OpenMed/multicare-articles huggingface dataset:
Kleptomania Induced by Venlafaxine
Authors: Kumi Sakurada, Masashi Nibuya, Kazuo Yamada, Seishu Nakagawa, Eiji Suzuki
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Introduction. Kleptomania is an impulse-control disorder that results in an irresistible urge to steal. It is often observed as a comorbidity in patients undergoing pharmacological treatment for Parkinson's disease. Recurrent shopliftings are also observed in the clinical course of frontotemporal dementia. Case Presentation. After successful treatment of severe depression with venlafaxine at a dose of 225 mg/day, a 54-year-old euthymic female patient exhibited recurrent stealing behavior. After the diagnostic exclusion of frontotemporal dementia, kleptomania induced by venlafaxine administration was suspected. The symptoms of kleptomania disappeared with the gradual decrease in the venlafaxine dosage to 37.5 mg/day. Discussion. Venlafaxine is a dual serotonin-norepinephrine reuptake inhibitor. We considered two possible mechanisms to explain the pathophysiology of kleptomania in the present case: (1) increased dopaminergic neural transmission due to the inhibited dopamine reuptake by the norepinephrine transporter with a high dose of venlafaxine or (2) enhanced serotonergic neural transmission by the inhibition of serotonin reuptake by venlafaxine. In past studies, five cases of impulse-control disorder induced by selective serotonin reuptake inhibitors have been reported. This is the fourth report of venlafaxine-induced kleptomania and highlights the importance of considering the possibility of a rare side effect of kleptomania induced by antidepressant.
Generalized Comedones, Acne, and Hidradenitis Suppurativa in a Patient with an FGFR2 Missense Mutation
Authors: Rebecca Higgins, Andrew Pink, Robert Hunger, Nikhil Yawalkar, Alexander A Navarini
Journal: Front Med (Lausanne) (2017)
Keywords: acne, comedones, fibroblast growth factor-receptor gene 2, hidradenitis suppurativa, whole exome sequencing
MeSH terms: Case Reports

Mutations in the fibroblast growth factor-receptor gene 2 (FGFR2) gene have been implicated in numerous diseases, including nevus comedonicus (NC) and naevoid acne that have somatic missense mutations in FGFR2 in the affected tissue. A patient presented in our department with unusual, innumerable large comedones throughout his back reminiscient of NC, as well as multifocal hidradenitis suppurativa and acne. Topical and systemic treatments were unsuccessful. Whole exome sequencing of blood-derived DNA detected a germline mutation in FGFR2 that was predicted to be damaging. This could explain the multifocal and severe nature of the disease. We suggest screening other, phenotypically similar patients for FGFR2 mutations. Our findings, once confirmed independently, could indicate that therapeutic modulation of FGFR signaling in the acne tetrad could be effective.
Reduced Self-Awareness Following a Combined Polar and Paramedian Bilateral Thalamic Infarction. A Possible Relationship With SARS-CoV-2 Risk of Contagion?
Authors: Massimo Bartoli, Sara Palermo, Mario Stanziano, Giuseppina E Cipriani, Daniela Leotta, Maria C Valentini, Martina Amanzio
Journal: Front Psychol (2020)
Keywords: sars-cov-2, case study, executive functions, polar and paramedian thalamic infarction, reduced self-awareness

Reduced self-awareness is a well-known phenomenon investigated in patients with vascular disease; however, its impact on neuropsychological functions remains to be clarified. Importantly, selective vascular lesions provide an opportunity to investigate the key neuropsychological features of reduced self-awareness in neurocognitive disorders. Because of its rarity, we present an unusual case of a woman affected by a combined polar and paramedian bilateral thalamic infarction. The patient underwent an extensive neuropsychological evaluation to assess cognitive, behavioral, and functional domains, with a focus on executive functions. She was assessed clinically in the acute phase and after 6 months from the stroke, both clinically and by magnetic resonance imaging. The patient developed a cognitive impairment, characterised by prevalent executive dysfunction associated with reduced self-awareness and mood changes, in terms of apathy and depression. Such condition persisted after 6 months. In May 2020, the patient underwent the serology test in chemiluminescence to detect IgG antibodies against SARS-CoV-2. The result of the quantitative test highlighted a high probability of previous contact with the virus. We suggest that reduced self-awareness related to executive dysfunction and behavioral changes may be due to combined polar and paramedian bilateral thalamic lesion. Metacognitive-executive dysfunction affecting the instrumental abilities of everyday life might make people less able to take appropriate precautions, facilitating the risk of SARS-CoV-2 contagion.
Postpartum ovarian vein thrombosis: two cases and review of literature
Authors: Amos A Akinbiyi, Rita Nguyen, Michael Katz
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Introduction. We presented two cases of late presentation of ovarian vein thrombosis postpartum following vaginal delivery and cesarean section within a short period in our institution. Both of them had pelvic pain following their deliveries which was associated with fever and chills. One of them was quite a big-sized thrombophlebitic vein which was about 10 x 6 x 5 centimeters following a computed tomography. They were both treated initially for urinary tract infection, while a large ovarian vein thrombosis was not diagnosed in the second patient until her emergency department admission. Conclusion. Ovarian vein thrombosis is rare, but could present late, and difficult to diagnose, hence, should be considered as a differential diagnosis in a postpartum woman with fever and tender pelvic mass.
Response to sunitinib in combination with proton beam radiation in a patient with chondrosarcoma: a case report
Authors: Jennifer Dallas, Iman Imanirad, Rajiv Rajani, Roi Dagan, Sukanthini Subbiah, Rebecca Gaa, Wayne A Dwarica, Alison M Ivey, Robert A Zlotecki, Robert Malyapa, Danny J Indelicato, Mark T Scarborough, John D Reith, C Parker Gibbs, Long H Dang
Journal: J Med Case Rep (2012)

Introduction:
Chondrosarcoma is well-known to be primarily resistant to conventional radiation and chemotherapy.
Case presentation:
We present the case of a 32-year-old Caucasian man with clear cell chondrosarcoma who presented with symptomatic recurrence in his pelvis and metastases to his skull and lungs. Our patient underwent systemic therapy with sunitinib and then consolidation with proton beam radiation to his symptomatic site. He achieved complete symptomatic relief with a significantly improved performance status and had an almost complete and durable metabolic response on fluorine-18-fluorodeoxyglucose positron emission tomography.
Conclusions:
Our findings have important clinical implications and suggest novel clinical trials for this difficult to treat disease.
Cutaneous Vasculitis and Central Nervous System Infarctions due to Varicella Zoster Virus Vasculopathy in an Immunocompromised Patient
Authors: Karen Flores Rosario, Katherine C Michelis, Carol Bjorkman, Faris G Araj
Journal: Case Rep Transplant (2020)
MeSH terms: Case Reports

Varicella zoster virus (VZV) infection commonly presents as varicella during childhood, and zoster, later in life. Here, we present a rare and interesting case of VZV infection that manifested with both cerebral and spinal infarctions and cutaneous vasculitis in the absence of a classic vesicular rash in an immunocompromised patient.
MR Imaging of Migrated Nucleus Pulposus after Collagenase Injection of Lumbar Disc Herniation: A Case Report
Authors: Bai Jin Tao Sun, Bing Li, Xu Feng, Han Feng Yang
Journal: J Belg Soc Radiol (2022)
Keywords: mr imaging (mri), collagenase, lumbar disc herniation (ldh), nucleus pulposus prolapsus
MeSH terms: Case Reports

Magnetic resonance images (MRI) of migrated nucleus pulposus after collagenase treatment of lumbar disc herniation are rarely published. Here, we describe a 65-year-old woman with L5-S1 intervertebral disc herniation on the rear left. The patient was treated with a lumbar disc collagenase injection, and the pain was relieved. Two weeks later, the patient suddenly developed pain again after engaging in weight-bearing activity. Lumbar MRI showed a nodule in the spinal canal at the L5-S1 level. The patient underwent surgical treatment two days later. Pathology showed that the nodule was nucleus pulposus tissue. Teaching point: It is important to understanding the MR manifestations of migrated nucleus pulposus after collagenase treatment to prevent such misdiagnosis.
Clinical Efficacy, Safety and Tolerability of a New Subcutaneous Immunoglobulin 16.5% (Octanorm [Cutaquig®]) in the Treatment of Patients With Primary Immunodeficiencies
Authors: Roger H Kobayashi, Sudhir Gupta, Isaac Melamed, J Fernando Mandujano, Ai Lan Kobayashi, Bruce Ritchie, Bob Geng, Thomas Prescott Atkinson, Syed Rehman, Eva Turpel-Kantor, Jiří Litzman
Journal: Front Immunol (2019)
Keywords: scig, antibodies, immunoglobulins, infections, infusion site reactions, primary immunodeficiencies
MeSH terms: Immunization, Passive / methods, Immunologic Deficiency Syndromes / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Immunoglobulin G / administration & dosage, Immunoglobulin G / blood, Immunoglobulins, Intravenous / administration & dosage, Immunoglobulins, Intravenous / pharmacokinetics, Immunoglobulins, Intravenous / therapeutic use, Infusions, Subcutaneous, Male, Middle Aged, Young Adult, Immunoglobulin G, Immunoglobulins, Intravenous, Octagam

Introduction: Subcutaneously administered immunoglobulin (SCIG) is increasingly used to treat patients with primary immunodeficiencies (PIDs). Octanorm (marketed as cutaquig® in USA and Canada) is a new 16.5% solution of human SCIG, manufactured by a process based on that of the intravenous preparation (IVIG) octagam®. Objectives: To investigate the efficacy, safety and tolerability of octanorm in a prospective, open-label, single-arm phase 3 study involving adult and pediatric patients with PIDs (NCT01888484; clinicaltrials.gov/ct2/show/NCT01888484). Methods: Patients who were previously treated with IVIG received a total of 64 weekly SCIG infusions, including 12 weekly infusions during the wash-in/wash-out period, followed by 52 weekly infusions during the evaluation period. Results: A total of 61 patients aged 2-73 years received 3,497 infusions of octanorm. The mean dose per patient was 0.175 g/kg/infusion. The mean calculated dose conversion factor from the patients' previous IVIG dose for octanorm was 1.37. No serious bacterial infections developed during the study. The rate of other infections per person-year during the primary observation period was 3.43 (upper 95% CI 4.57). All but one non-bacterial infection were mild or moderate in intensity. IgG trough levels were constant during the course of the study. Eleven patients (18.0%) experienced 14 mild or moderate systemic adverse events (AEs) related to octanorm. The rate of related AEs per infusion was 0.004. In 76.7% of infusions, no infusion site reactions were observed and only two (0.3%) reactions were deemed severe. The incidence of site reactions decreased with successive infusions. Conclusion: The new 16.5% SCIG octanorm was shown to be efficacious in preventing infections in PIDs, and was well tolerated.
Rash induced by enteral vancomycin therapy in an older patient in a long-term care ventilator unit: case report and review of the literature
Authors: Jeremy Barron, Adolfo Lattes, Esther-Lee Marcus
Journal: Allergy Asthma Clin Immunol (2018)
Keywords: clostridium difficile colitis, drug hypersensitivity, vancomycin
MeSH terms: Case Reports

Background:
Oral vancomycin is a first-line treatment for severe Clostridium difficile colitis. Oral vancomycin is perceived to lack systemic absorption or systemic adverse effects; however, a few cases of hypersensitivity to oral vancomycin have been reported, all in hospitalized patients.
Case presentation:
In the present case, a 66-year-old woman with end-stage neurodegenerative disease residing in a long-term care facility developed a maculopapular rash following treatment with enteral vancomycin for recurrent C. difficile colitis. The rash resolved after withdrawal of the drug.
Conclusion:
Rashes associated with oral vancomycin treatment include maculopapular rash, urticaria, red man syndrome, and linear IgA bullous dermatitis. Risk factors for systemic vancomycin absorption include renal insufficiency, severe intestinal inflammation, and high vancomycin dose and duration. Routine serum testing of vancomycin levels, even in these high risk cases, is not recommended. Clinicians should be aware that enteral vancomycin can cause hypersensitivity reactions which may be serious.
Torsion of Atypical Meckel's Diverticulum Treated by Laparoscopic-Assisted Surgery
Authors: Atsushi Kohga, Kimihiro Yamashita, Yuto Hasegawa, Kiyoshige Yajima, Takuya Okumura, Jun Isogaki, Kenji Suzuki, Akihiro Kawabe, Akira Komiyama
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Introduction:
Meckel's diverticulum (MD) is the most common congenital anomaly of the intestine, with an incidence of 2~4%. Of those, only 2% of patients with MD are symptomatic. Torsion of MD is extremely rare, and only a dozen cases have been previously reported.
Case report:
The patient was a 49-year-old male who presented to our emergency room with a chief complaint of lower abdominal pain. Computed tomography imaging revealed an irregular polycystic mass connected to the small intestine that measured 7.5 cm in a diameter. A laparoscopic-assisted partial resection of the jejunum was performed. The lesion was found to have caused torsion and was located 130 cm from the ileocecal valve. The specimen was polycystic in appearance and showed communicating links with the submucosal layer of jejunum but not with the lumen. The pathological diagnosis was a torsion of an atypical presentation of MD.
Conclusion:
This case was different from typical cases of MD in that it was located on significantly oral side and had the appearance of polycystic morphology.
Spontaneous bilateral pneumothorax and pneumomediastinum independent of mechanical ventilation as complications of COVID-19 pneumonia: A case report
Authors: Matthew Antony Manoj, Basavaprabhu Achappa, Nikhil Victor Dsouza, Shruti Sundar, Vinay Bs
Journal: Qatar Med J (2022)
Keywords: covid-19, pandemic, pneumomediastinum, pneumothorax, respiratory complication

Since the beginning of the COVID-19 pandemic, several infected patients have suffered from unusual and severe complications. Among these rare complications, pneumothorax and pneumomediastinum have attracted clinical attention. Such complications might be challenging to diagnose immediately because of the atypical presentation in some cases. Accurate diagnosis is essential to ensure effective treatment. Here, we present the case of a 62-year-old male who presented with symptoms of COVID-19 acute respiratory distress. There was diffuse subcutaneous emphysema in the face, neck, shoulder, and chest wall on clinical examination. The patient was started on oxygenation via a non-rebreather mask. On further evaluation, his chest X-ray revealed bilateral peripheral opacities in the lung fields, bilateral pneumothorax, and subcutaneous emphysema, after which intercostal drainage tubes were inserted. The patient's oxygen saturation was not satisfactory, and he was switched to a high-flow nasal cannula. However, his condition deteriorated, and he was put on mechanical ventilation and inotropic support. Despite our best efforts, the patient succumbed to the disease. We want to emphasize the importance of this adverse event despite his nonsmoking history and the exclusion of positive pressure ventilation. Although benign, early diagnosis of this condition is vital, as the condition could lead to worse morbidity if left unrecognized.
Massive Spontaneous Hemothorax as a Complication of Apixaban Treatment
Authors: M Abu Hishmeh, P Srivastava, Q Lougheide, M Srinivasan, S Murthy
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Introduction:
Hemothorax is usually related to chest or iatrogenic trauma from procedures such as central lines and thoracentesis. Spontaneous hemothorax is defined as pleural fluid hematocrit greater than 50% of serum hematocrit in absence of natural or iatrogenic trauma affecting the lung or pleural space. Coagulopathy secondary to anticoagulant use has been associated with spontaneous hemothorax. We present a case of spontaneous hemothorax in a patient taking apixaban for venous thromboembolism disease. To our knowledge, this is the first case report of apixaban as a cause of spontaneous hemothorax.
Case presentation:
A 56-year-old woman with end-stage renal disease (ESRD) was diagnosed with upper extremity deep vein thrombosis (DVT) one month prior to presentation and was started on apixaban presented with dyspnea and left-sided pleuritic chest pain for two weeks. She was found to have left-sided large pleural effusion which was diagnosed as hemothorax. Other etiologies for spontaneous hemothorax were excluded and drainage by 12-French pigtail catheter achieved total resolution of hemothorax in three days.
Discussion:
Apixaban is a DOAC used to prevent stroke or thromboembolic events in patients with nonvalvular atrial fibrillation and to prevent recurrent venous thromboembolic disease. Events such as gastrointestinal, intracranial, and soft tissue bleeding have been well-documented. However, bleeding manifestation as hemothorax is seldom reported. Our patient presented with isolated left-sided large pleural effusion which was diagnosed as spontaneous hemothorax. 12-Fr pigtail catheter drainage was effective in the management of our patient and provided total resolution in three days.
Conclusion:
Spontaneous hemothorax is a rare complication of anticoagulant therapy and might not exhibit the usual radiological signs of traumatic hemothorax. Health care providers should have high index of suspicion for spontaneous hemothorax when evaluating new pleural effusion in patients receiving DOACs therapy. Drainage by small bore pigtail catheter might be as effective as larger chest tubes.
Radiological Evaluation of a Malignant Gastrointestinal Stromal Tumor in a Female Patient With the Coincidental Detection of Primary Breast Cancer: A Case Report
Authors: Prasanthi R Ghanta, Rajasbala P Dhande, Gaurav V Mishra, Harshith K Gowda
Journal: Cureus (2023)
Keywords: axillary lymph node metastasis, breast lump, case report, cd117, computed tomography, gastrointestinal stromal tumor (gist), ultrasonography
MeSH terms: Case Reports

Gastrointestinal stromal tumors (GIST) are a rare and unique group of mesenchymal tumors arising from the gastrointestinal tract, omentum, mesentery, and retroperitoneum. Though they have certain typical radiological features that can differentiate them from epithelial tumors, it is often difficult to differentiate them from other non-epithelial tumors. Their features also vary depending on their size, site of origin, etc. When differentiation from other mesenchymal tumors on histopathology is difficult, receptor tyrosine kinase (C-KIT proto-oncogene/CD117) and gastrointestinal stromal tumor (GIST-1) discovered on GIST1 (DOG-1) expression are confirmatory. The concurrent presence of other primary cancers with GISTs has been described in the literature, among which most have been of gastrointestinal origin. Few cases of primary breast cancer in GIST have been described. Lymph nodal metastasis is rarely encountered in GIST, and metastasis to the breast is even rarer. We present a case of a 39-year-old female with non-specific symptoms who was referred for ultrasonography (USG) and computed tomography (CT) that showed a small intestinal GIST along with a breast lump and axillary lymphadenopathy that were labeled as metastases from the GIST on frozen sections; however, they were later diagnosed as primary breast cancer with axillary metastases on the histopathology and immunohistochemistry of the excision biopsy specimens post-surgery. The patient underwent surgical resection and chemotherapy.
Case report: Minimal tissue damage and low coagulation liver resection for hepatoblastoma using indocyanine green fluorescence and water-jet dissector
Authors: Shun Onishi, Takafumi Kawano, Nanako Nishida, Chihiro Kedoin, Ayaka Nagano, Masakazu Murakami, Koshiro Sugita, Toshio Harumatsu, Mitsuru Muto, Satoshi Ieiri
Journal: Front Pediatr (2023)
Keywords: hepatectomy, hepatoblastoma, indocyanine green, near-infrared fluorescence imaging, pediatric surgery, water-jet dissector
MeSH terms: Case Reports

Near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) has gained popularity in pediatric surgery as it has in general surgery. In addition, a water-jet dissector (WJD) has been successfully introduced in adult hepatic surgery. Tissue structures are dissected selectively and gently by the WJD. However, there have been no reports of hepatic resection for pediatric patients using a WJD. We applied NIR fluorescence imaging with ICG to visualize the resection line of the liver and used a WJD for liver parenchyma dissection in pediatric hepatoblastoma. The patient was a 3-year-old girl with a large liver tumor. Enhanced computed tomography revealed a liver tumor (maximum diameter: 120 mm) in the right lobe and three small lung metastases. The liver tumor was diagnosed as hepatoblastoma (PRETEXT 2) based on an open biopsy. We performed right hepatectomy after neoadjuvant chemotherapy. The right lobe was mobilized from the diaphragm, and then intraoperative ultrasound was performed to detect the localization of the tumor and its proximity to the vascular structures. We detected the right hepatic artery (RHA), right portal vein (RPV), and right hepatic vein (RHV). The middle hepatic vein was not involved. After ligation of the RHA and RPV to selectively control the right lobe inflow, ICG was administered intravenously and observed by an NIR endoscope. The resection line was clearly visualized by overlaying images in comparison to conventional demarcation line detection. Then, we used a WJD to dissect the parenchyma. Small vessels were divided from parenchymal tissue and were clearly visible. We resected them after clamping with metal clips. Finally, the RHV was transected by a linear stapler, and right hepatectomy was completed with 25 ml of blood loss. There was no postoperative hemorrhage. We performed hepaticojejunostomy because of stricture of the common bile duct on postoperative day 302. The patient was discharged after adjuvant chemotherapy. NIR imaging clearly showed the resection line. The WJD automatically separated, and thus made visible, the more resistant duct and vessel structures from the parenchyma. The combined use of NIR imaging and WJD was useful for pediatric hepatectomy.
Perinatal-lethal Gaucher disease presenting as hydrops fetalis
Authors: Emira BenHamida, Imene Ayadi, Ines Ouertani, Maroua Chammem, Ahlem Bezzine, Riadh BenTmime, Leila Attia, Ridha Mrad, Zahra Marrakchi
Journal: Pan Afr Med J (2015)
Keywords: gaucher disease, hydrops, lysosomal storage disorder, perinatal form
MeSH terms: Gaucher Disease / diagnosis, Hydrops Fetalis / etiology, Case Reports, Arthrogryposis / etiology, Female, Gaucher Disease / physiopathology, Hepatomegaly / etiology, Humans, Hydrops Fetalis / diagnosis, Ichthyosis / etiology, Infant, Newborn, Splenomegaly / etiology, Gaucher Disease, Perinatal Lethal

Perinatal-lethal Gaucher disease is very rare and is considered a variant of type 2 Gaucher disease that occurs in the neonatal period. The most distinct features of perinatal-lethal Gaucher disease are non-immune hydrops fetalis. Less common signs of the disease are hepatosplenomegaly, ichthyosis and arthrogryposis. We report a case of Gaucher's disease (type 2) diagnosed in a newborn who presented with Hydrops Fetalis.