OpenMed/multicare-articles huggingface dataset:
Type 1 neovascularization may confer resistance to geographic atrophy amongst eyes treated for neovascular age-related macular degeneration
Authors: Elona Dhrami-Gavazi, Chandrakumar Balaratnasingam, Winston Lee, K Bailey Freund
Journal: Int J Retina Vitreous (2015)
Keywords: age-related macular degeneration, anti-vascular endothelial growth factor, geographic atrophy, type 1 neovascularization

Background:
To report a series of age-related macular degeneration (AMD) patients in whom progression to geographic atrophy (GA) in one eye receiving frequent intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) therapy for type 1 neovascularization (NV) was slower than that of the fellow eye with non-neovascular AMD.
Methods:
Retrospective, observational case series examining the clinical course and GA progression rate in four consecutive patients in which one eye harbored type 1 neovascular AMD and was receiving anti-VEGF therapy, while the fellow eye manifested signs of non-neovascular AMD only. Eligibility criteria included anti-VEGF therapy duration of over 4 years and over 50 injections. Lesion evolution was documented via multimodal imaging. GA at baseline and final visits was quantified and GA progression rate for each eye was determined.
Results:
Four consecutive patients were followed for a mean interval of 94 months (range 62-120). One eye harbored type 1 NV while the fellow eye remained non-neovascular. The former received a mean of 65.5 ± 15.2 anti-VEGF injections. Mean rate of GA progression in non-neovascular eyes was 0.076 ± 0.024 mm2/month and in type 1 NV eyes was 0.004 ± 0.005 mm2/month. Difference in GA progression rate between type 1 and non-neovascular eyes was found to be statistically significant (P = 0.001).
Conclusions:
These findings support previous hypotheses that, unlike type 2 and 3 lesions, type 1 NV may represent a neovascular AMD subtype more resilient to GA formation. This may have implications for anti-VEGF regimens in the management of type 1 NV.
Gastrointestinal Malignancy Presenting with a Virchow's Node in a Patient with Rothmund-Thomson Syndrome
Authors: Kara Nadeau, Michele Brule
Journal: Case Rep Genet (2018)
MeSH terms: Case Reports

Rothmund-Thomson syndrome is a genetic disorder with characteristic findings in childhood as well as a predisposition to osteosarcoma, skin cancer, and hematological malignancy. We present the first reported case of duodenal malignancy in a patient with Rothmund-Thompson syndrome. An enlarged Virchow's node was noted and an advanced duodenal adenocarcinoma was diagnosed shortly thereafter. The features of Rothmund-Thomson syndrome are discussed, as well as current management and screening guidelines for duodenal adenocarcinoma.
Pediatric suppurative parotitis caused by Burkholderia pseudomallei
Authors: Zengzhen Fu, Yingzi Lin, Qiang Wu, Qianfeng Xia
Journal: J Venom Anim Toxins Incl Trop Dis (2016)
Keywords: burkholderia pseudomallei, melioidosis, parotitis, pediatrics
MeSH terms: Case Reports

Background:
Suppurative parotitis caused by Burkholderia pseudomallei has been rarely found outside endemic areas.
Case presentation:
Herein, we report the recovery of Burkholderia pseudomallei from the pus of a suppurative parotitis observed in a 12-year-old boy who lived in Hainan province, China. Specimens of necrotic tissue were collected and sections were stained with hematoxylin and eosin. Pus sample was also collected for bacteriological examination. The suppurative inflammation was observed in the necrotic tissue section and Burkholderia pseudomallei were detected in the sample.
Conclusion:
In this adolescent, Burkholderia pseudomallei infection was present in the parotid, which consists of the first report of this bacterium in a parotitis case acquired in China.
Severe combined immunodeficiency: a case series from a paediatric hospital in Kenya
Authors: Rohini Kalagouda Patil, Anne Irungu, Beatrice Kabera, Doreen Karimi Mutua, Wangui Manguyu, David Kiptum Lagat, Kaumbulu Cleopas Mutua
Journal: Pan Afr Med J (2021)
Keywords: kenya, severe combined immunodeficiency, children, primary immunodeficiency disorders
MeSH terms: Pneumonia / diagnosis, Severe Combined Immunodeficiency / diagnosis, Case Reports, Fatal Outcome, Female, Hospitals, Pediatric, Humans, Infant, Kenya, Male, Pneumonia / immunology, Severe Combined Immunodeficiency / immunology, Severity of Illness Index

Severe Combined Immunodeficiency (SCID) involves the lymphocyte lineage and mimics Human Immunodeficiency Virus (HIV) disease common in our region, making it difficult to diagnose and manage effectively. SCID in East Africa stands underdiagnosed because of lack of awareness and diagnostic resources. A case series of three SCID patients admitted to a Tertiary Paediatric Centre in Kenya between 2016 and 2019. The clinical presentations, laboratory findings, management and outcome for each were studied. Three cases were diagnosed between the ages of 4 to 15 months. Two of them were male and one was a female. All had a history of previous sibling death. There was no parental consanguinity. All presented with pneumonia. One of them had vaccine acquired Rotavirus infection and a persistent generalised maculopapular rash. The T, B cell profile was T- B- in two and T- B+ in one case and the immunoglobulins were reduced in all. All the cases were fatal. Thus, Primary immunodeficiency disorders are prevalent in East Africa. A proper clinical history, examination and laboratory tests like a haemogram, peripheral blood film can aid to suspect and diagnose SCID even with limited resources.
Persistent Response and Prolonged Survival Following Pembrolizumab Discontinuation Due to Long-Lasting Autoimmune Colitis in Advanced NSCLC: A Case Report
Authors: Angela Damato, Loredana De Marco, Silvia Serra, Mario Larocca, Alicia Garcia Arias, Ermanno Rondini, Carmine Pinto
Journal: Front Oncol (2021)
Keywords: colitis, immune checkpoint inhibitors, non-small-cell lung cancer, pembrolizimab, survival
MeSH terms: Case Reports

Pembrolizumab is a programmed death receptor-1 (PD-1) inhibitor that has been approved for treatment of a wide variety of malignancies including non-small-cell lung cancer (NSCLC). Immune-mediated colitis is a known adverse effect of pembrolizumab which can lead to the treatment interruption, although not compromising the control of the oncological disease. Herein, we report the case of a 59-year-old woman on pembrolizumab for advanced NSCLC which developed a severe and persistent colitis treated with infliximab for several months following anti-PD-1 antibody discontinuation. This strategy resulted in an improvement but not complete recovery of the gastrointestinal toxicity despite revealed sustained response and control of the oncological disease with prolonged survival over 24 months.
Hepatic and renal failure after anterior myocardial infarction induced apical ventricular septal defect
Authors: Dirk Lossnitzer, Vedat Schwenger, Stephanie Lehrke, Evangelos Giannitsis, Martin Zeier, Hugo A Katus, Henning Steen
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

We report the case of a 68-year-old man suffering from incremental hepatic and renal failure one month after anterior myocardial infarction. Cardiac MRI showed a pronounced apical post-AMI aneurysm, a moderate to severe mitral and tricuspid regurgitation as well as a hemodynamically highly significant 12 mm apical ventricular septal defect with a left-to-right ventricular shunt of almost 63% as the underlying cause. Heart X-ray revealed a severe LAD in-stent restenosis. CAPD catheter drainage of hydroperitoneum due to congestive liver and renal failure was provided in combination with intensified CAPD hemodialysis. Heart surgery was performed where the apical aneurysm was excised, the mitral valve was reconstructed, the IVSD was closed and the subtotally in-stent occluded LAD was bypassed. Post-surgery, the ascites were significantly reduced, and CAPD hemodialysis therapy could be terminated since the renal function gradually improved (MDRD = 25 mL/min). To our knowledge, for the first time we report successful CAPD catheter drainage of hydroperitoneum in combination with CAPD hemodialysis.
Association of Limb-Girdle muscular dystrophy with multiple sclerosis: A case report
Authors: Mahsa Arzani, Hamed Rezaei, Abdorreza Naser Moghadasi
Journal: Caspian J Intern Med (2018)
Keywords: limb-girdle muscular dystrophy, multiple sclerosis, myopathy
MeSH terms: Case Reports

Background:
The association of limb-girdle muscular dystrophy (LGMD) with other neurological disorders is uncommon.
Case presentation:
We report a 25-year-old female with LGMD who suffered from slowly progressive proximal muscular weakness and atrophy since she was 12 years of age. The patient recently presented with acute loss of left side visual acuity. After evaluation, findings were suggestive of multiple sclerosis.
Conclusions:
This is the first report of LGMD in association with MS. The simultaneous occurrence of MS with myopathies may be incidental but there may be a genetic susceptibility for both diseases. This comorbidity may influence the treatment of MS.
Percutaneous Approach to a Complicated Case of Nephrolithiasis in a Pregnant Woman: A Case Study
Authors: Giuseppe Giusti, Danilo Abate, Antonello De Lisa
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Background:
Lithiasis during pregnancy can be a serious problem representing a danger to both the mother and the fetus. Surgical intervention is needed in approximately one-third of patients reporting pain despite analgesia and/or signs of persistent infection and obstruction, but there is a lack of consensus in the scientific literature as to the use of the most appropriate procedure to treat this condition.
Case presentation:
We describe our experience in the treatment of a complicated reno-ureteral lithiasis in a 27-year-old patient in the first trimester of pregnancy. The patient had a calcified ureteral stent with associated stone formation in the right kidney and a bladder stone at the distal extremity of the stent. She was treated by a combined approach by percutaneous nephrolithotripsy and transurethral cystolithotripsy. The procedure we performed was effective.
Conclusion:
Our experience reinforces the feasibility and safety of the kidney stone removal by the percutaneous approach also in a pregnant patient and supports the recommendations of the European guidelines: "in experienced centers, where necessary, percutaneous nephrolithotripsy should be considered." The technical precautions taken have proven to be valid and are supported by the current literature. Therefore, we feel they can be recommended.
Noninvasive endoscopic hemostasis technique for post-papillectomy bleeding using a novel self-assembling peptide (with video)
Authors: Akira Miyano, Takeshi Ogura, Hiroki Nishikawa
Journal: JGH Open (2022)
Keywords: purastat, bleeding, endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, hemostasis
MeSH terms: Case Reports

Although a novel hemostatic agent has been used for endoscopic mucosal resection in submucosal dissection, there are few case reports of its use in pancreato-biliary endoscopic procedures. We describe a case of post-endoscopic papillectomy bleeding in which endoscopic hemostasis was achieved using a novel hemostatic agent.
Osteoid Osteoma in Children Younger than 3 Years of Age
Authors: Nikolaos Laliotis, Chrysanthos Chrysanthou, Panagiotis Konstantinidis, Lizeta Papadopoulou
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

We present a case series of four children, younger than 3 years old, with osteoid osteoma of the lower limb. Pain and limping were the main symptoms. With careful clinical examination, we could localize the affected area. Radiological evaluation revealed cortical thickening in 3 children. On MRI examination, we found extensive edema, with normal bony cortices. The central nidus was found in 3 children. CT scan was the most accurate examination which revealed the central nidus with surrounding sclerosis. Bone scans had positive uptake in the affected area. Our patients were treated with an intralesional excision biopsy, with simultaneous radiofrequency ablation in those affected in the femur. Pathological specimens confirmed the diagnosis of osteoid osteoma. There was uneventful recovery of our patients. This case series contributes to the limited description of osteoid osteoma diagnosed and treated in very young children.
A 64-Year-Old Woman with Chest Pain, Limb Weakness, and Endometrial Cancer
Authors: Simon Ponthus, Omar Kherad, Nicole Petriccioli, Johannes Alexander Lobrinus, Pierre-André A Guerne
Journal: Case Rep Rheumatol (2017)
MeSH terms: Case Reports

Necrotizing autoimmune myopathy (NAM) is a rare subgroup of idiopathic inflammatory myopathies (IIM). This pathology usually affects proximal limb muscles and in some cases the myocardium. Patients usually display proximal limb weakness. Muscular biopsy is required to confirm the diagnosis. We report the case of a 64-year-old woman with an atypical first presentation of NAM, manifested by chest pain in the context of metastatic endometrial cancer. The diagnosis of NAM was however made when she returned a second time with proximal limb weakness. A treatment with prednisone was then initiated, to which rituximab was rapidly associated, beside a specific chemotherapy.
A Case of Retroperitoneal Synovial Sarcoma in Pregnancy Treated with Antepartum Doxorubicin plus Ifosfamide Chemotherapy
Authors: Bradley H Sipe, Sarah G Običan, Evita Henderson-Jackson, Nicole D Riddle, Rikesh Makanji, Ricardo J Gonzalez, Andrew S Brohl
Journal: Case Rep Oncol Med (2021)
MeSH terms: Case Reports

We report a case of a 25-year-old pregnant woman diagnosed with a large, unresectable retroperitoneal synovial sarcoma. Successful neoadjuvant treatment with doxorubicin plus ifosfamide prepartum and continuing postpartum resulted in significant disease response allowing for later tumor resection. Following the first prepartum chemotherapy cycle, a decreased amniotic fluid index was noted, representing a potential complication of chemotherapy. Induction of labor was performed at 33 weeks gestation with excellent outcome in the newborn. This case highlights the complex medical decision-making process in the setting of cancer diagnosed during pregnancy, balancing oncologic and obstetric concerns, and to our knowledge is only the second reported case of synovial sarcoma treated with neoadjuvant cytotoxic chemotherapy in the antepartum period.
Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants
Authors: Emily E Miller, Leigh Christopher Reardon
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

Neutropenic enterocolitis (NE) historically primarily affects pediatric patients with leukemia who are undergoing chemotherapy or who have recently received bone marrow transplants. Although a few case reports have shown NE occurring outside of this typical population, to our knowledge, this is the first published case of NE occurring in the setting of pediatric heart transplant. This patient was diagnosed several months after pediatric heart transplant, with radiographs showing evidence of pneumatosis intestinalis. Although NE does not typically affect solid organ transplant patients, this patient had a variety of risk factors that may have predisposed her to development of NE such as severe neutropenia, supratherapeutic tacrolimus level, immunosuppression with cytotoxic agents, and elevated Epstein-Barr viral load. Fortunately, this patient improved with bowel rest, fluids, antibiotics, and alteration of her immunosuppressive regimen. However, NE can be fatal, and thus it is an important condition to consider, even in patients without leukemia or on chemotherapeutic regimens.
Therapeutic management of hypothenar hammer syndrome causing ulnar nerve entrapment
Authors: Emanuele Cigna, Anna Maria Spagnoli, Mauro Tarallo, Liliana De Santo, Giampaolo Monacelli, Nicolò Scuderi
Journal: Plast Surg Int (2010)
MeSH terms: Case Reports

Introduction. The hypothenar hammer syndrome is a rare traumatic vascular disease of the hand. Method and Materials. We report the case of a 43-years-old man with a painful tumefaction of the left hypothenar region. The ulnar artery appeared thrombosed clinically and radiologically. The patient underwent surgery to resolve the ulnar nerve compression and revascularise the artery. Results. The symptoms disappeared immediately after surgery. The arterial flow was reestablished. Postoperatively on day 20, a new thrombosis of the ulnar artery occurred. Conclusion. Hypothenar hammer syndrome is caused by repetitive trauma to the heel of the hand. The alterations of the vessel due to its chronic inflammation caused an acute compression of the ulnar nerve at the Guyon's canal and, in our case, do not allow a permanent revascularisation of the ulnar artery.
Late Deep Infections Complicating Percutaneous Pinning of Supracondylar Humerus Fractures
Authors: Achraf H Jardaly, Ketrick LaCoste, Shawn R Gilbert, Michael J Conklin
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Objectives:
Complications following treatment of supracondylar humerus fractures are typically seen shortly postoperatively. Late complications occurring years after percutaneous pinning are rare but can be indolent and have permanent sequelae. We present cases of children presenting with late deep infections to discuss their diagnosis and treatment.
Methods:
After institutional review board approval, we retrospectively reviewed records of three children who developed deep infections at least one year after percutaneous pinning of their supracondylar humerus fracture. Patient details and outcomes were analyzed. Radiographs and magnetic resonance imaging were reviewed along with each patient's clinical course and treatment.
Results:
We report 3 cases of osteomyelitis and/or septic arthritis presenting at least one year after supracondylar humerus fractures treated with closed reduction and percutaneous pinning. The patients required several irrigation and debridement procedures with placement of antibiotic beads in addition to a prolonged course of antibiotics.
Conclusion:
Delayed deep infections can occur after closed reduction and percutaneous pinning of supracondylar humerus fractures in children. Vigilance is required to diagnose and treat such occurrences, and prolonged follow-up is needed to monitor for recurrent or intractable infections.
Duodenal Adenocarcinoma in a Patient with Partial Intestinal Malrotation
Authors: William T Li, Sonia Sethi, Adrienne N Christopher, Deepika Koganti, Charles J Yeo
Journal: J Pancreat Cancer (2018)
Keywords: congenital anomaly, intestinal malrotation, pancreaticoduodenectomy

Background: Small bowel cancers, specifically duodenal cancer, occur at very low rates but require aggressive surgical resection when diagnosed. An even rarer finding is the presence of intestinal malrotation. Case Presentation: We present the unique case of a patient with both duodenal cancer and partial intestinal malrotation undergoing pancreaticoduodenectomy. We discuss the challenges faced and techniques used to successfully perform a surgical resection in this circumstance. Conclusion: Understanding of intestinal malrotation and review of the imaging is crucial in preparing for a resection of a duodenal tumor in a patient with this condition.
Idiopathic Renal Infarction Mimicking Appendicitis
Authors: Marco Di Serafino, Rosa Severino, Chiara Gullotto, Francesco Lisanti, Enrico Scarano
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Renal infarction is a rare cause of referral to the emergency department, with very low estimated incidence (0.004%-0.007%). Usually, it manifests in patients aged 60-70 with risk factors for thromboembolism, mostly related to heart disease, atrial fibrillation in particular. We report a case of idiopathic segmental renal infarction in a 38-year-old patient, presenting with acute abdominal pain with no previous known history or risk factors for thromboembolic diseases. Because of its aspecific clinical presentation, this condition can mimic more frequent pathologies including pyelonephritis, nephrolithiasis, or as in our case appendicitis. Here we highlight the extremely ambiguous presentation of renal infarct and the importance for clinicians to be aware of this condition, particularly in patients without clear risk factors, as it usually has a good prognosis after appropriate anticoagulant therapy.
Atypical optic neuritis - a case with a new surprise every visit
Authors: Kirandeep Kaur, Bharat Gurnani, Nirmala Devy
Journal: GMS Ophthalmol Cases (2020)
Keywords: demyelination, neuritis, tuberculosis
MeSH terms: Case Reports

Demyelination is the most common cause of optic neuritis. Typical optic neuritis needs intravenous steroids followed by tapering dose oral steroids. Atypical optic neuritis entails clinical manifestations that deviate from the classic pattern of features. Atypical ON can have devastating visual results if not treated in a timely fashion. Thus, it is critical that cases of atypical optic neuritis are recognized early to initiate proper treatment and preserve vision. Our case presented as an atypical case of optic neuritis. The patient had painless onset and was not responding to steroids, but presentation in the other eye and systemic administration of antivirals helped in management of this case.
Concomitant primary ovarian paraganglioma neuroendocrinal differentiated urothelial tumor in a BOTOX-injected bladder: A case report
Authors: M A Elbaset, Abdelwahab Hashem, M Abd Elhameed, Ahmed S El-Hefnawy
Journal: Int J Surg Case Rep (2019)
Keywords: bcg, case report, neuroendocrine differentiation, onabotulinumtoxin a (btx) injection, overactive bladder, paraganglioma

Introduction:
There is no reported data for patients with malignant bladder Botox® injection related outcomes. Herein, we reported effect of Botox® injection in case of BCG cystitis. In addition, reporting of rare incidence of both primary neuroendocrine differentiation of bladder tumor and primary ovarian paraganglioma post cystectomy.
Presentation of case:
A-64 years old female presented with sever irritative lower urinary tract symptoms (LUTS) post vesical BCG installation for carcinoma in situ. Patient's symptoms were relieved after Botox® bladder injection after anticholinergics failure. One year later, she came back with hematuria. Cystoscopy showed nodular bladder lesion. Hypertension episodes were noticed during cystoscopic resection. Pathological examination showed presence of muscle invasive transitional cell carcinoma (TCC) with neuroendocrine differentiation. Patient underwent radical cystectomy and pathology was associated with incidentally discovered primary ovarian paraganglioma.
Discussion:
Intravesical BCG is a standard adjuvant treatment for carcinoma in situ with 75% induced cystitis as a local side effect. The International Bladder Cancer Group's recommendation for BCG cystitis included many agents, these treatment options had very limited outcomes. The existence of paraganglioma in the female genital tract described rarely <1% in the vagina, uterus, vulva and ovary with only few reports. The same as paraganglioma small cell differentiation of vesical urothelial tumor is a rare entity with no reported cases of simultaneous occurrence and to differentiate each other as primary or metastatic.
Conclusion:
Bladder Botox® injection could be offered as a treatment for overactive bladder-like symptoms in malignant cystitis. Neuroendocrine tumors are with a rare entity could be happened instantaneously in urogenital tract.