OpenMed/multicare-articles huggingface dataset:
Idiopathic gastric fundus necrosis: Case report about a rare and fatal clinical condition
Authors: Valeria Tognoni, Carlo Gazia, Anton Mariani Ivanikhin, Cristine Pathirannehalage Don, Dario Venditti
Journal: Int J Surg Case Rep (2020)
Keywords: acute gastric dilatation, case report, gastric fundus ischemia, gastric surgery, necrosis, stomach
MeSH terms: Case Reports

Introduction:
Gastric fundus ischemia is a rare event, which does not account for many significant clinical studies. This disorder could have different etiologies, but authors agree that a prompt diagnosis and a proper treatment could avoid dangerous complications and ultimately the death of the patient.
Presentation of case:
We herein report an interesting idiopathic case of acute gastric dilatation and fundus ischemia of an 83-year-old Caucasic woman who was admitted to the Emergency Department complaining of abdominal discomfort, vomiting and constipation.
Discussion:
In literature, only a few case reports about this condition are reported. Possible risk factors, etiologies, and the different therapeutic options available for this condition are examined, in order to try to favor clinicians to formulate a timely diagnosis and provide patients with rapid healthcare services.
Conclusion:
Further investigations are still needed to analyze the pathophysiological pathways responsible of gastric fundus ischemia and to provide a definitive treatment to this dangerous disorder.
Case report: Acute ST-elevation myocardial infarction and cardiogenic shock caused by a giant right sinus of Valsalva aneurysm and right coronary artery compression
Authors: Lianyue Ma, Jianmin Yang, Yan Liu, Fang Wang, Tongtao Liu, Ying Wang, Hourong Sun, Cheng Zhang, Yun Zhang
Journal: Front Cardiovasc Med (2022)
Keywords: acute myocardial infarction, case report, computed tomography angiography, echocardiography, right coronary artery compression, sinus of valsalva aneurysm
MeSH terms: Case Reports

A sinus of Valsalva aneurysm (SVA) is a rare aortic disease that may be congenital or acquired. Patients with an intact SVA are usually asymptomatic, whereas a ruptured SVA may cause acute chest pain and dyspnea. We present a rare case of acute ST-elevation myocardial infarction and cardiogenic shock in a 51-year-old man. Emergency coronary angiography revealed a giant aneurysm with an absence of flow in the right coronary artery. Both two-dimensional echocardiography and computed tomography angiography showed a giant right SVA, which ruptured into the pericardial sac and led to extrinsic compression of the right coronary artery. Surgical repair combined with coronary bypass grafting was performed. Unfortunately, the patient died from low cardiac output syndrome and postoperative multiple organ failure. This case highlights that the possibility of SVA rupture should be considered in acute myocardial infarction cases and that echocardiography and coronary computed tomography angiography are important in providing an accurate and rapid SVA diagnosis.
Case report: Idiopathic subglottic stenosis in a girl; successful treatment with macrolides
Authors: Wolfgang Tebbe, Helmut Wittkowski, Johannes Tebbe, Georg Hülskamp
Journal: Front Pediatr (2022)
Keywords: child, idiopathic subglottic stenosis, macrolide, review, therapy
MeSH terms: Case Reports

An 8-year-old girl presented with treatment-refractory cough and inspiratory stridor. Bronchoscopies showed progressive scarring leading to narrowing of the proximal trachea (Myer-Cotton Grade 2) and epithelial metaplasia of the tracheal and bronchial mucosa. After excluding other causes of congenital and acquired tracheal stenosis, an idiopathic subglottic tracheal stenosis (iSGS) was diagnosed. Because of the patient's young age, a judicious therapeutic approach seemed appropriate. Therapy with azithromycin, followed by roxithromycin, was started. Symptoms almost completely subsided, spirometry normalized, and endoscopic and histologic findings improved considerably. Therapy has been continued for more than 3 years with normal lung function values, and no compromise on physical activities and development. In instances of iSGS, therapy with macrolides is worth considering before more invasive procedures such as dilatation, laser, intralesional injections, or surgical resection are performed.
Two Cases of Successful Treatment With Hachimijiogan for Irregular Menstruation
Authors: Tatsuji Hirabayashi
Journal: Front Nutr (2020)
Keywords: hachimijiogan, kampo prescription medication, case report, crude drug preparation, irregular menstruation
MeSH terms: Case Reports

Hachimijiogan (HJG), a Kampo prescription medication composed of eight crude drugs, has been used for treatment of climacteric disturbance and irregular menstruation. In the Japanese pharmaceutical market, HJG pills consisting of a powdered mixture of these crude drugs are available, as well as a water extract preparation. In this study, two cases of successful treatment with HJG pills are reported. Case 1 was a 37-years-old woman who had irregular menstruation that had previously been treated with HJG extract granules for 3 months; however, her symptoms were not improved. Subsequent treatment with HJG pills at a dose of 40 pills/day for 10 months led to slight improvement of her menstrual cycle, and at a dose of 60 pills/day, her menstrual cycle was normalized. Case 2 was a 29-years-old woman who had irregular menstruation for more than 5 years and was previously treated with HJG extract granules, which led to slight improvement of her symptoms. Her menstrual cycle improved slightly after 9-months treatment with HJG pills at a dose of 40 pills/day and was normalized at a dose of 60 pills/day. This study suggests that the HJG crude drug preparation is more effective than the HJG extract preparation in some cases.
Postanesthetic Severe Oral Angioedema in Patient's Taking Angiotensin-Converting Enzyme Inhibitor
Authors: Acílio Marques, Carla Retroz-Marques, Sara Mota, Raquel Cabral, Matos Campos
Journal: Case Rep Anesthesiol (2014)

Angiotensin-converting enzyme (ACE) inhibitors are the leading cause of a drug-induced angioedema. This occurrence is frequently underdiagnosed, but its relapse can be life-threatening. The authors' intention in reporting this clinical case is to sound a warning about reviewing attitudes and surveillance to try to improve patient perioperative safety.
An Adolescent with Transient Hyperthyroxinemia after Blunt Trauma to Head and Neck
Authors: Michelle Romijn, Leo M G Geeraedts Jr, Jonathan I M L Verbeke, Martijn J J Finken
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Background:
Thyroid storm is a well-known complication of surgical procedures in the lower neck, but is rare after a blunt neck trauma. The cases described previously have mainly focussed on adults with pre-existent thyroid disease. In this case report, we describe the disease course of a previously healthy adolescent who had asymptomatic hyperthyroxinemia after a blunt trauma of the jaw and neck. Case Presentation. A 17-year-old girl presented at our emergency department after she fell on her head while roller blading. On physical examination, among other injuries, she had a swelling in the lower neck, which appeared to involve the thyroid gland. Subsequent laboratory analysis was indicative of primary hyperthyroxinemia, with a free T4 of 59 pmol/L (reference range: 12-22) and a TSH of 0.46 mU/L (reference range: 0.5-4.3), but the patient had no symptoms fitting with this. Four weeks after the initial presentation, the patient reported only complaints regarding tenderness in the jaw and neck region. She was no longer hyperthyroidic on biochemical evaluation (with a free T4 level of 15.6 pmol/L and a TSH level of 0.33 mU/L), and antibodies against thyroid peroxidase or TSH receptor were not present.
Conclusions:
This case might indicate that hyperthyroxinemia following a neck trauma may go unnoticed if hyperthyroid symptoms are mild or absent and thyroid function tests are not performed.
An unusual case report of erupted odontoma
Authors: Dhaval Mehta, Nilesh Raval, Sneha Udhani, Viral Parekh, Chintan Modi
Journal: Case Rep Dent (2013)

Odontomas are the most common of the odontogenic tumors of the jaws, which are benign, slow growing, and nonaggressive. They are usually asymptomatic and found in routine dental radiographic examination. Odontomas are usually associated with tooth eruption disturbances. Eruption of odontoma in oral cavity is rare entity. Here we report a case of an unusual erupted compound odontoma.
Therapeutic implications of intratumor heterogeneity for TP53 mutational status in Burkitt lymphoma
Authors: Enrico Derenzini, Ilaria Iacobucci, Claudio Agostinelli, Enrica Imbrogno, Clelia Tiziana Storlazzi, Alberto L Abbate, Beatrice Casadei, Anna Ferrari, Andrea Ghelli Luserna Di Rora, Giovanni Martinelli, Stefano Pileri, Pier Luigi Zinzani
Journal: Exp Hematol Oncol (2015)
Keywords: burkitt lymphoma, chk1, genomic instability, intra-tumor heterogeneity, myc, γ-h2ax
MeSH terms: Case Reports

Therapeutic implications of intra-tumor heterogeneity are still undefined. In this study we report a genetic and functional analysis aimed at defining the mechanisms of chemoresistance in a 43-year old woman affected by stage IVB Burkitt lymphoma with bulky abdominal masses and peritoneal effusion. The patient, despite a transient initial response to chemotherapy with reduction of the bulky masses, rapidly progressed and died of her disease. Targeted TP53 sequencing found that the bulky mass was wild-type whereas peritoneal fluid cells harbored a R282W mutation. Functional studies on TP53 mutant cells demonstrated an impaired p53-mediated response, resistance to ex vivo doxorubicin administration, overexpression of DNA damage response (DDR) activation markers and high sensitivity to pharmacologic DDR inhibition. These findings suggest that intra-tumor heterogeneity for TP53 mutational status may occur in MYC-driven cancers, and that DDR inhibitors could be effective in targeting hidden TP53 mutant clones in tumors characterized by genomic instability and prone to intra-tumor heterogeneity.
Priapism in a Child from Homocystinuria from Methylenetetrahydrofolate Reductase MTHFR (C677T) Mutation
Authors: Ameer Kakaje, Ammar Fadel, Osama Hosam Aldeen, Othman Hamdan
Journal: Case Rep Urol (2023)
MeSH terms: Case Reports

Priapism is a prolonged involuntary erection that can have severe complications if left untreated. Ischaemic priapism is very rare in children and requires urgent intervention to prevent permanent erectile dysfunction and penile shortening. It can be caused by ischaemia in sickle cell anaemia, leukaemia, trauma, drugs, or idiopathy. Homocystinuria is a rare autosomal recessive disorder that can cause hyperhomocysteinemia and hypercoagulability. Very few reports suggested that priapism can be caused by hyperhomocysteinemia, and they were in adults. However, we present the first of such a case to the best of our knowledge of a prepubescent child who only had the MTHFR (C677T) mutation that causes homocystinuria and had ischaemic priapism. A nine-year-old Syrian Arab boy was presented with priapism that lasted for a few hours. Blood tests show normal blood count, film, and haemoglobin electrophoresis. However, prothrombin time, partial thromboplastin time, homocysteine level, and C-reactive protein were elevated. Other coagulation tests were within the normal range. Doppler ultrasonography found decreased cavernous blood flow, and warm 0.9% saline lavage of the cavernosa was indicated and successfully treated the priapism. Genetic testing for the homozygous MTHFR (C677T) mutation was later confirmed, and warfarin was indicated. In conclusion, homocystinuria is very rare in priapism, and this is the first case to report this phenomenon in a child. Ultrasonography in low-income countries is an essential tool that helps identify a wide variety of medical conditions such as priapism and can be successfully managed by aspiration with warm saline.
EBV Infection in XLP1 Manifested Solely by Behavioral Aggression and Effective Treatment Using Rituximab
Authors: Michelle M Korah-Sedgwick, Luke A Wall
Journal: Case Reports Immunol (2018)
MeSH terms: Case Reports

Patients with X-linked lymphoproliferative disease 1 (XLP1) are exquisitely susceptible to Epstein-Barr virus (EBV), with the first EBV infection often resulting in rapid death. In a manner not previously described, a 5-year-old patient with XLP1 presented solely with behavioral aggression, with no laboratory evidence of organ dysfunction or inflammation. Although EBV-IgM was negative, PCR confirmed the presence of EBV in both the blood and cerebrospinal fluid. MRI of the brain showed frontal lobe foci. After failure to eradicate his viremia with ganciclovir, rituximab was administered. EBV was eradicated from the blood after the second rituximab infusion and remained absent for 5 months, at which time he underwent hematopoietic stem cell transplant. Although EBV classically produces fulminant infection in patients with XLP1, this case demonstrates that EBV infection may be initially subtle. Acute change in behavior should prompt evaluation. This case also demonstrates the possible effectiveness of rituximab in the treatment of acute EBV infection.
Right Ventricular Perforation From a Floating Rib Following Deep Sternal Wound Infection Debridement and Application of a Vacuum-Assisted Closure Device: A Case Report and Literature Review
Authors: Amanda J Ross, Nada N Berry
Journal: Eplasty (2017)
Keywords: debridement, infection, sternal wound, vacuum-assisted closure, ventricular perforation

Introduction: Deep sternal wound infection following major cardiac surgery is a deleterious complication with sequelae that can be life threatening. The use of vacuum-assisted closure therapy in management of sternal wounds with resultant right ventricular rupture has been documented in the cardiothoracic and to a lesser extent in the reconstructive literature. Methods/Case Report: We present a case of a 67-year-old male patient who suffered from right ventricular perforation from a floating rib following debridement of a deep sternal wound infection and placement of a vacuum-assisted closure device. Results: Despite meticulous debridement and ensuring the release of all retrosternal adhesions, massive bleeding was encountered shortly after application of the vacuum-assisted closure device. Fortunately, quick identification of the complication and the application of direct manual pressure allowed for swift return to the operating room for repair of the defect. The patient secondarily underwent definitive closure of the mediastinal wound with an omental flap and bilateral pectoral advancement flaps. Discussion: Following the conclusion of this article, the reconstructive surgeon should be able to (1) identify patients at risk for ventricular perforation, (2) exhaust all means intraoperatively to prevent cardiac perforation when using vacuum-assisted closure therapy, (3) comprehend the physiology associated with vacuum-assisted closure use in this patient population, (4) have protocols in place for the management of patients with deep sternal wound infection with vacuum-assisted closure therapy postoperatively, and (5) understand basic tenets of ventricular rupture treatment should this occur to ensure prompt repair and survival.
Endovascular treatment of a pulmonary artery pseudoaneurysm caused by Swan-Ganz catheter deployment in an anticoagulated patient
Authors: A M Ierardi, G Xhepa, A M Musazzi, M De Chiara, C Beghi, G Carrafiello
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

We present a case report of an anticoagulated 78-year old man presenting a pulmonary artery pseudoaneurysm following Swan-Ganz catheter deployment after an aortic valve and aortic root replacement. Diagnosis was established by cone beam CT angiography and catheter angiographyand embolisation was achieved via a combination of plug and glue. This case emphasises the importance of endovascular techniques in the management of iatrogenic pulmonary pseudoaneurysms and shows the benefit of using highly hemostatic polymeric agent in anticoagulated patients to obtain a rapid and effective occlusion.
Orthodontic, Maxillofacial Surgery, and Prosthodontic Rehabilitation Supported by Miniscrew in a Patient with Cleft Lip and Palate
Authors: Alberto De Stefani, Giovanni Bruno, Martina Barone, Antonio Gracco
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Aim. This paper is aimed at reporting the clinical case of a patient with cleft lip and palate treated with a multidisciplinary approach. Case Report. An 11-year-old patient presented cleft lip and palate, with persistent oronasal communication, tooth displacement, and upper and lower crowding with a deep curve of Spee. He was treated with metal bracket orthodontic therapy, graft surgery, and prosthetic rehabilitation supported by miniscrews. Conclusions. Cleft lip and/or palate patients require adequate management of the case to resolve the anomalies connected to their condition and to improve their quality of life.
Case report: MOG-IgG-associated encephalitis with Epstein-Barr virus infection and Alzheimer's pathologic change in cerebrospinal fluid
Authors: Lin Li, Chuan Li, Dan Yao, Yun-Feng Hao, Chao Zhao, Qi Yan, Jun-Tong Liu, Shu-Yu Liu, Wen-Ping Zhu, Ying Du, Wei Zhang
Journal: Front Neurol (2022)
Keywords: alzheimer's disease, epstein-barr virus, mog-igg associated encephalitis, cerebrospinal fluid biomarkers, rituximab
MeSH terms: Case Reports

Immunoglobulin G antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) associated disease is a rare, demyelinated disease in the central nerve system (CNS) predominately involving optic nerve, spinal cord, and brain leading to optic neuritis (ON), transverse myelitis (TM), encephalitis. The phenotype of MOG-IgG-associated encephalitis is similar to acute disseminated encephalomyelitis (ADEM) presenting with seizures, abnormal behavioral and psychological symptoms, and cognitive impairment. A few brain biopsies show multiple sclerosis (MS) pattern histopathology with T cells, macrophages, and complement activation. To date, how MOG-IgG is produced is unknown. Herein, we report a case of a 32-year-old male with MOG-IgG-associated encephalitis presenting MOG-IgG in cerebrospinal fluid (CSF) but seronegative, as well as Epstein-Barr virus (EBV) infection and Alzheimer's pathologic change in CSF (Aβ42 = 317 pg/ml, T-Tau = 538 pg/ml, p-Tau =10.09 pg/ml). With a combination treatment of administering intravenous immunoglobulin (0.4 mg/kg/d, 5 days) with a low dose of methylprednisolone (80 mg/d, 5 days) and rituximab (100 mg/week, 3 weeks), the patient recovered significantly after 3 months follow-up. This case provides us with new thoughts into the production of MOG-IgG and the possible pathologic mechanism of MOG-IgG-associated disease (MOG-AD) and simultaneously further confirms the interaction between EBV and changes of CSF biomarkers of Alzheimer's disease (AD).
A Rare Presentation of Extraosseous Ewing Sarcoma Manifesting as a Dumbbell Tumor on the Nape of the Neck
Authors: Abrar A AlAtwan, Mousa Behbehani, Ali Sayed Ali
Journal: Case Rep Surg (2022)
MeSH terms: Case Reports

Ewing sarcoma is a rare poorly differentiated and highly malignant tumor primarily affecting the skeletal system. It most commonly presents during the first two decades of life and rarely might it be of extraskeletal origin. Majority of extraskeletal cases are reported in the paravertebral and lower limb, with very few cases reported in the cervical spine region. We report a case of extraskeletal Ewing sarcoma in a 42-year-old man who presented with a 1-year history of neck swelling associated with neck pain, diagnosed by computed tomography and magnetic resonance imaging scans, in conjunction with histological analysis. Very few cases of cervical EES presenting as dumbbell tumors have been documented in the literature especially in this age group.
Dapsone induced hemolysis in a patient with ANCA associated glomerulonephritis and normal G6PD level and implications for clinical practice: case report and review of the literature
Authors: Scott M Lee, Duvuru Geetha
Journal: Springerplus (2015)

Dapsone is a commonly used second line drug for prophylaxis of pneumocystis jirovecii pneumonia (PJP) in immunocompromised patients. Oxidant hemolysis, caused by dapsone's metabolite hydroxylamine, is a common side effect, and screening for glucose-6-phosphate dehydrogenase (G6PD) deficiency is recommended before the drug is started in order to prevent potential hemolytic reactions. We report a case of dapsone induced hemolytic anemia in a patient with ANCA associated glomerulonephritis and normal G6PD level. Her anemia improved after cessation of therapy with dapsone. We review the literature of dapsone induced hemolysis in patients who have normal G6PD level and discuss potential pathways leading to hemolytic anemia and its implications for clinical practice.
Treatment of Recurrent Primary Cutaneous Mucinous Carcinoma of the Eyelid with Modified Wide Local Excision
Authors: Stephanie M Tillit, Siva S R Iyer, Eric J Grieser, John T LiVecchi
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Primary cutaneous mucinous carcinoma (PCMC) is a rare, low-grade malignant neoplasm of the sweat gland, whose history has been controversial regarding eccrine versus apocrine origin. This case report describes a 53-year-old male who presented to the University of Florida, Gainesville, ophthalmology clinic and was referred to the oculoplastics service with a painless, subcentimeter mass on the lateral right upper eyelid including the canthus, consistent with recurrent primary cutaneous mucinous carcinoma of the eyelid. Four years prior, the patient had undergone excisional biopsy of the lesion in a clinic, which revealed residual tumor, but the patient deferred further surgery at the time. The patient underwent surgical excision of the mass with reconstruction without operative complications and with negative surgical margins. PCMC is difficult to diagnose clinically due to its rarity and requires a histopathological examination for confirmation of the diagnosis. This report presents the first case in the literature of primary cutaneous mucinous carcinoma in a patient with human immunodeficiency virus (HIV). With this case report, we aim to raise awareness of primary cutaneous mucinous carcinoma as a potential part of the differential diagnosis for malignant eyelid lesions, including those present in patients with HIV.
Case Report: Application of Thoracoscopic Clamp Radiofrequency Ablation on Atrial Tachycardia Originating From Right Atrial Appendage After Catheter Ablation Failure
Authors: Li Luo, Zuoan Qin, Ruizheng Shi, Liangqing Ge
Journal: Front Cardiovasc Med (2021)
Keywords: atrial tachycardia, catheter ablation, radiofrequency ablation, right atrial appendage, tachycardia cardiomyopathy
MeSH terms: Case Reports

Atrial tachycardia originating from the right atrial appendage has a higher probability of failure of catheter ablation. Here we report a case of a 13-year-old boy with incessant tachycardia, complicated by heart enlargement, and heart failure. Electrophysiological examination showed that atrial tachycardia (AT) originated from the apex of the right atrial appendage, and endocardial catheter ablation was ineffective. After thoracoscopic approach, the right atrial appendage was successfully ablated with bipolar radiofrequency ablation forceps, atrial tachycardia was terminated and sinus rhythm was restored. Within 3 months since the patient was discharged from the hospital, no arrhythmia occurred and the heart structure returned to normal. Thus, thoracoscopic clamp radiofrequency ablation may be a reasonable choice for young patients with atrial tachycardia originated from the right atrial appendage when transendocardial ablation is not effective.