OpenMed/multicare-articles huggingface dataset:
Vigabatrin-Induced Encephalopathy in a 5.5-Month-Old Girl with Infantile Spasms due to Tuberous Sclerosis
Authors: Eleni Klinaki, Ioanna Argyri, Georgia Amountza, Gerina Ioannidou, Despoina Maritsi, Anastasia Garoufi, George Vartzelis
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

A 5.5-month-old female infant with tuberous sclerosis complex presented with infantile spasms and was treated with vigabatrin. As her condition did not improve, she was given adrenocorticotropic hormone (ACTH) intramuscularly which stopped the spasms and improved the electroencephalogram (EEG) abnormalities. However, she developed encephalopathy with apathy, drowsiness, and generalized slowing in the EEG. Discontinuation of vigabatrin quickly improved her symptoms and reversed the EEG slowing. A high index of suspicion is required in order to diagnose vigabatrin-induced encephalopathy, especially as the underlying disorders of these patients can be erroneously considered the cause of the observed encephalopathy.
An unusual recurrence of pruritic creeping eruption after treatment of cutaneous larva migrans in an adult Ghanaian male: a case report with a brief review of literature
Authors: Neils Ben Quashie, Emmanuel Tsegah
Journal: Pan Afr Med J (2015)
Keywords: cutaneous, hookworm, migrans, pruritic skin, serpiginous
MeSH terms: Albendazole / administration & dosage, Anthelmintics / administration & dosage, Larva Migrans / parasitology, Skin Diseases, Parasitic / parasitology, Case Reports, Review, Albendazole / therapeutic use, Anthelmintics / therapeutic use, Drug Resistance, Ghana, Humans, Larva Migrans / drug therapy, Male, Middle Aged, Pruritus / parasitology, Recurrence, Skin Diseases, Parasitic / drug therapy, Anthelmintics, Albendazole

The hookworm related Cutaneous Larva Migrans is a common disease present in the tropic and subtropical areas of the world. The disease is self limiting and would naturally resolve within weeks. However, an unusual recurrence of the disease in a Ghanaian male after standard treatment was observed and is herein reported. A 52 year old Ghanaian male of Akan dissent was diagnosed with Cutaneous Larva Migrans in a clinic in Accra, Ghana. Symptoms of the disease persisted for three days after treatment with a 400mg single dose Albendazole and was only resolved after re-dosing with 400 mg daily of the same drug for three days. Two months post-treatment, the usual pruritic creeping eruption typical with the disease re-appeared even though the victim has not been re-exposed to any possible larva contaminated source. This could possibly be a case of hookworm-related larva resistance to a standard anti-helminthic therapy and host immunity.
NOTCH 1 Mutation in a Patient with Spontaneous and Recurrent Dissections of Extracranial Arteries
Authors: Carlos Guevara, Gonzalo Farias, Kateryna Bulatova, Pablo Alarcón, Wendy Soruco, Carlos Robles, Marcelo Morales
Journal: Front Neurol (2017)
Keywords: notch1, pro2122leu, dissection of extracranial arteries, recurrent dissection of extracranial arteries, stroke
MeSH terms: Case Reports

Dissections of extracranial arteries are estimated to account for only 2% of all ischemic strokes but for approximately 20% of strokes in patients younger than 45 years old. Most dissections of extracranial arteries involve some trauma stretch, mechanical stress, or connective tissue abnormalities. In the absence of these disorders, determining the etiology of recurrent extracranial dissections is quite challenging because the underlying nature of these cases is poorly understood. We report the case of a 44-year-old female with recurrent dissections of the vertebral and carotid arteries associated with a heterozygous mutation p.Pro2122Leu in the NOTCH 1 gene. Her mother with a thoracic aortic aneurysm was also positive for this variant.
The Four-Cluster Spectrum of Mind-Body Interrelationships: An Integrative Model
Authors: Yacov Ezra, Oded Hammerman, Golan Shahar
Journal: Front Psychiatry (2019)
Keywords: bio-psycho-social model, cognitive behavioral therapy, functional somatic syndromes, hypnosis, medical psychology, mind-body medicine, psychosomatic medicine

Despite the shift toward a biopsychosocial paradigm of medicine, many physicians and mental health professionals (MHPs) find it difficult to treat patients with psycho-somatic disorders. This situation is particularly troublesome due to the high prevalence of these conditions. Although progress has been made over the last few decades in understanding mechanisms underlying the mind-body relationship, disparities remain between research and its clinical implementation. One possible reason for this is the lack of a comprehensive, agreed-upon model that incorporates a biopsychosocial framework and is rooted in an understanding of the various psychobiological pathways. Such a model would enable better communication between physicians and MHPs, allowing them to provide coordinated, stratified treatment. In this paper, four archetypal case studies, together with standard care options are presented to illustrate the current state of affairs. A four-tiered conceptual model of mind-body interrelationships based on pathophysiological and psychopathological mechanisms is suggested to help optimize the treatment of somatic complaints. This Four-Cluster model consists of: (1) Organic Conditions: Structural, or degenerative processes that can affect mood and psychological responses but are not clearly exacerbated by stress. (2) Stress Exacerbated Diseases: Biological disorders with a distinct pathophysiology, such as inflammatory or autoimmune diseases, whose progression is clearly exacerbated by stress. (3) Functional Somatic Syndromes: Conditions wherein heightened sensitivity to stimuli together with hyper-reactivity of the autonomic system form a "vicious cycle" of mutually enhancing learning processes. These processes involve biological mechanisms, such as central sensitization and psychological mechanisms such as catastrophization and selective attention. (4) Conversion Disorder: Physical manifestations of psychological distress, expressed somatically. Symptoms are solely an expression of problems in patients' psychic functioning and are not caused by biological pathology. Finally, suggested management of the aforementioned case studies is presented through the lens of the Four-Cluster model and a proposed integration of our model with existing theories is discussed. As it is rooted in an understanding of psychobiological pathways of illness, the proposed model enables a new way to discern which form of mind-body interaction is manifesting in different diseases and proposes a way to coordinate treatment plans accordingly, to enhance the accuracy and efficacy of care.
Oblivion: autopsy findings of a 31-year-old man with sudden cardiac arrest, a case report of a sequalae of Kawasaki disease
Authors: Daniel Fernando Gallego, Maria Eugenia Zuluaga Ruiz, Desiree Ann Marshall
Journal: Autops Case Rep (2022)
Keywords: coronary aneurysm, coronary disease, death, sudden, forensic pathology, mucocutaneous lymph node syndrome
MeSH terms: Case Reports

A 31-year-old man presented to the hospital after suffering a sudden cardiac arrest. Despite optimal therapy, the patient passed away. His medical history included febrile rash at age 2. At autopsy, there was aneurysmal dilation and severe coronary artery stenosis by atherosclerotic plaques and myocardial fibrosis. These findings were presumed to be due to complications of Kawasaki disease, given the remote history of severe febrile rash as a toddler and the presence of chronic coronary artery injury, recanalization, and thrombosis with ischemic heart disease leading to sudden cardiac collapse and death.
Case Report: Nintedanib for immune-related pneumonitis triggered by anti-PD-1 treatment in a patient with SMARCA4-mutant NSCLC: a case report
Authors: Changwen Deng, Ganxiu Deng, Xiaoping Zhu
Journal: Front Pharmacol (2023)
Keywords: nsclc, smarca4-mutant, case report, immune checkpoint inhibitors, nintedanib
MeSH terms: Case Reports

SMARCA4-mutant lung cancer accounts for approximately 10% of non-small-cell lung cancers (NSCLCs), has few effective treatments, and has been associated with a poor prognosis. Our case report describes a 73-year-old man who was diagnosed with SMARCA4-mutant advanced lung adenocarcinoma. Routine driver gene mutation screening was negative, and tumor tissue immunohistochemistry analysis showed the absence of the BRG1 protein (encoded by SMARCA4). In addition to the standard chemotherapy regimens, programmed cell death protein 1 (PD-1) inhibitors were administered. After three cycles of combination therapy, the focus of the primary lung tumor shrunk evidently, but radiological interstitial abnormalities emerged in the basal and subpleural areas of the bilateral lungs. The patient's clinical condition deteriorated and he was diagnosed with immune checkpoint inhibitor (ICI)-associated pneumonia. Thus, the combination regimen was discontinued, corticosteroid therapy was administered according to guidelines, and nintedanib was added, given that interstitial abnormalities were observed on chest computed tomography (CT). Following the above treatment, the patient's condition improved, the standard chemotherapy regimen was restarted, and nintedanib treatment was maintained. The patient's clinical condition continued to improve, and follow-up CT showed significant resolution of the interstitial abnormalities and stabilization of the primary tumor lesion. In summary, we report the case of a patient with SMARCA4-mutant NSCLC, which is generally considered to be associated with a poor prognosis owing to a lack of effective treatments. The patient responded favorably to initial combination therapy with ICIs, although he subsequently developed immune-related adverse events. We also found that nintedanib, a multitargeted anti-fibrotic agent, was beneficial for the treatment of immune-related lung injury and showed potential anti-tumor effects.
Extra-Adrenal Myelolipoma Containing Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia: A Case Report and Review of the Literature
Authors: Komal Arora, Jagmohan Sidhu
Journal: Case Rep Hematol (2016)

Myelolipoma is a benign tumor consisting of mature fat interspersed with hematopoietic elements resembling bone marrow. The vast majority occurs within the adrenal glands, but several cases of extra-adrenal myelolipomas (EAMLs) have been reported. We report a case of a 64-year-old male who presented with complaint of lower abdominal discomfort. CT scan of abdomen and pelvis showed a 6 cm × 5 cm, well-circumscribed, predominantly fatty mass in the presacral region. Histological examination of the pelvic mass revealed a myelolipoma heavily infiltrated by small lymphoid cell aggregates with immunophenotypic features of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL). Review of the literature revealed that there is only one published report of SLL/CLL involving a myelolipoma, which was also an extra-adrenal myelolipoma, and, therefore, our case is the second case of a SLL/CLL involving a myelolipoma that is an extra-adrenal myelolipoma. Extra-adrenal myelolipomas seem to the preferred myelolipomas for involvement by SLL/CLL.
Remarkable Response of EGFR- and HER2- Amplified Metastatic Colon Cancer to Pyrotinib After Failed Multiline Treatments: A Case Report and Literature Review
Authors: Hong-Shuai Li, Li-Li Yang, Ming-Yi Zhang, Ke Cheng, Ye Chen, Ji-Yan Liu
Journal: Front Oncol (2020)
Keywords: colorectal cancer, human epidermal growth factor receptor 2, pyrotinib, resistance, trastuzumab
MeSH terms: Case Reports

Human epidermal growth factor receptor 2 (HER2) has been verified as a valuable biomarker and treatment target in metastatic colorectal cancer (mCRC). Pyrotinib, a novel irreversible HER2/epidermal growth factor receptor (EGFR) dual tyrosine kinase inhibitor, can efficiently inhibit the proliferation of HER2-positive cancer cells in many tumors. We report a case of a 40-year-old woman with both HER2- and EGFR-amplified metastatic colon cancer, who developed refractory disease resistant to multiline therapies (including trastuzumab with lapatinib) but achieved a remarkable response after pyrotinib treatment. For patients with HER2-positive mCRC, who have developed resistance to trastuzumab and lapatinib, pyrotinib is a promising new candidate, which can be used as salvage therapy.
Considerations for the use of immunosuppression for the management of pemphigus during the COVID-19 pandemic with a focus on rituximab: Case reports from a single center experience in Australia
Authors: Ben Koszegi, Corey Stone, Dedee F Murrell
Journal: Front Med (Lausanne) (2023)
Keywords: covid-19, immunosuppression, pemphigus, rituximab, vaccine
MeSH terms: Case Reports

Pemphigus is a rare group of autoimmune mucocutaneous blistering conditions for which the mainstay of treatment is immunosuppression. This is usually achieved with high dose corticosteroids as well as steroid sparing agents. Rituximab is now recommended as a first line treatment for moderate to severe pemphigus vulgaris, the commonest form of pemphigus, alongside corticosteroids. During the early stages of the COVID-19 pandemic the use of rituximab was reduced in our department due to its long term irreversible B-cell suppression. During the COVID-19 pandemic careful pharmacological selection was undertaken for our pemphigus patients to balance the risks of immunosuppression. To demonstrate this, we report three pemphigus patients who required treatment for COVID-19 and assessment throughout the pandemic. To date there has been limited published data regarding the clinical outcomes of pemphigus patients who have developed COVID-19 infections following rituximab infusions, especially in those patients who have received COVID-19 vaccinations. Following careful personalized consideration, all three pemphigus patients presented received rituximab infusions since the start of the COVID-19 pandemic. These patients had also received COVID-19 vaccinations prior to becoming infected with COVID-19. Each patient had a mild COVID-19 infection after receiving rituximab. We advocate for all pemphigus patients to have a full course of COVID-19 vaccinations. Antibody response to COVID-19 vaccinations should ideally be confirmed by measuring pemphigus patient's SARS-CoV-2 antibodies prior to receiving rituximab.
SLE and Non-Hodgkin's Lymphoma: A Case Series and Review of the Literature
Authors: Prajwal Boddu, Abdul S Mohammed, Chandrahasa Annem, Winston Sequeira
Journal: Case Rep Rheumatol (2017)
MeSH terms: Case Reports

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder punctuated by varied multiorgan complications all along the course of its natural history. Lymphoma represents a relatively well-recognized malignant phenomenon associated with lupus. The cause and effect relationships of lymphoma in SLE have been subject to extensive scrutiny with several studies reporting on clinic-pathologic characteristics and risk factors predicting lymphoma development in SLE. However, the pathogenic role of immunosuppressives in SLE-related lymphoma still remains unclear, and indices to help guide diagnosis, prognostication, therapy, and posttreatment monitoring are yet to be established. In this review, we describe 3 SLE patients who developed non-Hodgkin's lymphoma at different time points of their disease. Through a careful dissection of the aforementioned cases, we intend to apprise readers of the currently available literature surrounding risk factors, management, and prognosis in SLE-related lymphoma. We will also review and discuss the implications of immunosuppressives in SLE-related lymphoma and the role of mycophenolate mofetil in SLE-related primary CNS lymphoma development.
Percutaneous transhepatic biliary stenting in patients with intradiverticular papillae and biliary strictures caused by ampullary carcinoma: A case report
Authors: Hong-Tao Niu, Qiang Huang, Ren-You Zhai
Journal: Oncol Lett (2014)
Keywords: endoscopic retrograde cholangiopancreatography, intradiverticular papilla, malignant biliary stricture, percutaneous transhepatic biliary stenting

Endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy is a well-established procedure for the treatment of bile duct strictures. However, the procedure is difficult to perform in patients with intradiverticular papillae or tumor infiltration of the major papilla. Percutaneous transhepatic biliary stenting (PTBS) is commonly used in the management of malignant biliary stricture. The current study reports two cases of PTBS performed to treat malignant obstructive jaundice caused by ampullary carcinoma complicated with intradiverticular papillae. PTBS is potentially a safe technique for this relatively rare condition.
Cecal Endometriosis Presenting as Hematochezia in a Postmenopausal Female
Authors: Roland J Quintana-Rapatalo, Davong D Phrathep, Ivanna Ward, Kevin D Healey, Stefan Anthony, Michael Herman
Journal: Cureus (2023)
Keywords: cecal endometriosis, cyclical abdominal pain, endometriosis, hematochezia, postmenopausal female
MeSH terms: Case Reports

Our report highlights the diagnosis of cecal endometriosis as a unique cause of hematochezia in a postmenopausal female. Cecal endometriosis manifesting as intermittent hematochezia and abdominal pain is uncommon but requires prompt clinical diagnosis and management. We report a case of cecal endometriosis causing hematochezia and subsequent syncope, which prompted the patient's admission to the emergency department. In our patient, a diagnosis of cecal endometriosis was made after a colonoscopy, with multiple biopsies confirming the presence of endometrial tissue embedded in the cecum. We aim to bring awareness of cecal endometriosis presenting as hematochezia in a postmenopausal woman with a history of abdominal pain. This case highlights intestinal endometriosis as a differential diagnosis to be considered in women, regardless of age, with intermittent hematochezia and abdominal pain.
Hibernoma: a rare case of adipocytic tumor in head and neck
Authors: Alexandra Rodriguez Ruiz, Sven Saussez, Thibaut Demaesschalck, Jérôme R Lechien
Journal: BMC Ear Nose Throat Disord (2017)
Keywords: head,, hibernoma,, lipoma, neck,, tumor,
MeSH terms: Case Reports

Background:
Hibernoma is a rare soft tissue tumor stem from persistent fetal brown fat tissue. This benign tumor may occasionally occur in head and neck area and, in most cases, is characterized by an asymptomatic slow growth.
Case presentation:
We presented an uncommon case of hibernoma of the posterior cervical triangle occurring in a 30-year-old man referred to the department of otolaryngology. The patient suffered from a right, very painful, and rapidly growing mass since 3 months. MRI examination reported both an infiltrating mass and a homogenous enhancement of an underlying vascularization after the injection of intravenous contrast. According to the risk of sarcoma, a surgical procedure was made to completely excise the mass that was a hibernoma.
Conclusions:
Hibernoma may occur with an uncommon clinical presentation imitating malignancy. MRI plays a key role in the differential diagnosis and surgery remains the better therapeutic approach.
Long-term survival from gastrocolic fistula secondary to adenocarcinoma of the transverse colon
Authors: Matthew J Forshaw, Jamasp K Dastur, Kothandaraman Murali, Michael C Parker
Journal: World J Surg Oncol (2005)

BACKGROUND: Gastrocolic fistula is a rare presentation of both benign and malignant diseases of the gastrointestinal tract. Malignant gastrocolic fistula is most commonly associated with adenocarcinoma of the transverse colon in the Western World. Despite radical approaches to treatment, long-term survival is rarely documented. CASE PRESENTATION: We report a case of a 24-year-old woman who presented with the classic triad of symptoms associated with gastrocolic fistula. Radical en-bloc surgery and adjuvant chemotherapy were performed. She is still alive ten years after treatment. CONCLUSIONS: Gastrocolic fistula is an uncommon presentation of adenocarcinoma of the transverse colon. Radical en-bloc surgery with adjuvant chemotherapy may occasionally produce long-term survival.
An Unusual Fatal Outcome of Laparoscopic Cholecystectomy: A Case Report
Authors: Catarina Osório, Diogo Silva, Luís Teles, Tiago Ferreira, Mário Nora
Journal: Cureus (2023)
Keywords: clostridium perfringens, gas gangrene, intravascular hemolysis, klebsiella oxytoca, laparoscopic cholecystectomy complication
MeSH terms: Case Reports

Clostridium perfringens (C. perfringens) and Klebsiella oxytoca (K. oxytoca) are pathogenic human bacteria. Clostridium perfringens sepsis with intravascular hemolysis is a catastrophic process with an extremely high mortality rate (70 to 100%). A 74-year-old male submitted to an elective laparoscopic cholecystectomy due to cholelithiasis and develops severe abdominal pain only 10 hours after being discharged from hospital. He was admitted to the emergency department with associated jaundice, fever, and hematuria. On arrival, his hemoglobin level was 9.2 g/dL but fell to 3.4g/dL within two hours. Massive intravascular hemolysis was diagnosed and a liver abscess with gas gangrene was shown in the contrast-enhanced computed tomographic. Despite proper management, a fatal outcome was unavoidable and the patient died eight ours later. Microbiological examination isolated C. perfringens and K. oxytoca. Liver abscesses caused by C. perfringens and K. oxytoca are extremely rare complications of laparoscopic cholecystectomy. Early recognition and prompt antibiotic therapy as well as control of septic focus are essential to minimize this fatal outcome.
Interval Hysterectomy for Placenta Percreta - a Case Report
Authors: Mohammad Sazzadul Huque, Mini Ravi
Journal: Cent Asian J Glob Health (2019)
Keywords: case report, complications of placenta percreta, interval hysterectomy, placenta percreta

Introduction:
Placenta percreta is an abnormality of placentation where it invades the serosa and can go beyond it. Complications include massive hemorrhage, bladder dysfunction, and severe infections during delivery. The aim of this study is to report a complex case of placenta percreta managed by interval hysterectomy.
Case presentation:
Pre-operative: 34 years old patient with previous three cesarean sections was followed in antenatal clinic. She came with repeated bouts of vaginal bleeding at 30-31 weeks. At 32 weeks and 4 days classical cesarean section was done with placenta left in situ. Prophylactic bilateral internal iliac artery balloon was inserted. Post cesarean section, uterine artery embolization was performed. Post-operative: Clinical features of pulmonary embolism (PE) developed about 4 hours later. Post-Operative Day 13: Total abdominal hysterectomy was done. After few days of discharge, the patient presented to the emergency department with shortness of breath. She was consequently diagnosed with chronic pulmonary embolism and treated with warfarin.
Conclusion:
This is a case of placenta percreta managed by interval hysterectomy. However, the most widely accepted method of management is cesarean hysterectomy. In this case, interval hysterectomy was done due to the possibility of bladder invasion by placenta, to decrease the amount of blood loss and to reduce the number of days stayed in hospital. Appropriate management for the patient must be personalized, whether it is by cesarean hysterectomy or interval hysterectomy, as each has risks and benefits.