OpenMed/multicare-articles huggingface dataset:
Intensive Care in a Patient with Toxic Epidermal Necrolysis
Authors: J Wallenborn, M Fischer
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose. This prevented further progression of the TEN. Despite marked improvement in skin findings, the ICU stay was prolonged by a complex analgosedation, transient kidney failure, volume management, positioning therapy, and vegetatively impeded weaning. Moreover, there was colonization with multiresistant bacteria (MRSA and VRE). Nonetheless, the patient could be restored to health and was released after four weeks. Infliximab seems to be effective in the treatment of TEN, especially in cases of rapid progression. Moreover, patients with TEN are difficult to handle in intensive-medical care, whereby attention should especially be paid to sufficient pain therapy, and the positioning of the patient is a particular challenge.
Catatonia Development in a Patient with Bipolar Disorder Following Electroconvulsive Therapy: A Case Report
Authors: Azadeh Mashayekhi, Alireza Ghayoumi
Journal: Iran J Psychiatry (2019)
Keywords: bipolar disorder, catatonia, electroconvulsive therapy, vitamin b12 deficiency
MeSH terms: Case Reports

Objective: Electroconvulsive therapy (ECT) is a major treatment of catatonia; and catatonia development during electroconvulsive therapy is a highly surprising phenomenon. We present a patient with bipolar disorder who developed catatonia during ECT. Case Reports : A 21-year-old woman, with a known case of bipolar disorder in manic phase without psychotic feature, history of long acting antipsychotic use, and severe B12 deficiency, was treated with ECT. Full catatonia syndrome developed after the fifth session of ECT. Conclusion: In rare cases, catatonia can develop during ECT course in the presence of some precipitating factors. Thus, these precipitating factors should be eliminated as much as possible before the start of ECT course to prevent catatonia development.
GATA2 deficiency detected by newborn screening for SCID: A case report
Authors: Alejandra Escobar Vasco, Larisa Broglie, Julie-An Talano, John Routes, James Verbsky, Allison Remiker
Journal: Front Pediatr (2023)
Keywords: gata2, t cell receptor excision circles, hematopoietic stem cell transplant, inborn errors of immunity, severe combined immunodeficiency
MeSH terms: Case Reports

The early diagnosis and treatment of inborn errors of immunity (IEI) is crucial in reducing the morbidity and mortality due to these disorders. The institution of newborn screening (NBS) for the diagnosis of Severe Combined Immune Deficiency (SCID) has decreased the mortality of this disorder and led to the discovery of novel genetic defects that cause this disease. GATA2 deficiency is an autosomal dominant, pleiotropic disease with clinical manifestations that include bone marrow failure, monocyte and B cell deficiency, leukemia, pulmonary alveolar proteinosis and lymphedema. We present the case of an infant identified by newborn screening for SCID due to GATA2 deficiency.
Benign idiopathic retroperitoneal cyst: A case series of three patients
Authors: Danish Ali, Muhammad Zeeshan Sarwar, Fareeha Manzoor, Syed Asghar Naqi
Journal: Int J Surg Case Rep (2019)
Keywords: case series/report, idiopathic benign cysts, retroperitoneal cysts, retroperitoneal mass

Importance:
Retroperitoneal cysts are a rare entity in the field of surgery and their management remains a clinical dilemma for many surgeons. This study addresses the clinical management of three benign retroperitoneal cysts which were presented in our hospital.
Objectives:
The objective of this case series is to explore the different clinical presentation of the retroperitoneal cyst (RPC). This study also aims at different tools of investigations especially role of CT scan in the diagnosis of RPC and finally the different treatment options available for RPC.
Methods:
This is a single centered case series of three retroperitoneal cysts which were presented in surgical department of our hospital in the year 2016 and 2017. Total three patients were presented in this case series, two of them were females and one was male. Females were 13 years and 23 years age-old, male was 45 years old. Two of them admitted through the Outdoor Patient Clinic and one was presented to the surgical emergency. Informed consent from the patients and guardian (case1) has been taken. Research work has been reported in line with the PROCESS criteria.
Results:
They were investigated and treated in our hospital. Two of them were diagnosed with retroperitoneal cysts preoperatively and one was diagnosed pre-operatively. In all three cases, surgery had been carried out and they had been observed in their early postoperative period and then followed up for two years. All biopsies had been followed and turned out to be benign idiopathic cysts. These patients have been followed up for 2 years after completion of their treatment.
Conclusion:
Retroperitoneal cysts in adults are an uncommon manifestation of abdominal pathology. Their presentation is quite vague. The rarity catches the surgeon off guard at times. Radiology plays a crucial role in defining these lesions and complete surgical excision remains the cornerstone of treatment for symptomatic and complicated patients.
Intrahepatic cholangiocarcinoma with gastric metastasis misdiagnosed as primary gastric cancer: A case report and literature review
Authors: Qingshun Zhu, Shengyong Zhai, Enkang Ge, Lei Li, Xuguang Jiao, Jinqiu Xiong, Guangxu Zhu, Yuanyuan Xu, Jianjun Qu, Zhengjiang Wang
Journal: Front Oncol (2022)
Keywords: pet/ct, gastric, immunohistochemical staining, intrahepatic cholangiocarcinoma, metastasis
MeSH terms: Case Reports

We describe a case of intrahepatic cholangiocarcinoma with gastric metastasis misdiagnosed as primary gastric cancer. In addition, combined with the literature, we summarized the clinical and imaging features of gastric metastasis of intrahepatic cholangiocarcinoma in order to improve the understanding of the preoperative diagnosis. Positron emission tomography/computed tomography (PET/CT) is accurate in evaluating the primary tumor, lymph node metastasis, and distant metastasis of patients. In addition, immunohistochemical staining can determine the primary site of metastatic adenocarcinoma. For patients who can not determine the location of the primary tumor, the rigorous preoperative examination is necessary, it can improve the accuracy of diagnosis and avoid excessive treatment of patients.
Benign Symptomatic Squamous Papilloma of the Uvula: A Case Report and Review of the Literature
Authors: Ethar A Albasry, Zahra M Alyousef, Mohammed A Alazizi
Journal: Cureus (2023)
Keywords: benign tumors, globus dysphagia, human papillomavirus (hpv), squamous papilloma, uvula
MeSH terms: Case Reports

Squamous papillomas are benign lesions that are associated with human papillomavirus infection. Oral squamous papilloma of the uvula is uncommon and rarely causes symptoms. In this case report, we present a rare case of symptomatic squamous papilloma of the uvula where the patient complained of mass-related symptoms such as dysphagia and choking sensation. The lesion was surgically excised using electrocautery with excellent outcomes. In addition, we reviewed literature related to the lesion.
The return of an old nemesis: Survival after severe tricyclic antidepressant toxicity, a case report
Authors: Al Giwa, Edwin Oey
Journal: Toxicol Rep (2018)
Keywords: acidosis, cardiac arrythmia, lidocaine, overdose, pulseless ventricular tachycardia, recurrent cardiac arrest, sodium bicarbonate, torsades, toxicity, toxicology, tricyclic antidepressant, vtach, ventricular tachycardia, wide complex tachycardia
MeSH terms: Case Reports

Tricyclic antidepressants (TCAs) were first approved by the Food and Drug Administration (FDA) for use as antidepressants in the 1950s. Although their function as an antidepressant in the U.S. has largely been replaced by newer and safer alternatives, they are still prescribed for various conditions, including chronic pain and intractable depression. We will discuss a case of a TCA overdose presenting with generalized tonic-clonic seizures and multiple recurrent cardiac arrests. This is a case of a 34 year-old female who was brought in by Emergency Medical Services (EMS) with generalized tonic clonic seizure, status post intentional ingestion of multiple drugs. Her vital signs were: Temperature-38.8 °C, Heart Rate-140 beats per minute, Respiratory Rate (RR)-25 breaths per minute, Blood Pressure (BP)-139/77 mmHg, Oxygen Saturation (SaO2)-99% on 100% nonrebreather facemask (NRB). Her electrocardiogram (EKG) showed a widened ventricular tachyarrhythmia and she was immediately given an ampule of sodium bicarbonate. Over the span of the subsequent 2 h, she had recurrent pulseless ventricular tachycardic arrest 5 times in the emergency department (ED). After 5 days of further stabilization, the patient had a subsequent complete recovery with normal neurological function at discharge from the medical unit. In the ED it is imperative that we understand the now uncommon presentation of a TCA overdose in order to initiate immediate treatment. It is also important to understand the optimal treatment choices in patients that presents with TCA toxicity, especially arrhythmias that are refractory to initial treatment choices. Overall, severe TCA poisoning is often fatal; however, we demonstrated that with high quality resuscitative efforts, despite multiple arrests, survival to discharge with normal neurological outcome is possible.
Multifocal bilateral desmoid tumour of perirenal tissues with peribiliary localization
Authors: Beatrice Sacconi, Renato Argirò, Angelo Iannarelli, Alessandro Di Gaeta, Mario Bezzi
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Desmoid tumour (DT) is an unusual, benign tumour, more frequently observed in patients with familial polyposis and pregnant females. It usually presents as a single mass lesion, more frequently showing a compressive rather than an infiltrative growth pattern. We report a case of a 70-year-old male presenting with a multifocal, bilateral infiltrative DT of the perirenal tissue, with involvement of the choledochus wall. The patient was partly treated with tamoxifen and docetaxel, but both therapies were discontinued in accordance with the patient's decision owing to mild toxicity; however, a CT examination performed 3 months later showed an unexpected remarkable reduction of the tumour at all sites. At 1 year follow-up, new pathologic tissue was visible surrounding the right renal pelvis and the calices.
Gastric MALT Lymphoma with Increased Plasma Cell Differentiation Showing Unique Endoscopic Features
Authors: Masaya Iwamuro, Takehiro Tanaka, Kenji Nishida, Seiji Kawano, Yoshiro Kawahara, Shogen Ohya, Tadashi Yoshino, Hiroyuki Okada
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

A 62-year-old woman was diagnosed with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with increased plasma cell differentiation of the stomach. Esophagogastroduodenoscopy showed slightly elevated, whitish lesions in the gastric body. Magnifying endoscopic observation revealed that the gastric surface epithelium was swollen, but the structure was not destroyed or diminished. Elongated, tortuous vasculature was observed on the surface of the whitish lesions. The patient underwent eradication treatment for Helicobacter pylori, which resulted in complete remission. Although the appearance of abnormal vessels and the destruction of gastric epithelial structure are the typical features of gastric MALT lymphoma during magnifying endoscopy, the present case showed different features, which were rather similar to those observed in a previously reported case of gastric plasmacytoma. The current case indicates that magnifying endoscopic features are not uniform among gastric MALT lymphomas.
A technique for approximating transition rates from published survival analyses
Authors: Markian A Pahuta, Joel Werier, Eugene K Wai, Roy A Patchell, Doug Coyle
Journal: Cost Eff Resour Alloc (2019)
Keywords: cancer, multistate model, quality adjusted life year, survival analysis

Background:
Quality-adjusted-life-years (QALYs) are used to concurrently quantify morbidity and mortality within a single parameter. For this reason, QALYs can facilitate the discussion of risks and benefits during patient counseling regarding treatment options. QALYs are often calculated using partitioned-survival modelling. Alternatively, QALYs can be calculated using more flexible and informative state-transition models populated with transition rates estimated using multistate modelling (MSM) techniques. Unfortunately the latter approach is considered not possible when only progression-free survival (PFS) and overall survival (OS) analyses are reported.
Methods:
We have developed a method that can be used to estimate approximate transition rates from published PFS and OS analyses (we will refer to transition rates estimated using full multistate methods as true transition rates).
Results:
The approximation method is more accurate for estimating the transition rates out of health than the transition rate out of illness. The method tends to under-estimate true transition rates as censoring increases.
Conclusions:
In this article we present the basis for and use of the transition rate approximation method. We then apply the method to a case study and evaluate the method in a simulation study.
Sarcoidosis with prevalent and severe joint localization: a case report
Authors: Livio G Moccia, Sabrina Castaldo, Emanuela Sirignano, Maddalena Napolitano, Enrica Barra, Alessandro Sanduzzi
Journal: Multidiscip Respir Med (2016)
Keywords: bronchoalveolar lavage, corticosteroid therapy, high resolution chest tomography, mediastinal lymph nodes, metacarpophalangeal joints, sarcoidosis-systemic granulomatous disease
MeSH terms: Case Reports

Background:
Sarcoidosis is a systemic granulomatous disease of unknown origin, characterized by the formation of granulomas without central necrosis. Each organ and tissue can be affected by the disease, but in most cases mainly the lungs and mediastinal lymph nodes but also skin, heart, eyes and joints are involved, the latter are mainly the metacarpophalangeal joints and bone lesions are often associated with involvement of the overlying skin. The diagnosis is often of exclusion, based on clinical and radiological suspicion, and should be confirmed by biopsy, although in each case it is necessary to exclude other possible causes of granulomatosis, including infections by mycobacteria. Here it is reported a case of particularly aggressive sarcoidosis with primitive involvement of the small joints of the hands and feet, and mediastinal lymph nodes.
Case presentation:
The subject, a man, 60 years old, born in Morocco but living in Italy for many years, presented important involvement of bone structures and soft periarticular tissue, and was affected by the formation of granulomas without "caseum necrosis". The painful symptoms and the skin ulceration had led to surgical amputation of the distal phalanges of most fingers of his hands and feet, but with subsequent resurgence of lesions in acral locations after surgery. The PET/CT scan showed an amount of radiotracer in mediastinal lymph nodes, while the lymph nodes sampled by TBNA were normal and the CD4/CD8 ratio was less than 3 in the bronchoalveolar lavage. We ruled out any possible infectious cause, including mycobacterial infection (both tubercular and atypical), so the patient was treated with systemic corticosteroids, with an excellent clinical and radiological response.
Conclusions:
Such a case shows how the disease can have variable expressions, without primitive lung involvement; therefore, it should be necessary to consider any possible, unpredictable localization of the disease.
Posterior Reversible Encephalopathy Syndrome in a Male With Polysubstance Abuse: A Case Report
Authors: Dhan B Shrestha, Jurgen Shtembari, Eliz Achhami, Lukash Adhikari, Dinesh Rengarajan
Journal: Cureus (2023)
Keywords: drug and substance abuse, neurological manifestations, neurological recovery, posterior circulation, posterior reversible encephalopathy syndrome (pres)
MeSH terms: Case Reports

Posterior reversible encephalopathy syndrome (PRES) is a neurologic disorder with multiple etiologies. The signs and symptoms of PRES are non-specific, making the differential diagnosis broad. Although PRES is suspected clinically, a diagnosis requires characteristic findings on imaging. In patients with undiagnosed PRES, the coexistence of substance abuse can divert the care provider from pursuing imaging studies, leading to a missed diagnosis. We describe the case of a 51-year-old male who presented with altered mental status and was diagnosed with PRES despite having a positive urine drug screen.
Iatrogenic Cushing's syndrome in children following nasal steroid
Authors: Isaac Oludare Oluwayemi, Abiola Olufunmilayo Oduwole, Elizabeth Oyenusi, Alphonsus Ndidi Onyiriuka, Muhammad Abdullahi, Olubunmi Benedicta Fakeye-Udeogu, Chidozie Jude Achonwa, Moustapha Kouyate
Journal: Pan Afr Med J (2014)
Keywords: iatrogenic, cushing's syndrome, nasal steroid
MeSH terms: Betamethasone / adverse effects, Cushing Syndrome / chemically induced, Glucocorticoids / adverse effects, Hydrocortisone / blood, Neomycin / adverse effects, Case Reports, Administration, Intranasal, Betamethasone / administration & dosage, Drug Combinations, Glucocorticoids / administration & dosage, Humans, Iatrogenic Disease, Infant, Male, Neomycin / administration & dosage, Nigeria, Drug Combinations, Glucocorticoids, betamethasone, neomycin drug combination, Betamethasone, Neomycin, Hydrocortisone

Cushing syndrome is a hormonal disorder caused by prolonged exposure of body tissue to cortisol. We report two cases of iatrogenic Cushing's syndrome in two Nigerian children following intranasal administration of aristobed-N (Betamethasone + Neomycin) given at a private hospital where the children presented with feature of adenoidal hypertrophy. Two months into treatment children were noticed to have developed clinical and laboratory features of iatrogenic Cushing's syndrome with critical adrenal suppression. Serum cortisol (at presentation): 1(st) patient: 12nmol/L (reference range 240-618), 2(nd)
Patient:
1.69nmol/L. Serum cortisol (3 months after weaning off steroid): 343.27 nmol/L (within normal range for the first patient; second patient newly presented and has just begun steroid weaning off process. The serum cortisol level one month into weaninig off process was 128 nmol/L). Unsupervised topical steroid administration in children can cause adrenal suppression with clinical features of Cushing's syndrome.
Management of Psoriasis Herpeticum in Pregnancy: A Clinical Conundrum
Authors: Leanne Almario, Albert S Antonyan, Dennis A Porto, Hunter Gomez-Roberts, Ali Alhousseini, Bernard Gonik
Journal: Case Rep Obstet Gynecol (2016)

Introduction. Kaposi varicelliform eruption (KVE) is a widespread cutaneous viral infection, most commonly herpes simplex virus, which affects patients with underlying dermatosis. When KVE occurs in a patient with a history of psoriasis, it is referred to as psoriasis herpeticum, a rare subtype of KVE with only a handful of cases reported in the literature. To the authors' knowledge, we report for the first time a case of psoriasis herpeticum in pregnancy. Case Presentation. A 23-year-old woman in her third pregnancy presented at 26-week gestation with a 10-year history of psoriasis. Cutaneous examination revealed diffuse psoriatic plaques with scattered ~1 cm erosions. Punch biopsy of the skin revealed herpes simplex virus (HSV) infection within a psoriatic plaque, necessitating dermatological treatment. The patient experienced premature rupture of membranes at 37-week gestation. Pelvic exam showed no evidence of herpetic lesions. After labor augmentation, the patient delivered a healthy female infant with no evidence of HSV infection. Discussion. Psoriasis herpeticum is a rare and potentially devastating complication of an underlying dermatosis. With a paucity of data available to guide pregnancy-specific issues, the general management of this condition is controversial and requires a multidisciplinary care approach. Concerns for systemic infection in the mother and vertical transmission to the neonate are of critical importance.
Adalimumab: Another Medication Related to Osteonecrosis of the Jaws?
Authors: Andrea Cassoni, Umberto Romeo, Valentina Terenzi, Marco Della Monaca, Oriana Rajabtork Zadeh, Ingrid Raponi, Maria Teresa Fadda, Antonella Polimeni, Valentino Valentini
Journal: Case Rep Dent (2016)

Objective. The acronym MRONJ has been created in order to identify "Medication-Related Osteonecrosis of the Jaw," observed after the use of Bisphosphonates, RANK ligand inhibitor, and antiangiogenic medications. Only a case of osteonecrosis of the jaw in a Chron's disease patient following a course of Bisphosphonate and Adalimumab therapy has been recently described, so that it has been supposed that also this medication could promote manifestation of osteonecrosis. Clinical Case. On August, 2014, a 63-year-old female with a history of idiopathic arthritis treated with medical treatment with Adalimumab from 2010 to 2013 presented referring pain in the right mandible. Results. This patient presented with nonexposed osteonecrosis of the jaw after placement, on September, 2010, of four titanium fixtures in the mandible. Conclusions. The authors suggest that the biologic therapy with an anti-TNF-α antibody might promote the manifestation of osteonecrosis and compromise oral healing capacity of the bone.
The First Report of Multicentric Carpotarsal Osteolysis Syndrome Caused by MAFB Mutation in Asian
Authors: Pongsakorn Choochuen, Kitiwan Rojneuangnit, Thanitchet Khetkham, Sookkasem Khositseth
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Multicentric carpotarsal osteolysis syndrome (MCTO) is a rare skeletal disorder characterized by aggressive osteolysis associated with progressive nephropathy. The early clinical presentation can mimic polyarticular juvenile idiopathic arthritis. Since 2012, MAFB mutations have been discovered in all MCTO patients. Therefore, the early diagnosis can be made based on genetic confirmation. We report the clinical manifestation of mineral bone disease and the molecular genetic study of a Thai female adolescent with MCTO. She presented with end-stage renal disease, bilateral wrist and ankle joint deformities, and subtle facial dysmorphic features. We identified a heterozygous missense MAFB mutation at nucleotide 197 from C to G (NM_005461.4; c.197C>G), predicting the change of amino acid at codon 66 from serine to cysteine (p.Ser66Cys), and the mutation was absent in the parents, indicating a de novo mutation. This report confirms the previous link between MAFB mutation and MCTO. Her unexplained hypercalcemia after a regular dose of calcium and active vitamin D supported an important role of MafB in the negative regulation of RANKL-mediated osteoclast differentiation. Therefore, we would encourage the physicians who take care of MCTO patients to closely monitor serum calcium level and perform a genetic study as a part of the management and investigation.