OpenMed/multicare-articles huggingface dataset:
Common variable immunodeficiency associated with hepatosplenic T-cell lymphoma mimicking juvenile systemic lupus erythematosus
Authors: A A Jesus, C M A Jacob, C A Silva, M Dorna, A C Pastorino, M Carneiro-Sampaio
Journal: Clin Dev Immunol (2011)
MeSH terms: Common Variable Immunodeficiency / complications, Lymphoma, T-Cell / complications, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Antineoplastic Agents / therapeutic use, Antirheumatic Agents / therapeutic use, Child, Common Variable Immunodeficiency / diagnosis, Common Variable Immunodeficiency / drug therapy, Fatal Outcome, Female, Humans, Immunoglobulins, Intravenous / therapeutic use, Liver Neoplasms / complications, Liver Neoplasms / pathology, Lupus Erythematosus, Systemic / diagnosis, Lymphoma, T-Cell / drug therapy, Lymphoma, T-Cell / pathology, Splenic Neoplasms / complications, Splenic Neoplasms / pathology, Antineoplastic Agents, Antirheumatic Agents, Immunoglobulins, Intravenous

Common variable immunodeficiency (CVID) is a heterogeneous disorder with susceptibility to infections, autoimmune manifestations, and cancer. To our knowledge, CIVD with T-cell lymphoma mimicking juvenile systemic lupus erythematosus (JSLE) was not described in the literature, and one case was reported herein. An 8-year-old female was admitted in our Pediatric Immunology Unit with a clinical history of hypogammaglobulinemia, recurrent upper respiratory infections, and pneumonias. She had a marked decrease of three serum immunoglobulin isotypes, and the diagnosis of CVID was established. At the age of 17 years, she presented with oral ulceration, nonerosive arthritis, nephritis, serositis, cytopenia, positive antiphospholipid antibodies, and positive antinuclear antibody fulfilling the American College of Rheumatology (ACR) criteria for SLE. She was treated with intravenous methylprednisolone for three consecutive days, and intravenous immunoglobulin, and maintenance therapy of chloroquine, azathioprine and prednisone 40 mg/day. Two months later, she died of septic shock secondary to acute pneumonia. The necropsy showed hepatosplenic T-cell lymphoma with diffuse involvement of bone marrow, spleen, liver, and lungs. The lymphoma cells were positive for CD3 immunostaining and negative for CD20 and lysozyme. In conclusion, the association of CVID and hepatosplenic T-cell lymphoma may simulate JSLE diagnosis.
Comprehensive Management of Acute Ischemic Stroke in Psoriatic Patient
Authors: Al Rasyid, Taufik Mesiano, Mohammad Kurniawan, Rakhmad Hidayat, Reyhan Eddy Yunus, Endi Novianto, Ocktafiani Ocktafiani, Elvan Wiyarta, Salim Harris
Journal: Case Rep Dermatol Med (2023)
MeSH terms: Case Reports

Background:
Stroke is one of the top causes of death and disability in several nations. Patients with psoriasis are susceptible to multiple comorbidities, including stroke. In addition to acute ischemic stroke, psoriasis and chronic inflammation require comprehensive treatment. Here, we present a comprehensive management case of a patient with an acute ischemic stroke and psoriasis. Case Presentation. A 42-year-old man came to the emergency department complaining of sudden left-sided weakness that started two and a half hours before being admitted to the hospital. The patient was treated with cyclosporine from 2013 to 2019 for a history of psoriasis. The patient was then treated for secondary stroke prevention using aspirin, vitamin B6, vitamin B12, folic acid, simvastatin, cyclosporine, and topical treatment. After two days of treatment, the patient's condition improved clinically, and he was discharged without further neurological deficits. As a home medication, the patient's cyclosporine was switched to the initial dose of methotrexate (7.5 mg/week) and titrated weekly to a response dose of 10 mg in the 10th week. After three months of follow-up, the patient's condition remained stable, devoid of similar symptoms or sequelae.
Conclusions:
Cyclosporine should only be used for a maximum of 1 year for stroke management with psoriasis and be substituted for other systemic agents such as methotrexate. In addition, anticoagulants, antihypertensive, antihyperlipidemic, vitamin B6, vitamin 12, and folic acid regimens are highly recommended for comprehensive therapy of cardiovascular comorbidities.
Clinicopathological analysis of composite lymphoma: A two-case report and literature review
Authors: Wei Gui, Jing Wang, Li Ma, Yanli Wang, Liping Su
Journal: Open Med (Wars) (2020)
MeSH terms: Case Reports

Objective:
The objective of this study was to evaluate the clinicopathological features and treatment of composite lymphoma (CL) with cervical lymph node enlargement.
Methods:
In this study, two cases of CL are presented. Biopsies of enlarged cervical lymph nodes by excision revealed two distinct types of lymphomas. The diagnoses were confirmed by routine histopathology, immunohistochemistry, in situ hybridization, polymerase chain reactions and flow cytometry. Case 1 was diagnosed with Hodgkin's lymphoma and cytotoxic T-cell lymphoma complicated by Epstein-Barr virus infection. Case 2 was diagnosed with diffuse large B-cell lymphoma and angioimmunoblastic T-cell lymphoma.
Results:
Case 1 received one cycle of adriamycin, bleomycin, vincristine and dacarbazine (ABVD regimen) combined with chidamide, followed by one cycle of gemcitabine and dexamethasone (GDP regimen) combined with chidamide, and then oral acyclovir. The patient achieved stable disease, but was lost to follow-up. Case 2 received eight cycles of cyclophosphamide, pirarubicin, vincristine and dexamethasone (CTOP regimen) combined with chidamide, and the patient achieved complete remission. Nine months later, relapse was confirmed. She received chidamide monotherapy for 3 months, which was then terminated. One year later, the patient underwent progressive disease and died.
Conclusions:
CL is a kind of rare disease. Due to the complexity of CL, clinicians should consider both disease components in order to increase the likelihood of effective treatment. This is important.
Mucinous adenocarcinoma of the appendix with inguinal node metastases
Authors: Ricardo Vaz-Pereira, Rita Marques, Urânia Fernandes, Ana Monteiro, João Pinto-de-Sousa
Journal: Autops Case Rep (2021)
Keywords: adenocarcinoma mucinous, appendix, groin, lymphatic metastasis
MeSH terms: Case Reports

Mucinous adenocarcinoma of the appendix is a rare neoplasm with a low propensity for lymph node metastasis. The present case refers to an appendicular mucinous adenocarcinoma with inguinal lymph node metastasis. A 71-year-old woman underwent an appendectomy due to a clinical presentation of acute appendicitis. However, the histological examination of the surgical specimen revealed a mucinous adenocarcinoma of the appendix. After staging, the patient underwent a right hemicolectomy and was proposed for adjuvant chemotherapy. At the 3rd year of follow-up, inguinal lymphadenopathy was diagnosed, which biopsy confirmed inguinal node metastases from primary colorectal cancer, with areas of extracellular mucin. Restaging revealed liver and peritoneal metastasis, and the patient was proposed for palliative chemotherapy. Appendicular neoplasms, due to their rarity, represent a diagnostic and therapeutic challenge. This clinical case depicts an unusual metastasis pathway for an unusual neoplasm.
An Unusual Presentation of Extracavitary Primary Effusion Lymphoma: Internal Jugular Vein Occlusion, Intractable Symptoms of Intracranial Hypertension, and Prolonged Remission after Highly Active Antiretroviral Therapy
Authors: Anindita Ghosh, Rodrick Chitaurirwa Zvavanjanja, Joshua Baalwa
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Primary involvement of the skeletal muscle by extracavitary primary effusion lymphoma (PEL) is an extremely rare phenomenon. We report an unusual case of PEL involving the jugulodigastric skeletal muscle without serous cavity involvement which resulted in complete occlusion of the ipsilateral proximal internal jugular vein, causing the patient to present with clinical features of intractable throbbing headache, photophobia, acute confusion state, sporadic syncopal attacks, and dyspnea without obvious palpable neck swellings. This led to an initial clinical suspicion, dedicated diagnostic workup, and empiric therapy for acute meningoencephalitis, severe atypical pneumonia, and acute pulmonary embolism. Owing to his refractory symptoms, exploratory CT imaging eventually revealed a heterogenous jugulodigastric mass, and finally, a pathologic diagnosis of extracavitary PEL was identified as the cause of his intracranial hypertension. The patient remains in remission 22 months after commencing a dolutegravir-based HAART regimen without any chemotherapeutic intervention.
Effect of physiotherapy rehabilitation on osteogenesis imperfecta with a midshaft tibial fracture in the 11-year-old patient: a case report
Authors: Radha Manish Nangliya, Deepak Satish Jain, Akshaya Virendra Saklecha, Deepali Swapnil Patil
Journal: Pan Afr Med J (2022)
Keywords: osteogenesis imperfecta, brittle bone disease, case report, midshaft tibial fracture, physiotherapy rehabilitation
MeSH terms: Osteogenesis Imperfecta / complications, Osteogenesis Imperfecta / diagnosis, Osteogenesis Imperfecta / therapy, Tibial Fractures / therapy, Case Reports, Bone Density, Child, Humans, Male, Physical Therapy Modalities, Quality of Life

Osteogenesis imperfecta (OI), a brittle bone disease is a rare genetic condition characterised by skeletal anomalies that results in higher bone fragility, reduced bone mass, deformity, and other connective-tissue signs in which the body is unable to form healthy bones. This case report presents a case of an 11-year-old male kid who visited our hospital with a complaint of pain and deformity in his left leg. After investigations, he was diagnosed with osteogenesis imperfecta with a midshaft tibial fracture of the left leg. Physical therapy rehabilitation was started and plays one of the important roles in the management of this condition along with medical and orthopedic management. Physical therapy involves strengthening exercises, stretching exercises, bracing, functional activities, gait training, etc. This case study highlighted that physical therapy rehabilitation along with multidisciplinary care; can help the patient with pain management and functional independence which enhances the patient's strength, endurance, prevents deformity, and improves the patient's quality of life.
A Case of Urachal Carcinoma of the Abdominal Wall in a Kidney Transplant Recipient
Authors: Takuya Yamazaki, Yasushi Nagaba, Yoshitaka Shimada, Yoshinori Taoka, Satoru Minamida, Dai Koguchi, Masahiro Hagiwara, Sho Watanuki, Hide Nagaba, Kazunari Yoshida, Yasuo Takeuchi
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Urachal carcinoma is an extremely rare malignant tumor arising from the urachus in the fetus. We report a patient who developed urachal carcinoma 18 years after kidney transplantation. A 59-year-old man was admitted because of abdominal pain and massive ascites. He had undergone kidney transplantation 18 years earlier and had end-stage renal disease requiring dialysis. Abdominal CT showed massive ascites and an abdominal wall cystic mass separated from the peritoneal cavity. Hemodialysis was started, and paralytic ileus was diagnosed and treated. His ileus symptoms improved temporarily, but he died of myocardial infarction. An autopsy was performed, which revealed cystadenocarcinoma in the abdominal wall mass, leading to a diagnosis of urachal carcinoma.
Sarcoidosis: Is It a Possible Trigger of Inclusion Body Myositis?
Authors: Ali Zakaria, Issam Turk, Kenneth Leung, Ana Capatina-Rata, Waseem Farra
Journal: Case Rep Rheumatol (2017)
MeSH terms: Case Reports

Sarcoidosis is a multisystem disorder of unknown etiology, characterized pathologically by the presence of nonnecrotizing granulomatous inflammation in affected organs. Although skeletal muscle is involved in 50-80 percent of individuals with sarcoidosis, symptomatic myopathy has been shown to be a rare manifestation of the disease. Inclusion body myositis (IBM) is a rare acquired idiopathic inflammatory myopathy with the insidious onset of asymmetric and distal muscle weakness that characteristically involves the quadriceps, tibialis anterior, and forearm flexors. Moreover, dysphagia can be the presenting complaint in one-third of patients. Herein, we are presenting a case of 67-year-old African American female who presented with one-month history of new onset progressive dyspnea on exertion. She was diagnosed with stage IV sarcoidosis based on chest CT scan findings and transbronchial lung biopsy revealing nonnecrotizing granulomatous inflammation. Over the next three months after her diagnosis, she presented to the hospital with progressive dysphagia associated with asymmetrical distal muscle weakness. A quadriceps muscle biopsy revealed features consistent with inclusion body myositis. We are reporting this case as it may support the hypothesis of sarcoidosis being a trigger that possibly promotes the development of inclusion body myositis, leading to a very poor prognosis.
Multimodal Elimination for Intoxication with a Lethal Dose of Organic Mercury
Authors: L C Napp, C Moelgen, F Wegner, P Heitland, H D Koester, M Klintschar, M Hiss, A Schaper, B Schieffer, J Bauersachs, A Schäfer, J Tongers
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

We here report on a case of massive organic mercury intoxication in a 40-year-old man that resulted in progressive multiorgan failure. We treated the patient intravenously and enterally with the chelating agent (RS)-2,3-bis(sulfanyl) propane-1-sulfonic acid (DMPS) in addition to hemodialysis. The patient was treated for 6 weeks and could successfully be weaned from mechanical ventilation and hemodialysis. He awoke and was sent to rehabilitation, but unfortunately died 7 months later from refractory status epilepticus. Autopsy revealed severe brain atrophy consistent with organ damage from massive mercury intoxication. The present case illustrates that bimodal DMPS application is sufficient for detoxification from lethal mercury levels, with an associated chance for weaning of organ support and survival to discharge. The case further reminds us of intoxication as a cause of multiorgan dysfunction. We propose to immediately initiate combined parenteral and enteral detoxification in cases of methyl mercury intoxication, especially in cases of high doses.
Systemic Capillary Leak Syndrome Induced by Influenza Type A Infection: A Case Report
Authors: Masafumi Fukuda, Masakazu Nabeta, Nobuhisa Hirayu, Mikinori Kannae, Osamu Takasu
Journal: Cureus (2023)
Keywords: acute kidney injury, influenza virus type a, renal replacement therapy (rrt), rhabdomyolysis, systemic capillary leak syndrome
MeSH terms: Case Reports

Rhabdomyolysis accompanying influenza virus infection is a notable extrapulmonary complication. We experienced a case of influenza type A followed by rhabdomyolysis and systemic capillary leak syndrome (SCLS). A 57-year-old man with no significant past medical history was diagnosed as having influenza type A six hours after fever onset, and treatment with oseltamivir was started. Shock, rhabdomyolysis, and acute kidney injury (AKI) progressed rapidly. At 53 hours after starting the oral treatment, intensive care was initiated, including ventilation management. In the acute phase, a large-dose replacement was given for the SCLS and continuous renal replacement therapy for AKI; both eventually healed without sequelae.
Esophageal melanocytosis in oral opium consumption
Authors: Bita Geramizadeh, Fatemeh Asadian, Alireza Taghavi
Journal: Iran Red Crescent Med J (2014)
Keywords: melanosis, mouth, opium
MeSH terms: Case Reports

Esophageal melanocytosis is a rare and benign condition, characterized by melanocytic proliferation of the esophageal squamous epithelium with heavy melanin deposition. The etiology and pathogenesis has not been exactly known but it seems to be a chronic stimulus such as gastroesophageal reflux. This condition is very rare and about 35 cases have been reported so far, most of which have been from India and Japan. Herein, we present a case of esophageal melanocytosis in a patient with long history of oral opium consumption. To the best of our knowledge, such a history has not been reported.
Superior Mesenteric Artery Syndrome: A Rare Mimic of Common Causes of Upper Gastrointestinal Obstruction
Authors: Gayatri Madhab, Jette Madsen, Eva Brems Dalgaard, Arindam Bharadwaz
Journal: Euroasian J Hepatogastroenterol (2014)
Keywords: aortomesenteric angle, aortomesenteric distance, mdct, superior mesenteric artery syndrome, upper gi obstruction
MeSH terms: Case Reports

Rare causes of common symptoms often pose a diagnostic dilemma which can lead to unwanted loss of precious time in proper diagnosis and management. Superior mesenteric artery (SMA) syndrome is such a rare disorder. It typically presents with signs and symptoms of upper gastrointestinal (GI) obstruction which can be mimicked by a variety of clinical conditions, such as peptic ulcer, chronic pancreatitis, mesenteric ischemia and systemic lupus erythematosus (SLE). A high degree of clinical suspicion is required to direct proper investigations to narrow down to the correct diagnosis. Multi-detector CT (MDCT) proves to be invaluable not only in ruling out more common conditions mimicking SMA syndrome but also in arriving at the correct diagnosis quickly and effectively with great clinical accuracy and thereby removing confusion and delay in proper management.
Abbreviations:
SMA: Superior mesenteric artery; GI: Gastrointestinal; MDCT: Multidetector computed tomography; MPR: Multiplanar reconstruction; AMA: Aortomesenteric Angle; AMD: Aortomesenteric distance.How to cite this article: Madhab G, Madsen J, Dalgaard EB, Bharadwaz A. Superior Mesenteric Artery Syndrome: A Rare Mimic of Common Causes of Upper Gastrointestinal Obstruction. Euroasian J Hepato-Gastroenterol 2014;4(1):58-60.
An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome
Authors: Shanker Kundumadam, Vivek Reddy, Sagar Mallikethi Reddy, Pradeep Kathi, Aiden Abidov
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

There have been multiple reports of allergic reactions associated with acute coronary syndromes. This has been classically described as Kounis syndrome. We present an unusual case of 70-year-old male with multiple prior hypersensitivity reactions and history of coronary artery bypass grafting who presented recurrent episode of severe angioedema and anaphylaxis. He responded to epinephrine but subsequently developed a non-ST elevation myocardial infarction with worsening heart failure. Our case is unique in that, unlike classic Kounis syndrome, the acute coronary event in this case did not present concurrently with the allergic reaction; rather it took nearly 48 hours to present. Subsequent angiogram revealed patent grafts and significant decline in the left ventricular systolic function as compared to his own ECHO a year ago. We postulate that slow mediators of inflammation may play a role in delayed development of acute coronary events with associated LV dysfunction following episodes of angioedema and anaphylaxis.
Difficulty in Diagnosing Anti-neutrophil Cytoplasmic Antibody-Related Vasculitis With Interstitial Pneumonia and in Ascertaining the Cause of Associated Hematochezia: A Case Report
Authors: Ryuichi Ohta, Kotaro Murakami, Yudai Tanaka, Tsuyoshi Mishiro, Chiaki Sano
Journal: Cureus (2023)
Keywords: anti-neutrophil cytoplasmic antibody (anca)-associated vasculitis (aav), cytomegalovirus (cmv), general medicine, non-specific interstitial pneumonia, rural hospital
MeSH terms: Case Reports

The diagnosis of rheumatological diseases is challenging among older patients with multimorbidity. Rheumatological diseases in older patients show varied symptoms, such as fatigue, fever, and appetite loss. We encountered an older woman with anti-neutrophil cytoplasmic antibody (ANCA)-related vasculitis complicated by cytomegalovirus (CMV) infection. The case was further complicated by hematochezia and was eventually diagnosed as CMV infection with adverse reactions to medications. This case highlights the difficulty of diagnosing ANCA-related vasculitis and dealing with the complications arising due to the side effects of therapy.
Dichorionic diamniotic twin pregnancy discordant for bladder exstrophy
Authors: William Tu, Jane Chueh, William Kennedy
Journal: Adv Urol (2009)
MeSH terms: Case Reports

A 38 year-old woman presented with a dichorionic diamniotic twin pregnancy at gestational age of 32 weeks concerning for an abdominal wall mass in one of the twins. Initial ultrasound evaluation was suspicious for an omphalocele, but the affected twin was found to have bladder exstrophy at birth. This illustrates the difficulties of accurate prenatal diagnosis of bladder exstrophy in a twin pregnancy at a late gestation.
Multifactorial aetiology for non-uremic calciphylaxis: a case report
Authors: Sijan Basnet, Niranjan Tachamo, Rashmi Dhital, Biswaraj Tharu
Journal: J Community Hosp Intern Med Perspect (2018)
Keywords: calciphylaxis, non-uremic, paraganglioma, sodium thiosulfate, von kossa stain
MeSH terms: Case Reports

Calciphylaxis is commonly associated with end-stage renal disease patients on haemodialysis. We present a rare case of calciphylaxis in a non-uremic patient. The diagnosis was made clinically and confirmed with skin biopsy showing calcification of the dermal and subcutaneous tissues in the von Kossa stain. We believe that the combination of uncontrolled diabetes mellitus, a non-functioning paraganglioma and vitamin D deficiency in a susceptible female patient was responsible for causing calciphylaxis in our patient. An index of suspicion should be maintained by clinicians for calciphylaxis even in patients without uremia.
Misinterpretation of Gram Stain from the Stationary Growth Phase of Positive Blood Cultures for Brucella and Acinetobacter Species
Authors: Ali M Bazzi, Jaffar A Al-Tawfiq, Ali A Rabaan
Journal: Open Microbiol J (2017)
Keywords: acinetobacter, blood culture, brucella, coryneform, gram-stain
MeSH terms: Case Reports

Introduction:

Acinetobacter baumannii and Brucella species are Gram-negative organisms that are vulnerable to misinterpretation as Gram-positive or Gram-variable in blood cultures.
Objective:
We assess the random errors in gram stain interpretation to reduce the likelihood of such errors and therefore patient harm.
Methodology:
Aerobic and anaerobic blood cultures from two patients in an acute care facility in Saudi Arabia were subjected to preliminary Gram-staining. In case 1, VITEK-2 Anaerobe Identification, repeat Gram staining from a blood agar plate, Remel BactiDrop™ Oxidase test, Urea Agar urease test and real-time PCR were used to confirm presence of Brucella and absence of Coryneform species. In case 2, repeat Gram- staining from the plate and the vials, VITEK-2 Gram-Negative Identification, real-time PCR and subculture on to Columbia agar, blood agar, and MacConkey agar were carried out to identify A. baumannii.
Results:
In case 1, initially pleomorphic Gram-positive bacteria were identified. Coryneform species were suspected. Tiny growth was observed after 24 h on blood agar plates, and good growth by 48 h. Presence of Brucella species was ultimately confirmed. In case 2, preliminary Gram-stain results suggested giant Gram-positive oval cocci. Further testing over 18-24 h identified A. baumannii.
Conclusions:
Oxidase test from the plate and urease test from the culture vial is recommended after apparent identification of pleomorphic Gram-positive bacilli from blood culture, once tiny growth is observed, to distinguish Brucella from Corynebacterium species. If giant Gram-positive oval cocci are indicated by preliminary Gram-staining, it is recommended that the Gram stain be repeated from the plate after 4-6 h, or culture should be tested in Triple Sugar Iron (TSI) medium and the Gram stain repeated after 2-4 h incubation.