OpenMed/multicare-articles huggingface dataset:
Post-Transplant Thrombotic Microangiopathy due to a Pathogenic Mutation in Complement Factor I in a Patient With Membranous Nephropathy: Case Report and Review of Literature
Authors: Maryam Saleem, Sana Shaikh, Zheng Hu, Nicola Pozzi, Anuja Java
Journal: Front Immunol (2022)
Keywords: atypical hemolytic uremic syndrome, complement factor i, complement functional analysis, kidney transplantation, membranous nephropathy, thrombotic microangiopathy
MeSH terms: Atypical Hemolytic Uremic Syndrome / diagnosis, Atypical Hemolytic Uremic Syndrome / drug therapy, Atypical Hemolytic Uremic Syndrome / genetics, Glomerulonephritis, Membranous / genetics, Thrombotic Microangiopathies / genetics, Case Reports, Review, Research Support, Non-U.S. Gov't, Complement Factor I / genetics, Complement System Proteins / genetics, Humans, Mutation, Complement System Proteins, Complement Factor I

Thrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia, thrombocytopenia and organ injury occurring due to endothelial cell damage and microthrombi formation in small vessels. TMA is primary when a genetic or acquired defect is identified, as in atypical hemolytic uremic syndrome (aHUS) or secondary when occurring in the context of another disease process such as infection, autoimmune disease, malignancy or drugs. Differentiating between a primary complement-mediated process and one triggered by secondary factors is critical to initiate timely treatment but can be challenging for clinicians, especially after a kidney transplant due to presence of multiple confounding factors. Similarly, primary membranous nephropathy is an immune-mediated glomerular disease associated with circulating autoantibodies (directed against the M-type phospholipase A2 receptor (PLA2R) in 70% cases) while secondary membranous nephropathy is associated with infections, drugs, cancer, or other autoimmune diseases. Complement activation has also been proposed as a possible mechanism in the etiopathogenesis of primary membranous nephropathy; however, despite complement being a potentially common link, aHUS and primary membranous nephropathy have not been reported together. Herein we describe a case of aHUS due to a pathogenic mutation in complement factor I that developed after a kidney transplant in a patient with an underlying diagnosis of PLA2R antibody associated-membranous nephropathy. We highlight how a systematic and comprehensive analysis helped to define the etiology of aHUS, establish mechanism of disease, and facilitated timely treatment with eculizumab that led to recovery of his kidney function. Nonetheless, ongoing anti-complement therapy did not prevent recurrence of membranous nephropathy in the allograft. To our knowledge, this is the first report of a patient with primary membranous nephropathy and aHUS after a kidney transplant.
Intramuscular (Infiltrating) Lipoma of the Floor of the Mouth
Authors: Ben-Zion Joshua, Lipa Bodner, Ruthy Shaco-Levy
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Lipoma is a very common soft tissue neoplasm, but only infrequently found in the oral region. Intramuscular lipoma (IML) is a relatively common variant of lipoma. The most common site for IML is the large muscles of the extremities, and it is quite rare in the oral cavity. A case of IML affecting the floor of the mouth/tongue of a 42-year-old female is described. The patient presented with a 4 cm diameter yellow mass in the right side of the sublingual area. Axial and coronal magnetic resonance imaging demonstrated its infiltrating nature that can be distinguished from the ordinary well-encapsulated lesion. The lesion was excised with adequate surgical margins. Histopathologically, the lesion was composed of mature adipose tissue that infiltrated the muscle in a diffuse manner. No lipoblasts, atypical cells, or high mitotic index were found. There was no evidence of recurrence two years postoperatively. Review of the literature yielded that IML occurring in the sublingual region is extremely rare.
Malignant Diffuse-Type Tenosynovial Giant Cell Tumor in the Subcutaneous Tissue of the Midthigh: A Report of a Rare Tumor in an Unusual Location
Authors: Omar Salem, Khalid Kurdi, Amani Joudeh, Ahmad Al-Dhafiri, Zahra Alkhunaizi, Emad Al Absi
Journal: Case Rep Orthop (2022)
MeSH terms: Case Reports

Malignant TS-GCT is an extremely rare and aggressive tumor with only few cases published in the literature, due to the small number of cases is not completely understood and is diagnostically challenging. Although surgical treatment is the primary treatment modality, there is no consensus regarding adjuvant treatment. Regardless of mode of treatment, the tumor still caries unfavorable prognosis. In this paper, we reviewed the literature for cases of malignant TS-GCT. We also would like to present an additional case of malignant TS-GCT that was found in an unusual location in subcutaneous tissue of the midthigh.
Signet-ring cell carcinoma arising in the gastric stump after duodenopancreatectomy for ductal adenocarcinoma of the pancreas: a case report
Authors: Woubet T Kassahun, Peter Lamesch, Christian Wittekind, Matthias Neid, Jens P Schneider, Joachim Mössner, Johann Hauss
Journal: Clin Med Oncol (2008)
Keywords: gastric stump carcinoma, pancreatic carcinoma, peptic ulcer disease
MeSH terms: Case Reports

The development of malignancy in the gastric stump following surgery for peptic ulcer disease is well recognized. There are also few reports on carcinomas occurring after surgery for malignant gastric disease. However, carcinoma of the gastric stump after duodenopancreatectomy is extremely rare. We describe what we believe to be an unusual case of signet-ring cell carcinoma of the gastric stump developing at the anastomotic site 5 years after duodenopancreatectomy for ductal adenocarcinoma of the pancreatic head. We performed remnant gastrectomy and Roux-en-Y gastrojejunostomy as a curative resection. This experience clearly underlies that g astric stump carcinoma (GSC) may mimic metastatic disease recurrence leading to diagnostic confusion after surgery for malignancy. Although an increased risk of gastric stump carcinoma after pancreatoduodenectomy for pancreatic cancer has not been established, the possibility of such a complication should be kept in mind when evaluating patients after gastric resection who present with symptoms of metastatic disease recurrence years after the primary operation. Investigations should be independent of the entity of the primary disease or its localization, since GSC may well be amenable to surgical cure as demonstrated in the presented case. Outpatient follow up results of the last four years indicated no recurrence in this case.
Disseminated cryptococcosis and hepatitis C virus infection: A fatal co-infection
Authors: Ranjana Rohilla, Suneeta Meena, Neelam Kaistha, Anusha Krishna Raj, Pratima Gupta
Journal: Curr Med Mycol (2019)
Keywords: cryptococcosis, hepatitis c virus, matrix-assisted laser desorption ionization- time of flight mass spectrometry
MeSH terms: Case Reports

Background and purpose:
We report a case of disseminated cryptococcosis in a treatment-naïve patient, incidentally diagnosed with hepatitis C virus (HCV) infection and renal parenchymal disease. The patient succumbed to death given the very late diagnosis of the disease.
Case report:
A 54-year-old male presented with the chief complaints of abdominal pain, chest pain, and phlegmy cough for a month. There was a past history of decreased urine output, lower limb swelling, and fever lasting for 15-20 days. After a general physical examination, the differential diagnosis of hepatitis C-related liver disease with hepatic encephalopathy, disseminated tuberculosis, and septic shock was made. Radiological examination revealed renal parenchymal disease on ultrasound abdomen and opacity with reticulonodular opacity in the bilateral lung zones. In laboratory investigations, serum reactive sample was tested for anti-HCV antibodies. In addition, Cryptococcus var grubii was identified in blood culture using the matrix-assisted laser desorption ionization-time of flight mass spectrometry (Bruker Daltonics, Germany). The patient succumbed to death before the initiation of any specific antifungal therapy.
Conclusion:
Cryptococcosis-HCV co-infection is a fatal condition with a fulminant course that might be difficult to treat.
Anesthetic Management of a Voluminous Left Atrial Myxoma Resection in a 19 Weeks Pregnant with Atypical Clinical Presentation
Authors: Alexandros Alexis, Pierre Origer, Jean-Pierre Hacquebard, Didier De Cannière, Olivier Germay, Jean-Luc Vandenbossche, Yota Kapessidou
Journal: Case Rep Anesthesiol (2019)
MeSH terms: Case Reports

We report the case of a semi-urgent cardiac surgery, in a 19 gestation age pregnant. Despite the fact that the patient was asymptomatic, except for some palpitations, a large left auricle (LA) myxoma was fortuitously diagnosed with transthoracic echocardiography (TEE). Considering the important embolic risk, the tumor was successfully removed during cardiac surgery under cardiopulmonary bypass (CPB). Fetal bradycardia following defibrillation under stable maternal and CPB conditions was successfully managed. The postoperative period and remainder of the pregnancy was smooth and the delivery uneventful.
Myositis ossificans progressive: case report
Authors: Sofia Talbi, Nassira Aradoini, Iman El Mezouar, Fatima Ezzahra Abourazzak, Taoufik Harzy
Journal: Pan Afr Med J (2016)
Keywords: myositis ossificans progressive, ectopic bone, ossification
MeSH terms: Myositis Ossificans / diagnosis, Thigh / pathology, Case Reports, Adult, Female, Humans, Myositis Ossificans / diagnostic imaging, Myositis Ossificans / pathology

Myositis ossificans progressiva (MOP) is an autosomal dominant disorder. There is a progressive ectopic ossification and skeletal malformation, mainly in the connective tissue of muscle. The diagnosis is based on the clinical findings and radiological demonstration of the skeletal malformations. A 38-year-old female patient was admitted to our department with progressive increase of the thigh. Results of laboratory studies were normal. The radiography of the right thigh showed multiple intramuscular calcifications. Myositis ossificans progressiva should be diagnosed as early as possible and non-invasively, based upon history, clinical and radiological findings. Early and correct diagnosis is fundamental for indication of proper management of the disease.
Q Fever Endocarditis in Northeast Iran
Authors: Ali Akbar Heydari, Ehsan Mostafavi, Masoumeh Heidari, Mina Latifian, Saber Esmaeili
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

This report presents a case of chronic Q fever endocarditis. A 60-year-old male farmer and rancher was admitted to the hospital with symptoms of weight loss, fever, severe sweating, weakness, and anorexia. PCR was negative for C. burnetii in the blood sample, but phase I and II IgG antibodies against C. burnetii were positive (1 : 16384 and 1 : 2048, respectively) by the indirect immunofluorescent assay (IFA). According to the adjusted Duke criteria, Q fever endocarditis was confirmed, and the patient was successfully treated with doxycycline and hydroxychloroquine.
Case Report: Adult Onset Still's Disease after vaccination against Covid-19
Authors: Ujjwol Risal, Anup Subedee, Raju Pangeni, Rakshya Pandey, Suravi Pandey, Sudeep Adhikari, Buddha Basnyat
Journal: Wellcome Open Res (2022)
Keywords: aosd, covid-19 vaccination
MeSH terms: Case Reports

Vaccination against the virus responsible for COVID-19 has become key in preventing mortality and morbidity related to the infection. Studies have shown that the benefits of vaccination outweigh the risks. However, there are concerns regarding serious adverse events of some vaccines, although they are fortunately rare. Here, we report a case of a 47-year-old female from Kathmandu who presented with high grade fever, dry cough and erythematous rash a week after exposure to the Oxford-AstraZeneca vaccine. She had hepatosplenomegaly, persistent leucocytosis, anaemia and thrombocytosis along with markedly raised inflammatory markers. Her tests for infectious causes and haematological malignancies were negative and she showed no response to multiple antibiotics. Finally, she had a dramatic response to steroids with disappearance of fever and normalization of other laboratory parameters. Hence, she was diagnosed with Adult-onset Still's Disease (AOSD). She was under methotrexate and prednisolone tapering dose and doing well as of the time of writing. The trigger for the disease was hypothesized to be the vaccine because of the strong temporal association.
Compartment syndrome of the hand: beware of innocuous radius fractures
Authors: Francesco Maria Egro, Matthew Robert Frederick Jaring, Asif Zafar Khan
Journal: Eplasty (2014)
Keywords: compartment syndrome, complication, hand, injury, radius fracture
MeSH terms: Case Reports

Objective:
Describe an unusual presentation of compartment syndrome of the hand.
Methods:
An unusual and severe case of compartment syndrome of the hand occurred in a 68-year-old woman following an innocuous distal radius fracture and ulnar styloid avulsion fracture.
Results:
The patient required surgical decompression and amputation of the index, middle, ring, and little fingers.
Conclusions:
This article highlights the importance of clinical suspicion toward postinjury compartment syndrome even if a fracture is not adjacent to the compartment itself and no clear vascular disruption is present.
Early detection of widespread progressive brain injury after cardiac arrest: a single case DTI and post-mortem histology study
Authors: Jan S Gerdes, Ernst U Walther, Suad Jaganjac, Maria Makrigeorgi-Butera, Sven G Meuth, Michael Deppe
Journal: PLoS One (2014)
MeSH terms: Brain Injuries / diagnosis, Brain Injuries / pathology, Diffusion Tensor Imaging, Disease Progression, Heart Arrest / complications, Case Reports, Adult, Aged, Autopsy, Brain Injuries / complications, Early Diagnosis, Humans, Male, Middle Aged

Objective:
We tested the hypothesis in sense of a proof of principle that white matter (WM) degeneration after cardiopulmonary arrest (CPA) can be assessed much earlier by diffusion tensor imaging (DTI) than by conventional MRI.
Methods:
We performed DTI and T2-weighted FLAIR imaging over four serial acquisitions of a 76-year-old man with unresponsive wakefulness syndrome at day 41, 75, 173 and 284 after CPA. DTI was also performed in ten healthy control subjects. Fractional anisotropy (FA) derived from DTI was assessed in eleven regions of interest within the cerebral white matter (WM) and compared with post-mortem neuropathological findings.
Results:
In contrast to conventional FLAIR images that revealed only circumscribed WM damage, the first DTI demonstrated significant reduction of FA across the whole WM. The following FLAIR images (MRI 2-4) revealed increasing atrophy and leukoaraiosis paralleled by clinical deterioration with reduction of wakefulness and intractable seizures. Neuropathological findings confirmed the widespread and marked brain injury following CPA.
Conclusion:
DTI may help to evaluate microstructural brain damage following CPA and may have predictive value for further evolution of cerebral degeneration in the chronic phase after CPA.
Overdiagnosis of a typical carcinoid tumor as an adenocarcinoma of the lung: a case report and review of the literature
Authors: Ilhan Demirci, Susanne Herold, Andreas Kopp, Michael Flaßhove, Bernd Klosterhalfen, Hermann Janßen
Journal: World J Surg Oncol (2012)
MeSH terms: Adenocarcinoma / diagnosis, Carcinoid Tumor / diagnosis, Diagnostic Errors, Lung Neoplasms / diagnosis, Case Reports, Review, Adenocarcinoma / pathology, Aged, Biomarkers, Tumor / analysis, Carcinoid Tumor / pathology, Humans, Lung Neoplasms / pathology, Male, Receptors, LHRH / analysis, Biomarkers, Tumor, Receptors, LHRH

Background:
Overdiagnosis of bronchopulmonary carcinoid tumors together with overtreatment can cause serious postoperative consequences for the patient. We report of a patient with a typical bronchopulmonary carcinoid tumor, which was initially misdiagnosed and treated as an adenocarcinoma of the lung. GnrH receptors and the associated Raf-1/MEK/ERK-1/2-pathway are potential targets for analogs in cancer treatment. We suspected a correlation between the lack of tumor growth, application of leuprolide and the Raf-1/MEK/ERK-1/2-pathway. Therefore, we examined GnrH receptor status in the examined specimen.
Case presentation:
In 2010 a 77 year-old male patient was shown to have a tumor mass of about 1.7 cm diameter in the inferior lobe of the left lung. Since 2005, this tumor had hitherto been known and showed no progression in size. The patient suffered from prostate cancer 4 years ago and was treated with TUR-P, radiation therapy and the application of leuprolide. We conducted an explorative thoracotomy with atypical segment resection. The first histological diagnosis was a metastasis of prostate cancer with lymphangiosis carcinomatosa. After several immunohistochemical stainings, the diagnosis was changed to adenocarcinoma of the lung. We conducted a re-thoracotomy with lobectomy and systematic lymphadenectomy 12 days later. The tumor stage was pT1 N0 MX G2 L1 V0 R0. Further immunohistochemical studies were performed. We received the results 15 days after the last operation. The diagnosis was ultimately changed to typical carcinoid tumor without any signs of lymphatic vessel invasion. The patient recovered well from surgery, but still suffers from dyspnea and lack of physical performance. Lung function testing revealed no evidence of impairment.
Conclusion:
The use of several immunohistochemical markers, careful evaluation of hematoxylin-eosin sections and the Ki-67 labelling index are important tools in discriminating between carcinoids and other bronchopulmonary carcinomas. Although we could not detect GnrH-receptors in the examined specimen, there may be individual differences in expression. GnrH receptor profiles in typical and atypical carcinoids should be scrutinized. This could lead to new therapeutical options, since the GnrH receptor has already been described on atypical carcinoids. Clinically tested drugs such as leuprolide could come to use.
Epiphyseal fracture of the coracoid process occurring at the conjoined tendon origin
Authors: Kenjiro Nakama, Masafumi Gotoh, Yasuhiro Mitsui, Takahiro Okawa, Fujio Higuchi, Kensei Nagata
Journal: Case Rep Orthop (2011)
MeSH terms: Case Reports

Fracture of the coracoid process is uncommon, and most previous studies have reported this fracture occurring in association with direct trauma to the shoulder or transmission of force from the upper arm or elbow (Ada and Miller 1991, Benton and Nelson 1971, Eyres et al. 1995). We present a case in which epiphyseal fracture occurred at the origin of the conjoined tendon following excessive muscle contraction. We believe this represents the first description of such a method of injury.
Amelogenesis imperfecta and generalized gingival overgrowth resembling hereditary gingival fibromatosis in siblings: a case report
Authors: Emre Yaprak, Meryem Gülce Subaşı, Mustafa Avunduk, Filiz Aykent
Journal: Case Rep Dent (2012)

Amelogenesis imperfecta (AI) is a group of hereditary disorders primarily characterized by developmental abnormalities in the quantity and/or quality of enamel. There are some reports suggesting an association between AI and generalized gingival enlargement. This paper describes the clinical findings and oral management of two siblings presenting both AI and hereditary gingival fibromatosis (HGF) like generalized gingival enlargements. The treatment of gingival enlargements by periodontal flap surgery was successful in the management of the physiologic gingival form for both patients in the 3-year follow-up period. Prosthetic treatment was also satisfactory for the older patient both aesthetically and functionally.
Orbital tuberculosis in childhood with intracranial extension: a case report
Authors: Navneet Tuli
Journal: Cases J (2010)

The common causes of orbital masses in pediatric age group include pseudotumour, lymphomas, hemangioma and dermoid cyst. Orbital tuberculosis is rare especially in children. We report a case of 5 year old child who presented with proptosis and gross diminution of vision due to orbital tuberculoma. Ocular examination of the left eye revealed proptosis with the eyeball displaced downwards and forwards. Vision was counting finger close to face. CT Scan showed an extraconal soft tissue mass along posteromedial side of left orbit with lateral displacement of medial rectus muscle. On antitubercular treatment, proptosis regressed and visual recovery was observed over a period of six month vision, in the left eye at the last followup was 20/30.
Necrotizing Soft Tissue Fasciitis after Intramuscular Injection
Authors: Angelica Abbate, Piero Luigi Almasio, Martina Mongitore, Gaetano Di Vita, Rosalia Patti
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Necrotizing soft tissue fasciitis (NSTIs) or necrotizing fasciitis is an infrequent and serious infection. Herein, we describe the clinical course of a female patient who received a diagnosis of NSTIs after gluteus intramuscular injection. We also report the results of our review of published papers from 1997 to 2017. Since now, 19 cases of NSTIs following intramuscular injections have been described. We focus on the correlation between intramuscular injection and NSTIs onset, especially in immunosuppressed patients treated with corticosteroids, suffering from chronic diseases or drug addicted. Intramuscular injections can provoke severe tissue trauma, representing local portal of infection, even if correctly administrated. Otherwise, it is important not to inject drug in subcutaneous, which is a less vascularized area and therefore more susceptible to infections. Likewise, a proper injecting technique and aspiration prior to injection seem to be valid measure to prevent intra-arterial or para-arterial drug injection with the consequent massive inflammatory reaction. Necrosis at the infection site appears to be independent of the drug, and it is a strong additional risk factor for NSTIs.
Spontaneous second-trimester ruptured pregnancy of rudimentary horn: a case report in Yaounde, Cameroon
Authors: Florent Ymele Fouelifack, Jovanny Tsuala Fouogue, John Owoudou Messi, Danielle Tiako Kamga, Jeanne Hortence Fouedjio, Zacharie Sando
Journal: Pan Afr Med J (2014)
Keywords: cameroon, ectopic pregnancy, emergency, rudimentary uterine horn, rupture
MeSH terms: Pregnancy, Ectopic / diagnosis, Uterus / abnormalities, Case Reports, Cameroon, Female, Humans, Pregnancy, Pregnancy Trimester, Second, Rupture, Spontaneous, Young Adult

Rudimentary uterine horn pregnancy is rare and, to our knowledge, has not been previously reported in Cameroon. We herein report the case of a 22 year old second gravida referred for acute abdominal pain at 17 weeks of gestation. Physical examination revealed hemoperitoneum with hypovolemic shock. After resuscitation, an emergency exploratory laparotomy was done and we found hemoperitoneum of 3,500 milliliters, a bicornuate uterus with a ruptured right rudimentary communicating horn containing a non viable foetus. There were no other abnormalities. We performed an excision of the rudimentary horn with ipsilateral salpingectomy. Post-operative course was uneventful and the woman was discharged seven days later. This case emphasizes the importance of good antenatal care to avoid complications.