gibberish for 13 days, followed by fever for 1 day. Her brain MRI indicated limbic encephalitis. Metagenomic next-generation sequencing (mNGS) of CSF revealed HHV-7. Antibody testing showed positive anti-N-methyl-D-aspartate receptor (NMDAR) and anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) antibodies in CSF and serum. Ovarian teratoma was considered after pelvic MRI, which was then pathologically confirmed after laparoscopic ovariectomy. Her conditions improved after laparoscopic surgery, intravenous steroids, immunoglobulin, and rituximab therapy. Our findings suggested that the combination of multiple therapies including antiviral, immunotherapy, and resection of tumors were appropriate and improved the prognosis, when HHV-7 infection and ovarian teratoma were concomitant with multiple anti-neuronal antibodies of autoimmune encephalitis.
Metastasis of Breast Lobular Carcinoma to Endometrium Presenting as Recurrent Abnormal Uterine Bleeding: A Case Report and Review of Literature
Authors: Rodolfo Franco-Márquez, Adrián Gerardo Torres-Gaytán, Marcela Anahí Narro-Martinez, Anahí Carrasco-Chapa, Benjamín Gómez Núñez, Estefanía Boland-Rodriguez
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

There are few reports of breast cancer cases with uterine metastases. Here, we report a metastatic lobular carcinoma to endometrium presenting as abnormal uterine bleeding. Diagnosis was based in previous lobular breast carcinoma and immunohistochemistry.
Generalized aggressive periodontitis and its treatment options: case reports and review of the literature
Authors: T Roshna, K Nandakumar
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Generalized aggressive periodontitis results in rapid destruction of the periodontium and can lead to early tooth loss in the affected individuals if not diagnosed early and treated appropriately. The diagnostic features of the disease are characteristic, but the clinical presentation and patterns of destructions may vary between patients. Successful management of the disease is challenging especially if diagnosed at advanced stages of the disease, but not impossible with the current therapeutic choices for the disease. A vast array of treatment modalities is available which can be employed in the treatment of generalized aggressive periodontitis with varying success rates, but a definite guideline for the management is yet to be formulated. However, with the exponential rate of developments in periodontal research, regenerative therapy, tissue engineering, and genetic technologies, the future seems promising in regard to options at managing the disease. This paper attempts to describe the clinical and radiographic diagnostic features and the current treatment options along with a suggested protocol for comprehensive management of generalized aggressive periodontitis patients with case reports and a brief review.
Oculopharyngeal muscular dystrophy as a rare differential diagnosis for unexplained dysphagia: a case report
Authors: Klaus Bumm, Martin Zenker, Alessandro Bozzato
Journal: Cases J (2009)

Introduction:
We wish to report on a rare cause of dysphagia; oculopharyngeal muscular dystrophy (OPMD). It is a late adult onset autosomal dominant form of muscular dystrophy that constitutes as a rare diagnosis for any place outside of Canada and first case in southern Germany.
Case presentation:
We report the medical odyssey of a 57-year old male Caucasian patient. He was referred at our hospital for further clarification of a progressive dysphagia, which, at first view, was thought to be tumor related due to the patient's typical anamnesis.
Conclusion:
The present report outlines the importance of considering this rare disease for general medicine practitioners as well as head and neck specialists as a differential diagnosis for swallowing disorders with, even at second view, uncertain cause.
Case Report of a Massive Thigh Hematoma after Adductor Canal Block in a Morbidly Obese Woman Anticoagulated with Apixaban
Authors: Katherine L Koniuch, Bradley Harris, Michael J Buys, Adam W Meier
Journal: Case Rep Anesthesiol (2018)
MeSH terms: Case Reports

Hematoma formation after peripheral nerve block placement is a rare event. We report a case of a morbidly obese patient who was anticoagulated with apixaban and developed a massive thigh hematoma after an ultrasound-guided adductor canal block. Despite continuous visualization of the block needle, an unrecognized vascular injury occurred leading to a 14-cm hematoma in the anterolateral thigh. Morbid obesity warrants additional risk consideration when placing nerve blocks in an anticoagulated patient. In addition, early recognition and expert consultation are both important in the management of block-related hematomas.
Asymmetrical weakness associated with central nervous system involvement in a patient with guillain-barrè syndrome
Authors: Takao Kiriyama, Makito Hirano, Susumu Kusunoki, Daiji Morita, Minako Hirakawa, Yasuyo Tonomura, Takanori Kitauchi, Satoshi Ueno
Journal: Clin Med Case Rep (2009)
Keywords: cns, gbs, guillain-barrè syndrome, asymmetrical weakness, central nervous system, symmetrical weakness
MeSH terms: Case Reports

Guillain-Barrè syndrome (GBS) is usually associated with symmetrical weakness, and therefore asymmetrical weakness may confuse diagnosis. We report on a patient with GBS subsequent to Campylobacter jejuni enteritis who had asymmetrical weakness with CNS involvement. The patient tested positive for anti-ganglioside antibodies, including anti-GM1 IgM, anti-GD1b IgG, and anti-GT1a IgG. Patients with GBS can manifest asymmetrical signs and symptoms attributable to CNS involvement. Prompt, accurate diagnosis and treatment of post-C. jejuni GBS is especially important because its prognosis is relatively poor.
Case report: Cardiac metastatic leiomyoma in an Asian female
Authors: Juan Li, Hong Zhu, Shuang-Ye Hu, Shang-Qing Ren, Xing-Lan Li
Journal: Front Surg (2022)
Keywords: case report, heart, metastasizing leiomyoma, outcome, surgery
MeSH terms: Case Reports

Background:
Uterine leiomyomas are the most common gynecological tumors in women of child-bearing age and premenopausal women, while benign metastasizing leiomyomas of the heart are rare.
Case presentation:
We report a rare case of metastasizing leiomyoma in the heart of a 54-year-old woman 10 years after a uterine leiomyoma was discovered during hysterectomy. Echocardiography, cardiac plain scan and enhanced MRI at presentation showed a soft tissue signal mass in the right ventricle. A large cardiac mass attached to the chordae of the tricuspid valve and later shown to be histopathologically consistent with uterine leiomyoma was successfully resected through a right atriotomy.
Conclusions:
Our case report highlights a rare type of tumor of the heart and suggests that metastasizing leiomyoma should be considered in the differential diagnosis of right-sided cardiac tumors. The complete surgical resection of the tumor was considered to be the best treatment.
Anti-glomerular basement membrane disease with intense nephrotic syndrome: a new case report
Authors: Ikram Mami, Emna Ghzel, Rym Abida, Fadwa Hlaoui, Hela Jebali, Lamia Rais, Soumaya Beji, Fethi Ben Hamida, Lilia Ben Fatma, Karim Zouaghi
Journal: Pan Afr Med J (2021)
Keywords: anti-glomerular, basement membrane disease, case report, nephrotic syndrome, proteinuria
MeSH terms: Anti-Glomerular Basement Membrane Disease / diagnosis, Nephrotic Syndrome / diagnosis, Case Reports, Adult, Anti-Glomerular Basement Membrane Disease / complications, Autoantibodies / immunology, Biopsy, Humans, Immunoglobulin G / immunology, Male, Nephrotic Syndrome / etiology, Proteinuria / etiology, Autoantibodies, Immunoglobulin G, antiglomerular basement membrane antibody

Anti-glomerular basement membrane (anti-GBM) disease was usually described as a small vessel vasculitis presenting with acute kidney injury, haematuria and non-nephrotic proteinuria. We report a case of anti-GBM disease revealed by an intense nephrotic syndrome. The urinary protein level was 12g/day. Renal biopsy only showed crescent glomerulonephritis with linear staining of IgG in direct immunofluorescence without other glomerulonephritis. Immunoglobulin G (IgG) anti-GBM antibody titer was elevated.
Case report: Surgical strategies of a giant thrombus from the ascending aorta to the arch
Authors: Guanhua Li, Yingzhen Chen, Haikuo Wang, Yanping Liu, Hangyu Liu, He Sun, Zhiping Wang
Journal: Front Cardiovasc Med (2023)
Keywords: aortic arch, ascending aorta, deep hypothermic circulatory arrest, surgical strategies, thrombus
MeSH terms: Case Reports

Large mural thrombi in the relatively normal ascending aorta are extremely uncommon conditions that may lead to major adverse cardiovascular events due to new embolism. Because of their changeable variations, the management of these unstable thrombi is challenging and controversial. The size, morphology, location, embolic involvement, and patients' conditions are all crucial for therapeutic decision-making. Treatment options include anticoagulation, thrombolysis, surgical thrombectomy, and endovascular stenting. Therefore, surgical strategies should be highly individualized. Herein, we present a rare case of a huge thrombus from the ascending aorta to the arch in a 43-year-old man. Considering the high risks of catastrophic embolic events, surgical removal of the aortic mass, thromboendarterectomy, and reconstruction of the arterial wall were performed with a satisfactory outcome. This report illustrates our experience of surgical strategies and perioperative treatments for this challenging case, and contemporary surgical management for mural thrombi in the ascending aorta was also thoroughly discussed.
Isoproterenol Induced Insulin Resistance Leading to Diabetic Ketoacidosis in Type 1 Diabetes Mellitus
Authors: Ryan Hoff, Chung-Kay Koh
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Isoproterenol is known to cause insulin resistance and is often used to treat bradyarrhythmias from atrioventricular block. We report a case of isoproterenol induced diabetic ketoacidosis in a 77-year-old female patient treated with isoproterenol for atrioventricular block prior to insertion of permanent pacemaker. Diabetic ketoacidosis (DKA) developed within hours of starting an isoproterenol drip, and there were no other precipitating factors at that time. DKA resolved quickly after discontinuing isoproterenol and starting insulin drip. DKA is a common complication of diabetes mellitus, with about 140,000 hospital admissions for DKA in 2009. While the rate of DKA has increased by nearly 50% between 1988 and 2009, the rate of mortality has decreased. There are many causes of diabetic ketoacidosis, such as medication noncompliance, infection, pancreatitis, stroke, myocardial infarction, and many others. Isoproterenol may lead to diabetic ketoacidosis by increasing insulin resistance.
Identification of a novel deletion in the MMAA gene in two Iranian siblings with vitamin B12-responsive methylmalonic acidemia
Authors: Fatemeh Keyfi, Mohammad Reza Abbaszadegan, Arndt Rolfs, Slobodanka Orolicki, Morteza Moghaddassian, Abdolreza Varasteh
Journal: Cell Mol Biol Lett (2016)
Keywords: biochemical analysis, cobalamin, mmaa gene, methylmalonic acidemia, mutation analysis, novel deletion, structural analysis, vitamin b12
MeSH terms: Amino Acid Metabolism, Inborn Errors / enzymology, Frameshift Mutation, INDEL Mutation, Mitochondrial Membrane Transport Proteins / genetics, Case Reports, Amino Acid Metabolism, Inborn Errors / genetics, Base Sequence, Child, Preschool, Female, Humans, Infant, Iran, Male, Mitochondrial Membrane Transport Proteins / metabolism, Pedigree, Protein Structure, Tertiary, Siblings, Vitamin B 12, MMAA protein, human, Mitochondrial Membrane Transport Proteins, Vitamin B 12, Methylmalonic acidemia

Background:
Adenosylcobalamin (vitamin B12) is a coenzyme required for the activity of methylmalonyl-CoA mutase. Defects in this enzyme are a cause of methylmalonic acidemia (MMA). Methylmalonic acidemia, cblA type, is an inborn error of vitamin B12 metabolism that occurs due to mutations in the MMAA gene. MMAA encodes the enzyme which is involved in translocation of cobalamin into the mitochondria.
Methods:
One family with two MMA-affected children, one unaffected child, and their parents were studied. The two affected children were diagnosed by urine organic acid analysis using gas chromatography-mass spectrometry. MMAA was analyzed by PCR and sequencing of its coding region.
Results:
A homozygous deletion in exon 4 of MMAA, c.674delA, was found in both affected children. This deletion causes a nucleotide frame shift resulting in a change from asparagine to methionine at amino acid 225 (p.N225M) and a truncated protein which loses the ArgK conserved domain site. mRNA expression analysis of MMAA confirmed these results.
Conclusion:
We demonstrate that the deletion in exon 4 of the MMAA gene (c.674 delA) is a pathogenic allele via a nucleotide frame shift resulting in a stop codon and termination of protein synthesis 38 nucleotides (12 amino acids) downstream of the deletion.
Preoperative angiographic considerations and neurological outcome after surgical treatment of intradural spinal hemangioblastoma: a multicenter retrospective case series
Authors: Vicki M Butenschoen, Maximilian Schwendner, Vanessa Hubertus, Julia Onken, Nikolaus Koegl, Theresa Mohme, Stefanie Maurer, Tobias Boeckh-Behrens, Sven O Eicker, Claudius Thomé, Peter Vajkoczy, Marcus Czabanka, Bernhard Meyer, Maria Wostrack
Journal: J Neurooncol (2023)
Keywords: embolization, neurological outcome, spinal hemangioblastoma, vascularization
MeSH terms: Hemangioblastoma / diagnostic imaging, Hemangioblastoma / surgery, Spinal Cord Neoplasms / diagnostic imaging, Spinal Cord Neoplasms / surgery, Multicenter Study, Angiography, Humans, Neurosurgical Procedures, Retrospective Studies, Treatment Outcome

Purpose:
Intradural spinal hemangioblastomas are rare highly hypervascularized benign neoplasms. Surgical resection remains the treatment of choice, with a significant risk of postoperative neurological deterioration. Due to the tumor infrequency, scientific evidence is scarce and limited to case reports and small case series.
Methods:
We performed a retrospective multicenter study including five high-volume neurosurgical centers analyzing patients surgically treated for spinal hemangioblastomas between 2006 and 2021. We assessed clinical status, surgical data, preoperative angiograms, and embolization when available. Follow-up records were analyzed, and logistic regression performed to assess possible risk factors for neurological deterioration.
Results:
We included 60 patients in Germany and Austria. Preoperative angiography was performed in 30% of the cases; 10% of the patients underwent preoperative embolization. Posterior tumor location and presence of a syrinx favored gross total tumor resection (93.8% vs. 83.3% and 97.1% vs. 84%). Preoperative embolization was not associated with postoperative worsening. The clinical outcome revealed a transient postoperative neurological deterioration in 38.3%, depending on symptom duration and preoperative modified McCormick grading, but patients recovered in most cases until follow-up.
Conclusion:
Spinal hemangioblastoma patients significantly benefit from early surgical treatment with only transient postoperative deterioration and complete recovery until follow-up. The performance of preoperative angiograms remains subject to center disparities.
The Vanishing Stenosis: ST Elevation Myocardial Infarction and Rhythm Disturbance due to Coronary Artery Spasm-Case Report and Review of the Literature
Authors: J Gosai, C J Malkin, E D Grech
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

A 62-year-old lady was admitted with clinical and electrocardiograph features of acute myocardial infarction. Urgent coronary arteriography was performed, demonstrating a single discrete stenosis of one coronary artery. Following intracoronary injection of GTN, this stenosis completely resolved, as the symptoms did. The causes of acute myocardial infarction with normal coronary arteries are reviewed.
Delayed Presentation of Air Embolism Within Cerebral Arteries Following Computed Tomography-Guided Lung Biopsy
Authors: Cunli Yang, Shao J Ong, Stanley E Loh, Gopinathan Anil
Journal: Cureus (2023)
Keywords: acute ischaemic stroke, ct guided biopsy, hyperbaric oxygen therapy (hbot), iatrogenic complication, interventional radiology, lung biopsy, metastatic cancer of unknown primary, thoracic radiology, vascular air embolism
MeSH terms: Case Reports

Computed tomography (CT)-guided percutaneous core needle biopsy of the lung is a frequently performed interventional radiological procedure. Most complications are minor and self-resolving. However, a rare but potentially fatal complication is that of systemic air embolism, especially when to the cerebral or coronary arteries. This study reports a case of delayed (12 hours after initial biopsy) air embolism in the cerebral arteries that resulted from an otherwise uncomplicated biopsy of a lung nodule. It is vital for early diagnostic confirmation and appropriate treatment if possible, though maximal efforts at prevention are still recommended.
Case Report of a New Headache Developed by a Combat Soldier after an Episode of Exertional Heat Illness
Authors: Haggai Schermann, Mikhail Sherman, Ran Rutenberg
Journal: Front Neurol (2017)
Keywords: headache, headache disorders, heat stroke, hyperthermia, military personnel, secondary
MeSH terms: Case Reports

Only a few authors have reported about a new-onset headache among patients who sustained an episode of an exertional heat illness (EHI). This report presents a healthy and physically fit 20-year-old male who developed a completely new headache after an EHI event. The new headache could be aggravated or called by exertion or exposure to sun and environmental heat. It was severe enough to interfere with even moderate physical activity, but reacted well to a few hours' rest and OTC pain medications. An extensive work-up including laboratory blood tests, lumbar puncture, head CT, and CT angiogram was negative. The patient remained symptomatic on the 6-month follow-up. Continued abstinence from physical activity and waiting for spontaneous resolution were recommended. We suggest that the headache may be secondary to the hyperthermia brain damage during the EHI event and differs from exertional headache by its association with exposure to sun and environmental heat.