OpenMed/multicare-articles huggingface dataset:
Diagnosis of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery with Echocardiography and Digital Subtraction Angiography
Authors: Haiyan Yang, Jinqing Li, Xiaojuan Ji
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a common coronary artery anomaly associated with high mortality and may lead to sudden death if left unrecognized and untreated. This report describes an 8-year-old female who had cardiac murmur but with no clinical symptoms. Electrocardiogram (ECG) was normal, but echocardiography made the diagnosis of ALCAPA. Digital subtraction angiography (DSA) with cardiac catheterization angiography (CAG) confirmed the diagnosis, and finally, the patient received surgery. This case demonstrates that echocardiography is a sensitive and convenient technique for establishing the initial diagnosis of ALCAPA in both symptomatic and asymptomatic patients.
Combined lung-kidney transplantation: First case in Portugal
Authors: David T Silva, Carolina Dantas, Ana Sofia Santos, Cecilia Silva, Inês Aires, Francisco Remédio, Sofia Carrelhas, Ana Pena, João Eurico Reis, Paulo Calvinho, Luísa Semedo, João Cardoso, Fernando Nolasco, José Fragata
Journal: Respir Med Case Rep (2021)
Keywords: combined lung-kidney transplantation, continuous venovenous hemodiafiltration, cystic fibrosis, vv-ecmo
MeSH terms: Case Reports

A significant dysfunction of another organ is usually considered an absolute contraindication for lung transplantation, unless multiorgan transplantation is indicated and practical, as is the case of combined lung-kidney transplantation. Few cases of combined lung-kidney transplantation have been described in the literature; however, it is known that, in certain cases, it is the only way to offer an opportunity to selected patients with renal and lung dysfunction. The authors are not aware of any previously published case of a patient receiving both extracorporeal membrane oxygenation and continuous venovenous hemodiafiltration as a bridge for combined kidney-lung transplantation. The authors present the first case of combined lung-kidney transplantation performed in Portugal.
Novel treatment of traumatic CSF rhinnorhea using titanium mesh and onlay graft
Authors: Pankaj Ailawadhi, Deepak Agrawal, A K Mahapatra
Journal: J Pediatr Neurosci (2010)
Keywords: csf rhinnorhea, cranial defect, pericranial graft, repair, titanium mesh, trauma
MeSH terms: Case Reports

Post-traumatic rhinnorhea due to large frontobasal fractures remains a difficult entity to treat. The authors report the case of a 9-year-old boy who had persistent CSF rhinnorhea due to extensive frontobasal fractures and who was managed with transcranial extradural surgery with titanium mesh placement and only pedicled pericranial flap.
Case Report: A case report of acromegaly associated with primary aldosteronism
Authors: Joanna Matrozova, Silvia Vandeva, Sabina Zacharieva
Journal: F1000Res (2014)

We describe a patient with a rare combination of acromegaly and primary aldosteronism. A 37 year-old female patient was diagnosed with acromegaly on the basis of typical clinical, hormonal and image characteristics. She presented also with one of the most common co-morbidities - arterial hypertension. The patient has been regularly followed-up and after three surgical interventions, irradiation and adjuvant treatment with a dopamine agonist, acromegaly was finally controlled in 2008 (20 years after diagnosis). Arterial hypertension however, remained a therapeutic problem even after prescription of four antihypertensive drugs. She had normal biochemical parameters, except for low potassium levels 3.2 (3.5-5.6) mmol/l. This raised the suspicion of primary hyperaldosteronism, confirmed by a high aldosterone to plasma rennin activity ratio, high aldosterone level after a Captopril challenge test and visualization of a 35 mm left adrenal nodule on a CT scan. After an operation, the patient recovered from hypokalemia and antihypertensive therapy was reduced to a small dose of a Ca blocker. Co-morbid arterial hypertension is common in acromegaly, though it is rare for this to be caused by Conn's adenoma. The association of Conn's adenoma with acromegaly has been interpreted in two lines: as a component of multiple endocrine neoplasia type (MEN1) syndrome or as a direct mitogenic effect of hyperactivated GH-IGF1 axis.
Isolated Knee Arthritis as Early and Only Symptom of Whipple's Disease
Authors: Dario Giunchi, Natalie Marcoli, Luca Deabate, Marco Delcogliano, Enrique Testa, Christian Candrian, Paolo Gaffurini
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

We report a case of isolated Whipple's disease involving the knee of a 64-year-old female patient who presented recurrent monoarthritis whose origin was not clear. Initially, the cause of the gradually invalidating symptoms was related to a meniscal lesion and a diffuse minor grade chondropathy, but pain and functional impairment suggested that more exams were needed. Biopsies were performed during arthroscopy. The histology showed highly inflammatory infiltrates with PAS staining negative for Tropheryma while PCR revealed the infection with Tropheryma whipplei. This, following the recommendation of a rheumatologist and infectious disease specialist, led to biopsies of the gastrointestinal tract and analysis of the cerebrospinal fluid that showed no other organ involvement. This confirms the scientific literature that an isolated monoarthritis without involvement of the gastrointestinal tract caused by this bacterium is rare but can occur as an early manifestation of potentially fatal systemic disease. Moreover, a review of the scientific literature showed the uncertainty about epidemiology of this rare disease, suggesting that more and specific data are required.
Recurrent Desmoid Tumor of the Neck: A Case Report of a Benign Disease with Aggressive Behavior
Authors: Dionisios A Klonaris, Alexander D Karatzanis, Stylianos G Velegrakis, Eleni D Lagoudakis, Emmanuel P Prokopakis, George A Velegrakis
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

We present a case of a desmoid tumor recurrence in a patient with a history of a resected desmoid tumor of the right neck area with free surgical margins six months earlier. The neoplasm was found to invade the parapharyngeal space, and wide excision was performed including most of the sternocleidomastoid muscle (SCM), the thrombosed internal jugular vein (IJV), and the infiltrated spinal accessory nerve (SAN). The histopathologic findings displayed free microscopic margins, with close margins at the site of the parapharyngeal space extension. After 3 months, there was no sign of tumor recurrence. After 6 months, local tumor recurrence was identified on clinical examination and imaging. The decision of the Oncology Board was further treatment with radiotherapy (RT). Response to treatment was satisfactory, and the patient was on close follow-up for twelve months. Desmoid tumors are very rare benign neoplasms of mesenchymal origin with negligible mortality but high morbidity, due to their high recurrence rates, local tissue infiltration, and unpredictable disease course and response to treatment. No universally acceptable treatment protocols have been introduced to date. Appropriate patient counseling and close follow-up are warranted in all cases.
Physiological Basis of the Couvade Syndrome and Peripartum Onset of Bipolar Disorder in a Man: A Case Report and a Brief Review of the Literature
Authors: Evangelia Giourou, Maria Skokou, Stuart Peter Andrew, Philippos Gourzis
Journal: Front Psychiatry (2018)
Keywords: bipolar disorder, couvade syndrome, male, mood episode, peripartum-onset
MeSH terms: Case Reports

Rapid hormonal changes during pregnancy as well as psycho-social stressors accompanying parenthood have often been associated with peripartum mood episodes in women with bipolar disorder or with not yet clinically expressed bipolar diathesis. Yet, little is known about the correlation of peripartum onset of bipolar disorder in men. We present the case of a man with bipolar disorder with peripartum onset and subsequent episodes following the peripartum initiation of the disease, as well as the association of the couvade syndrome, as a pathological response to a man due to hormonal shifts observed in males cohabiting with a pregnant female. The patient had his first depressive episode during the peripartum period of his spouse, followed by two mixed episodes with psychotic features that leaded to his compulsory psychiatric evaluation and subsequent hospitalization and the diagnosis of Bipolar Disorder I. There is a well-known correlation between the peripartum period and mood disturbances to the point of inducing full blown episodes, suggesting of a bipolar disorder initiation or mood episodes relapsing in female patients already diagnosed with bipolar disorder. Due to the patient's psychological disturbances and the phenomenology of his symptoms, mainly concerning the psychotic features accompanying his episodes, we discuss the possible underlying biological correlates as a triggering mechanism, that might overlap the manifestation of the Couvade Syndrome as well as the initiation or relapse of Bipolar Disorder in males. It seems that males are not less influenced by hormonal and psycho-social factors posed upon them during the peripartum period of their cohabiting female spouse.
Multi-drug-resistant Enterococcus faecium bacteraemia in a liver transplant recipient
Authors: Nathan A Summers, John Gharbin, Rachel Friedman-Moraco, G Marshall Lyon, Joseph Lutgring
Journal: JMM Case Rep (2018)
Keywords: bacteraemia, chloramphenicol, liver abscess, solid organ transplant, tigecycline
MeSH terms: Case Reports

Introduction:

Enterococcus faecium is a commensal organism commonly colonizing the human gastrointestinal tract. Although it is generally a non-virulent organism, E. faecium can cause significant morbidity and mortality due to its inherent and acquired resistances to commonly used antimicrobials. Patients who are immunosuppressed are particularly vulnerable.
Case presentation:
A 65-75-year-old patient with a history of an orthotopic liver transplant for hepatitis C infection and diabetes was re-admitted to the hospital with abdominal pain and fever. The patient had several recent admissions related to the presentation reported here, which included treatment with a prolonged course of broad-spectrum antibiotics. The patient was found to have a recurrent liver abscess and blood cultures grew vancomycin-resistant E. faecium, non-susceptible to all tested agents: ampicillin, penicillin, vancomycin, daptomycin and linezolid. The patient was started initially on chloramphenicol intravenously while awaiting additional susceptibility testing, which ultimately revealed chloramphenicol non-susceptibility. Tigecycline was started but the patient ultimately decided to pursue hospice care.
Conclusion:
Multi-drug-resistant organisms are increasingly being recognized and are associated with poorer outcomes, particularly in immunosuppressed patients. We describe a particularly resistant organism and discuss potential therapeutic options.
Abatacept in the Treatment of Juvenile Dermatomyositis-Associated Calcifications in a 16-Year-Old Girl
Authors: Sukesh Sukumaran, Vini Vijayan
Journal: Case Rep Rheumatol (2020)
MeSH terms: Case Reports

Calcinosis is a feared complication of JDM that may be seen in up to 40% of children with JDM. It is associated with negative impact on the patients' quality of life due to weakness, functional disability, joint contractures, muscle atrophy, skin ulcers, and secondary infections. Calcinosis can present as superficial nodules or plaques, larger nodular deposits extending into deeper tissue layers, accumulation of calcifications along the fascial planes of muscles or tendons, or an exoskeleton of calcium leading to limitations in mobility and joint contractures. Currently, there are no known effective treatments for calcinosis and current therapy is based on anecdotal retrospective studies and cases series. We report the case of a child with JDM-associated calcinosis with extensive intramuscular calcifications who failed conventional therapies but demonstrated improvement as evident by decrease in calcinosis and improved physical function with use of abatacept. We found that use of abatacept was associated with improvement in functional outcome and recurrence did not occur. This case suggests use of abatacept as a safe and effective treatment option for calcinosis due to JDM. Furthermore, large-scale clinical studies are needed to validate our findings and to evaluate the long-term outcomes.
Lemon seed allergy: a case presentation
Authors: O Stephanie Kayode, Nuevalynne Prado, David J Thursfield, Stephen J Till, Leonard Q C Siew
Journal: Allergy Asthma Clin Immunol (2020)
Keywords: adult, anaphylaxis, case report, citrus, food hypersensitivity, hybridisation, immunoglobulin e, seed, tree nut
MeSH terms: Case Reports

Background:
We report a case of IgE-mediated hypersensitivity to lemon seed. We demonstrate for the first time a pattern of cross-sensitisation between seeds of citrus hybrid species from similar ancestral species origins.
Case report:
Described is a case of a 26-year-old female with recurrent anaphylaxis on exposure to lemon seed with sensitisation shown on prick to prick testing. Prick to prick testing was also performed to a variety of citrus fruit seeds and edible foods from additional notable families of the Sapindale order.
Conclusion:
In cases of unexplained or recurrent anaphylaxis in adult patients, citrus seed allergy should be considered.
Periprocedural considerations during implantation of ICD in a patient with Dextrocardia
Authors: Farid Aliyev, Cengizhan Turkoglu, Isil Uzunhasan, Cengiz Celiker
Journal: Indian Pacing Electrophysiol J (2010)
Keywords: icd implantation, dextrocardia

In this case report we present a patient with dextrocardia, who undergone implantation of dual chamber implantable cardioverter-defibrillator (ICD). Here we aimed to underline several specific considerations which must be noted when one considers to implant an ICD in a patient with dextrocardia.
Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Common Variable Immunodeficiency
Authors: Pasquale Comberiati, Giorgio Costagliola, Niccolò Carli, Annalisa Legitimo, Sofia D'Elios, Rita Consolini, Diego G Peroni
Journal: Front Immunol (2019)
Keywords: ige (immunoglobulin e), chronic urticaria, common variable immunodeficiency, intravenous immunoglobulin, omalizumab
MeSH terms: Chronic Urticaria / drug therapy, Common Variable Immunodeficiency / drug therapy, Omalizumab / therapeutic use, Case Reports, Adolescent, Adult, Female, Humans, Quality of Life, Young Adult, Omalizumab

Chronic spontaneous urtcaria (CSU) can represent the leading sign of a wide spectrum of systemic diseases, including primary immunodeficiencies. We describe the case of a young adult female with coexisting CSU and common variable immunodeficiency (CVID) successfully treated with omalizumab. The patient, with a history of recurrent respiratory infections during childhood, was referred to clinical attention due to the development of refractory CSU. During the diagnostic workup for the research of secondary causes of urticaria, an immunological assessment was performed, showing markedly reduced levels of IgG and IgM, poor antibody response against vaccinating antigens in absence of a T cellular deficiency. Therefore, the diagnosis of CVID was posed. Despite the immunoglobulin replacement and a trial with intravenous immunoglobulin at immunomodulatory dosage, the patient continued to experience severe urticaria, with significant impairment in the quality of life. After 2 years from the diagnosis of CVID, a treatment with omalizumab was started, showing complete remission of cutaneous symptoms after the first injection. The drug was well-tolerated, and the patient did not experience adverse effects during a 12-months follow-up.
Therapeutic plasma exchange: a second-line treatment for brodifacoum poisoning following an anaphylactoid reaction to vitamin K
Authors: Ying Deng, Li Qiu
Journal: Clin Case Rep (2016)
Keywords: anaphylactoid reactions, brodifacoum poisoning, therapeutic plasma exchange, vitamin k1
MeSH terms: Case Reports

Vitamin K1 is the first-line therapy to brodifacoum poisoning. Anaphylactoid reactions may occur anytime during intravenous administration of vitamin K1 injection. Vitamin K1 must be ceased when anaphylactoid reactions emerge, and therapeutic plasma exchange could be a second-line option.
Ruptured ectopic pregnancy as complete hydatidiform mole: Case report and review of the literature
Authors: Aikaterini Athanasiou, Anis Féki, Arrigo Fruscalzo, Benedetta Guani, Nordine Ben Ali
Journal: Front Surg (2022)
Keywords: adnexal mass, ectopic pregnancy, haemoperitoneum, mole, tubal mass
MeSH terms: Case Reports

Usually, a hydatidiform mole (HM) develops inside the uterus. The occurrence of HM in ruptured tubal pregnancy is exceptional. Cases reported in the literature are scarce. In this article, a case of haemoperitoneum secondary to a ruptured fallopian tube by a complete mole is reported. A 50-year-old gravida 2, para 1 was admitted to the emergency department for acute abdominal pain. After the clinical examination, an abdominal sonography and CT scan were done, revealing the presence of an adnexal left mass associated with an important haemoperitoneum. A urine pregnancy test was done and was positive, indicating an immediate laparoscopic exploration. The laparoscopy revealed a haemoperitoneum secondary to a ruptured tubal mass. The pathological exam concluded a complete hydatidiform mole (CHM) invading the wall of the fallopian tube. Any acute abdominal pain in a potentially pregnant woman imposes first the routine realization of a pregnancy test. The occurrence of CHM in a ruptured fallopian tube is particularly rare and has exceptionally been diagnosed before the laparoscopic exploration.
Case report:18F-2-deoxy-2-fluoro-D-glucose positron emission tomography/computed tomography image findings of a dog with gossypiboma
Authors: Su-Hyeon Kim, Sungin Lee
Journal: Front Vet Sci (2023)
Keywords: 18f-deoxy-2-d-glucose, canine, dog, gossypiboma, positron emission tomography/computed tomography
MeSH terms: Case Reports

A 13-year-old, spayed, female mixed breed dog that had previously undergone mastectomy and ovariohysterectomy was referred for evaluation of metastasis after surgery. 18F-deoxy-2-D-glucose positron emission tomography/computed tomography (18F-FDG PET-CT) was performed and a soft-tissue mass was observed in the abdominal cavity. The characteristics of the abdominal mass were assessed and screening for metastasis was done with follow-up 18F-FDG PET scans. Uptake of 18F-deoxy-2-D-glucose was higher in the peripheral region and lower in the center of the abdominal mass. Exploratory laparotomy was performed, and the removed abdominal mass was consistent with a gossypiboma, which is a retained surgical sponge composed of non-absorbable material with cotton matrix. This case report describes the characteristics of 18F-FDG PET-CT imaging in a dog with an abdominal gossypiboma, which has not been reported in the veterinary literature before.
Reactivation of Epstein-Barr Virus Presenting as Massive Splenomegaly after Initiation of Golimumab Treatment
Authors: Anthony J Febres-Aldana, Christopher A Febres-Aldana, Kathrin Dvir, Gliceida Galarza-Fortuna, Michael Schwartz, Ana M Medina, Vathany Sriganeshan
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

Epstein-Barr virus infection is most commonly asymptomatic in the acute setting, where the end result of infection is the adoption of a viral latency phenotype. The virus can reactivate later in life leading to the abnormal proliferation of the infected B, T, or NK cells. Hereby, we report a 71-year-old female with seronegative rheumatoid arthritis who presented with massive splenomegaly, pancytopenia, and positivization of antibodies against double-stranded deoxyribonucleic acid (dsDNA) after initiation of the anti-tumor necrosis factor (TNF) golimumab. The diagnosis of EBV-associated lymphoproliferative disorder (LPD) was demonstrated by elevation of the plasmatic EBV viral load. Withdrawal of the anti-TNF and treatment with the anti-CD20 antibody rituximab were able to revert the clinical abnormalities. EBV-associated LPDs are described after initiation of other anti-TNF agents, such as infliximab, but no reports of golimumab-associated EBV LPD are found in the literature. The mechanisms for this occurrence are not clear, but these are known to involve expression of a panel of viral proteins specific to the viral latency phenotypes.
Chylothorax and chylous ascites due to juvenile paracoccidioidomycosis: a case report
Authors: Ana Paula Freitas Bahia Dos Santos, Tomás Varella Costa Russo, Beatriz Pascuotte, Luis Felipe Silva Visconde, Adryelle Carolynne Nogueira Luetz, Andrey Biff Sarris, Matheus Dias Girão Rocha, Fernanda Guioti Puga, Gilberto Gambero Gaspar, Valdes Roberto Bollela, Roberto Martinez
Journal: Rev Soc Bras Med Trop (2023)
MeSH terms: Chylothorax, Chylous Ascites, Lymphadenopathy, Paracoccidioidomycosis, Case Reports, Adolescent, Fever, Humans

Paracoccidioidomycosis (PCM) is a systemic fungal infection caused by Paracoccidioides species. Chylothorax is a rare complication of PCM. A 16-year-old adolescent presented daily fever, lymphadenomegaly, sweating, weight loss, ventilatory-dependent pain, and dysphagia, which confirmed PCM. During treatment, the patient developed chylothorax and chylous ascites. Chronic inflammatory and fibrotic lymphadenopathy may obstruct lymphatic vessels, resulting in the extravasation of lymph into the abdomen or pleural cavities. Chylothorax is one of several complications of PCM and can lead to respiratory insufficiency, even in patients undergoing antifungal therapy.
TSEN54 Gene-Related Pontocerebellar Hypoplasia Type 2 Could Mimic Dyskinetic Cerebral Palsy with Severe Psychomotor Retardation
Authors: Iliyana Hristova Pacheva, Tihomir Todorov, Ivan Ivanov, Desislava Tartova, Katerina Gaberova, Albena Todorova, Diana Dimitrova
Journal: Front Pediatr (2018)
Keywords: tsen54 gene, dyskinetic cerebral palsy, epilepsy, microcephaly, pontocerebellar hypoplasia, severe psychomotor retardation
MeSH terms: Case Reports

Pontocerebellar hypoplasia (PCH) type 2 is a very rare autosomal recessive neurodegenerative disorder with prenatal onset that disrupts brain development. We present three patients (two siblings and one unrelated child) with PCH 2 linked to the most common mutation c.919G > T (p.Ala307Ser) in TSEN54 gene. The disease started soon after birth with feeding difficulties, extrapyramidal symptoms, psychomotor retardation, progressive microcephaly. Two of the patients were diagnosed with dyskinetic cerebral palsy (CP) at first. Despite the neurodegenerative character of PCH 2, the absence of regression and even some developmental progress in few patients, might erroneously lead to the incorrect diagnosis of dyskinetic CP. Megacisterna magna on brain ultrasound makes the diagnosis of PCH 2 highly probable and should prompt further imaging with MRI. MRI findings of PCH are pivotal for the diagnosis. Genetic testing for the most common mutation in TSEN54 gene should also be performed. Correct diagnosis of PCH 2 is essential not only for the prognosis of the patient, but also for prenatal diagnosis in future pregnancies. Knowledge of the clinical picture of PCH 2 will lead to correct and timely diagnosis. Advanced neuroimaging procedures and molecular genetic techniques provide valuable tools for prompt diagnosis of rare, but clinically important, neurogenetic imitators of CP.