OpenMed/multicare-articles huggingface dataset:
Novel Anterior Brainstem Magnetic Resonance Imaging Findings in Non-Small Cell Lung Cancer with Leptomeningeal Carcinomatosis
Authors: Chun-Yu Cheng, Chia-Yu Hsu, Yuan-Hsiung Tsai, Kuang-Lin Lin, Cih-En Huang, Yi-Hong Fan, Shy-Chyi Chin, Yen-Chu Huang
Journal: Front Neurol (2017)
Keywords: brain magnetic resonance imaging, brainstem, leptomeningeal carcinomatosis, lung cancer, restrictive diffusion
MeSH terms: Case Reports

Leptomeningeal carcinomatosis (LC) is found in around 4% of patients with non-small cell lung cancer (NSCLC). The most common radiological finding of LC is diffuse leptomeningeal enhancement on contrast-enhanced brain magnetic resonance imaging (MRI). Herein, we report a novel brain MRI finding-non-enhanced, band-like, symmetric restricted diffusion along the anterior surface of the brainstem-of LC in four patients with NSCLC. We also identified three additional cases with similar MRI findings in a literature review. We hypothesized that the restricted diffusion along the anterior brainstem was caused by malignant cells concentrating in the cistern around the brainstem and infiltrating into the circumferential perforating arteries along the anterior brainstem surface, which then resulted in microinfarctions.
Duplicated Inferior Vena Cava Thrombosis Mimicking Acute Pancreatitis in a COVID-19 Patient
Authors: Louis Costanzo, Bhesh R Karki, Brian Soto, Vladimir Falb, Cameron Page
Journal: Cureus (2023)
Keywords: anticoagulation, congenital malformation, covid-19, inferior vena cava, pancreatitis, thrombosis
MeSH terms: Case Reports

An 86-year-old woman with a recent hospitalization for severe coronavirus disease 2019 (COVID-19) infection presented to the emergency department with abdominal discomfort and bilateral leg swelling. She was mildly tachycardic on physical exam, with superficial abdominal vessel dilation and bilateral lower extremity edema. Her laboratory results were significant for a mildly elevated lipase of 260 U/L (normal range: 0-160 U/L) and a positive COVID-19 PCR test. CT of the abdomen and pelvis did not show any pancreatic abnormality but revealed a duplicated inferior vena cava (IVC) with a thrombus located in the right IVC. The patient was subsequently placed on full-dose anticoagulation with the eventual achievement of clot lysis. It appears that the incidence of thrombosis, including IVC thrombosis, has been on the rise due to COVID-19-associated coagulopathy; therefore, a high index of clinical suspicion in these cases may prove to be lifesaving.
Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric Case
Authors: Ivan Jose Ardila Gomez, Pilar Pérez López, Mónika Rocío Hernández Carreño, Juan Camilo Barrios Torres
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Dengue is a single-stranded RNA virus belonging to the Flaviviridae family. It is an endemic virus in tropical countries. In Colombia, 4 serotypes are present, and the disease is a burden for public health, social programs, and the economic sectors. The main vector is Aedes aegypti, and most infections are asymptomatic or minimally symptomatic. The hemorrhagic appearances of severe dengue are due to plasma leakage as a result of increased vascular permeability, severe thrombopenia, and hemoconcentration. In 2020, 78,979 cases of dengue were reported in Colombia. 38,836 (49.2%) of them were warning-free signs, 39,246 (49.7%) with warning signs, and 897 (1.1%) of severe dengue. As it is well-known, viral diseases are immune system activators, triggering off a loss of tolerance in it. Dengue is not an exception, and it is able to explain different autoimmune phenomena including macrophage activation. Mechanisms have been described by which an exacerbated response of the disease is triggered through the increase of infected cells, formation of immune complexes, and complement pathway activation, which lead to a cross-reaction of viral antigens with epithelial cells with platelets with subsequent endothelial dysfunction and bleeds. The first description of Evans syndrome was made in 1951 by Robert Evans. This syndrome is characterized by the combination of autoimmune hemolytic anemia, immune thrombocytopenia, and, less common/usual, immune neutropenia. This disease's etiology is unknown, and the dysregulation of the immune system is among its possibilities. Here, we present the case of an unusual hematological and immunological complication of a patient who developed Evans syndrome during severe dengue, taking into account the concomitantly limited literature available for these two diseases, the need for a broader diagnostic approach, multidisciplinary intervention, and a more complex therapeutic approach.
Case Report: A Promising Treatment Strategy for Noninfectious Uveitis
Authors: Xiao-Bao Liu, Lu-Shi Tang, Jing-Wen Chen, Chang-Song Lin, Qiu-Hong Liu, Qiang Xu
Journal: Front Pharmacol (2022)
Keywords: jak inhibitor, case report, glucocorticoid drugs, noninfectious uveitis, tofacitinib
MeSH terms: Case Reports

Background: Uveitis refers to inflammation in the uvea, retina, retinal blood vessels, and vitreous, which can lead to irreversible eye damage and permanent vision loss. Glucocorticoid drugs are the first-line treatment, but side effects, such as obesity and hyperglycemia, can occur. Therefore, biologics have become a new treatment choice. Case Presentation: A 18-year-old girl developed eye pain and was diagnosed with binocular uveitis. Prednisone 50 mg was administered once a day, and the redness and pain in both eyes improved. Later, the prednisone dose was gradually reduced, and treatment was discontinued 3 years ago. Two years ago, the patient's condition relapsed, with both eyes becoming red and painful. She was administered prednisone 20 mg once daily and adalimumab. Visual acuity in both eyes continued to progressively decrease, accompanied by cataracts. At the same time, the patient experienced complications, including obesity and hyperglycemia. Subsequently, a new treatment regimen, oral prednisone 20 mg once a day, tofacitinib 5 mg twice a day, and methotrexate 10 mg once a week, as well as the use of insulin to control blood sugar, was initiated. One month later, the patient's redness and eye pain eased, and her vision gradually improved. The dosage of prednisone was gradually reduced to 5 mg once daily. At the same time, her blood sugar returned to normal, and insulin was stopped. Outcomes: The patient was treated with tofacitinib for 10 months. Subsequently, her best-corrected visual acuity of the right eye rose from 0.06 to 0.075, and the best-corrected visual acuity of the left eye rose from CF/30 cm to CF/100 cm. Redness and eye pain were relieved, her glucocorticoid consumption reduced from 15 to 2.5 mg, and her blood sugar gradually normalized. Conclusion: This case study shows that tofacitinib relieves ocular inflammation in patients with uveitis and improves eyesight. We believe that JAK inhibitors could be another treatment option for noninfectious uveitis in patients who do not respond to conventional anti-TNF-α inhibitors (such as adalimumab).
Mucous Membrane Pemphigoid, Bullous Pemphigoid, and Anti-programmed Death-1/ Programmed Death-Ligand 1: A Case Report of an Elderly Woman With Mucous Membrane Pemphigoid Developing After Pembrolizumab Therapy for Metastatic Melanoma and Review of the Literature
Authors: Coralie Zumelzu, Marina Alexandre, Christelle Le Roux, Patricia Weber, Alexis Guyot, Annie Levy, Françoise Aucouturier, Sabine Mignot-Grootenboer, Frédéric Caux, Eve Maubec, Catherine Prost-Squarcioni
Journal: Front Med (Lausanne) (2018)
Keywords: adverse drug reaction, anti-programmed-death-1/death-ligand-1, bullous pemphigoid, drug accountability study, immune checkpoints inhibitors, melanoma, mucous membrane pemphigoid, pembrolizumab
MeSH terms: Case Reports

An 83-year-old patient developed erosions and a blister of the gingival mucous membrane, 6 months after discontinuation of the anti-programmed death-1 (anti PD-1) pembrolizumab therapy administered for 10 months for a metastatic melanoma. A diagnosis of mild mucous membrane pemphigoid (MMP) was made. Complete remission of MMP was rapidly obtained with minimal therapy (doxycycline). MMP remained in complete remission after a 3-month follow-up since discontinuation of the doxycycline therapy and no evidence of relapse of the melanoma was observed after a 14-month follow-up since discontinuation of the pembrolizumab therapy. The widespread use of anti PD-1 and anti-programmed death-ligand-1 (PD-L1) in several malignancies reveals new adverse events. MMP describes a group of chronic, inflammatory, mucous membrane-predominant, subepithelial auto-immune blistering diseases. It is clinically distinct from bullous pemphigoid another autoimmune blistering disease but shares some immunological similarities with it. Twenty-nine cases of bullous pemphigoid associated with anti PD-1/PD-L1 have been reported in the literature and one of MMP. Here, we described the case of a MMP developed after pembrolizumab and discussed the accountability of anti PD-1/PD-L1 in our case and the previous reported bullous pemphigoid and MMP cases using the Begaud system scoring.
Occult breast carcinoma presenting as gastrointestinal metastases
Authors: Lonzetta Neal, Nicole Sookhan, Carol Reynolds
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Occult breast cancer has frequently been described as presenting as axillary lymph node metastases but rarely as gastrointestinal metastases, Varadarajan et al. (2007). In extremely rare situations, cancerous lesions identified in the gastrointestinal tract have been determined to be metastatic lesions from primary breast cancers, Taal et al. (2000). We report a case of an occult lobular adenocarcinoma presenting as gastrointestinal metastases. It is essential that the possibility of lesions found in the gastrointestinal tract originating from distant or occult cancers be considered in order that appropriate therapeutic options may be discussed and considered early after diagnosis.
Treatment of an Erratic Extraction Socket for Implant Therapy in a Patient with Chronic Periodontitis
Authors: Yusuke Hamada, Srividya Prabhu, Vanchit John
Journal: Case Rep Dent (2016)

As implant therapy becomes more commonplace in daily practice, preservation and preparation of edentulous sites are key. Many times, however, implant therapy may not be considered at the time of tooth extraction and additional measures are not taken to conserve the edentulous site. While the healing process in extraction sockets has been well investigated and bone fill can be expected, there are cases where even when clinicians perform thorough debridement of the sockets, connective tissue infiltration into the socket can occur. This phenomenon, known as "erratic healing," may be associated with factors that lead to peri-implant disease and should be appropriately managed and treated prior to surgical implant placement. This case report describes the successful management of an erratic healing extraction socket in a 62-year-old Caucasian male patient with chronic periodontitis and the outcomes of an evidence-based treatment protocol performed prior to implant therapy. Careful preoperative analysis and cone beam computed tomography imaging can help detect signs of impaired healing in future implant sites and prevent surgical complications.
Case report: Compound heterozygous NUP85 variants cause autosomal recessive primary microcephaly
Authors: Ethiraj Ravindran, Gaetan Lesca, Louis Januel, Linus Goldgruber, Achim Dickmanns, Henri Margot, Angela M Kaindl
Journal: Front Neurol (2023)
Keywords: mcph-scks, nup85, brain development, microcephaly, speech disorder
MeSH terms: Case Reports

Nucleoporin (NUP) 85 is a member of the Y-complex of nuclear pore complex (NPC) that is key for nucleocytoplasmic transport function, regulation of mitosis, transcription, and chromatin organization. Mutations in various nucleoporin genes have been linked to several human diseases. Among them, NUP85 was linked to childhood-onset steroid-resistant nephrotic syndrome (SRNS) in four affected individuals with intellectual disability but no microcephaly. Recently, we broaden the phenotype spectrum of NUP85-associated disease by reporting NUP85 variants in two unrelated individuals with primary autosomal recessive microcephaly (MCPH) and Seckel syndrome (SCKS) spectrum disorders (MCPH-SCKS) without SRNS. In this study, we report compound heterozygous NUP85 variants in an index patient with only MCPH phenotype, but neither Seckel syndrome nor SRNS was reported. We showed that the identified missense variants cause reduced cell viability of patient-derived fibroblasts. Structural simulation analysis of double variants is predicted to alter the structure of NUP85 and its interactions with neighboring NUPs. Our study thereby further expands the phenotypic spectrum of NUP85-associated human disorder and emphasizes the crucial role of NUP85 in the brain development and function.
Diode Laser-Assisted Surgical Therapy for Early Treatment of Oral Mucocele in a Newborn Patient: Case Report and Procedures Checklist
Authors: Marina Consuelo Vitale, Maria Francesca Sfondrini, Giorgio Alberto Croci, Marco Paulli, Lorenzo Carbone, Paola Gandini, Andrea Scribante
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Mucocele (also known as ranula or salivary gland mucous cyst) of the newborn is a lesion present on the intraoral cavity, with the potential to interfere with respiration and feeding. In the present report, a case of mucocele in a 4-month female patient has been described. As conventional surgery can be followed by several complications such as intraoperative bleeding, difficulties in wound healing, and maintenance of sterility during surgery, in the present case, the use of diode laser has been planned. A topic anesthesia with lidocaine gel was performed. A diode laser (810 nm wavelength, continuous wave mode, power output of 3 watt, and 0.4 mm diameter fiber optic) was set for excising the lesion. The tip was directed at an angle of 10 to 15°, moving around the base of the lesion with a circular motion. The procedure was completed in 3 minutes. The patient was visited with a follow-up of 2 weeks and 4 months after excision. The intraoral wound healed without complications, and no signs of infection or mass recurrence were noted. The histopathological examination confirmed the diagnosis of mucocele. On the basis of the results of the present case report, the use of diode laser can be easily performed also in a noncompliant newborn patient for successful excision of mucocele lesions, and checklist of clinical procedures has been described.
Microcystic/Reticular Schwannoma of the Frontal Lobe: An Unusual Occurrence
Authors: Lauren Pearson, Erinc Akture, Julien Wonderlick, Gregory Fuller, Maryam Zenali
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Schwannoma is a benign peripheral nerve sheath tumor that typically involves cranial nerves of the head and neck region. Intraparenchymal occurrence of this tumor is uncommon. Even rarer in this site is the microcystic/reticular pattern of schwannoma. This histologic variant, first described in 2008, has a predilection for visceral organs. Herein, we report the first case of microcystic/reticular schwannoma of the frontal lobe.
Calcification of the Anterior Acromial Insertion of the Deltoid Muscle
Authors: Kiminori Yukata, Ashish Suthar, Yutaka Suetomi, Kazuhiro Yamazaki, Kazuteru Doi, Hiroshi Fujii
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

A 45-year-old man presented with severe left shoulder pain that was not associated with trauma. Plain radiography with the arm in an elevated position and ultrasonography demonstrated calcium deposits at the anterior acromial insertion site of left deltoid muscle. Conservative management could successfully relieve pain. At the 3-year follow-up, the calcification completely disappeared. To the best of our knowledge, calcium deposits at the acromial insertion site of the deltoid have not been reported in the literature. Clinicians who suspect calcific tendinitis but do not observe calcification around the rotator cuff should carefully palpate and examine other sites, such as the deltoid origin, and use ultrasonography or radiography.
A patient with superior semicircular canal dehiscence presenting with Tullio's phenomenon: a case report
Authors: Richard Jd Hewitt, Anthony O Owa
Journal: J Med Case Rep (2009)

Introduction:
Superior semicircular canal dehiscence represents a manageable cause of sound and pressure induced vertigo. This case highlights its presentation and investigation, including a review of the literature, and the authors' surgical technique used in its successful treatment.
Case presentation:
A 45-year-old Caucasian man presented with vertigo induced by sound or pressure. Subsequent investigation revealed dehiscence of the superior semicircular canal and the patient underwent a surgical repair.
Conclusion:
Surgery to repair or resurface the dehiscence represents an effective treatment modality, offering a resolution of symptoms with no detrimental effect on hearing or long-term sequelae. A five-layer composite repair consisting of temporalis fascia - bone pate - conchal cartilage - bone pate - temporalis fascia has been found to be safe and effective.
Severe Hypophosphatemia in Alcohol-Induced Acute Pancreatitis: A Case Report
Authors: Usamah Al-Anbagi, Shybin Usman, Abdulrahman Saad, Abdulqadir J Nashwan
Journal: Cureus (2023)
Keywords: acute pancreatitis, alcohol, alcohol-induced pancreatitis, electrolyte abnormalities, hypophosphatemia, pancreatitis, phosphate
MeSH terms: Case Reports

Mild hypophosphatemia can be reported in some cases of acute pancreatitis, especially in alcohol-induced pancreatitis (AIP), but severe hypophosphatemia (≤0.33 mmol/L) is rarely reported, even in cases with AIP. Here, we have a case report of a 43-year-old male with alcohol-related pancreatitis associated with a critical value of hypophosphatemia. We urge clinicians to consider undertaking serial monitoring of the serum phosphate levels of any patient admitted with acute pancreatitis, especially when alcohol is involved.
Successful Low-Dose tPA for Mechanical Mitral Valve Thrombosis in a Patient with Postinfarction Contained Left Ventricular Free Wall Rupture
Authors: James Livesay, Emmanuel Isang, Hassan Tahir, Raj Baljepally
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Prosthetic valve thrombosis is a potentially life-threatening complication diagnosed by a combination of clinical features and imaging modalities, but the optimal management in high bleeding risk patients remains controversial. Current treatment options for prosthetic valve thrombosis included surgery, thrombolytic therapy, and anticoagulation. We present a very unusual case of a patient with a recent ST-elevation myocardial infarction complicated by contained left ventricle free wall rupture and mechanical mitral valve thrombosis. Deemed a high surgical risk candidate, low-dose tissue plasminogen activator was used despite significant bleeding risk from contained left ventricle free wall rupture, which resulted in resolution of the thrombus. To the best of our knowledge, this is the first report of successful thrombolytic therapy for prosthetic mechanical mitral valve thrombosis in a patient with recent postmyocardial infarction contained left ventricular free wall rupture.
Pulmonary arteriovenous malformation in a child with multiple brain abscesses: A case report
Authors: S T Hlophe, R Masekela
Journal: Afr J Thorac Crit Care Med (2021)
Keywords: arteriovenous malformation, pulmonary
MeSH terms: Case Reports

Pulmonary arteriovenous malformations (PAVMs) are caused by abnormal connections between arteries and veins, which lead to right-to-left shunting of deoxygenated blood. Here, we report an 11-year-old male who presented with signs suggestive of intracranial pathology. The patient displayed signs of a chronic illness, possibly congenital malformation that was complicated by PAVM and multiple brain abscesses. This case illustrates the importance of doing a detailed examination and investigations, especially if the history alone is not helpful in making a diagnosis.
Case report: Drug rash with eosinophilia and systemic symptoms syndrome in a patient with anti-interferon-γ autoantibody-associated immunodeficiency
Authors: Yuxue Nie, Han Wang, Xiying Dong, Siqi Pan, Ting Zhang, Jun Ran, Ying Zhang, Junping Fan, Linqi Zhang, Jinglan Wang
Journal: Front Immunol (2022)
Keywords: burkholderia, adult-onset immunodeficiency due to anti-interferon-gamma antibodies, anti-ifn-γ autoantibodies, drug rash with eosinophilia and systemic symptoms, infection, sulfamethoxazole
MeSH terms: Drug Hypersensitivity Syndrome / complications, Drug Hypersensitivity Syndrome / etiology, Eosinophilia / chemically induced, Eosinophilia / complications, Eosinophilia / diagnosis, Exanthema, Immunologic Deficiency Syndromes, Mycobacterium Infections, Nontuberculous, Case Reports, Research Support, Non-U.S. Gov't, Adult, Anti-Bacterial Agents / therapeutic use, Autoantibodies, Female, Humans, Interferon-gamma, Middle Aged, Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects, Anti-Bacterial Agents, Autoantibodies, Trimethoprim, Sulfamethoxazole Drug Combination, Interferon-gamma

A 56-year-old Chinese woman with previous disseminated mycobacterium avium complex infection and recurrent cervical abscesses from Burkholderia cepacia complex visited our hospital. She was diagnosed with adult-onset immunodeficiency (AOID) and tested positive for interferon-γ-neutralizing autoantibody. Ceftazidime was administered as the initial antimicrobial treatment, which was later combined with sulfamethoxazole-trimethoprim (SMZ-TMP). She developed drug rash with eosinophilia and systemic symptoms (DRESS) syndrome after SMZ-TMP administration and improved after withdrawal of the culprit antibiotic and systemic glucocorticoids treatment. Her cervical infection was eventually cured after combined therapy of long-term antibiotics and anti-IFN-γ autoantibodies (AIGA) titer-lowering treatments including glucocorticoids, rituximab, and plasmapheresis. This is the first case of DRESS syndrome in the setting of AIGA-induced AOID and is worthy of notice.
ALK Rearrangement-Positive Pancreatic Cancer with Brain Metastasis Has Remarkable Response to ALK Inhibitors: A Case Report
Authors: Kai Ou, Xiu Liu, Weihua Li, Yi Yang, Jianming Ying, Lin Yang
Journal: Front Oncol (2021)
Keywords: alk kinase, eml4-alk fusion protein, alectinib, brain metastases, crizotinib, pancreatic cancer
MeSH terms: Case Reports

Patients with metastatic pancreatic cancer typically have poor prognosis due to the limited effectiveness of existing treatment options. ALK rearrangement-positive is rare in pancreatic cancer, but may occur in those with KRAS-wild type. We present a 34-year-old young man with ALK rearrangement-positive and KRAS-wild pancreatic cancer who had a remarkable response to crizotinib after resistance to prior chemotherapy and re-response to alectinib after brain metastases developed. This clinical observation suggests that comprehensive molecular profiling to guide targeted therapies is not only feasible, but also significantly improves survival outcomes for a subgroup of patients with pancreatic cancer.
Pneumocystis jirovecii pneumonia in a X-linked chronic granulomatous disease female carrier
Authors: Vasiliki Kalotychou, Demetrios Mermigkis, Maria G Kanariou, Marianna Tzanoudaki, Vasiliki Epameinondas Georgakopoulou, Irene Kourbeti, George L Daikos
Journal: IDCases (2021)
Keywords: chronic granulomatous disease, neutrophils’ oxidative activity, pneumocystis jirovecii, x-chromosome inactivation, x-linked carrier
MeSH terms: Case Reports

The X-chromosome linked (XL) female carriers of chronic granulomatous disease (CGD) are considered to have no risk for infection. Herein we present a female CGD XL-carrier who developed Pneumocystis jirovecii pneumonia and Serratia marcescens infection associated with age-related skewing of X-chromosome inactivation.