OpenMed/multicare-articles huggingface dataset:
Intraoperative angioedema induced by angiotensin II receptor blocker: a case report
Authors: Ala A Alhowary, Haitham Odat, Obada Alali, Ali Al-Omari
Journal: Patient Saf Surg (2018)
Keywords: angioedema, angiotensin receptor antagonists, intraoperative complications
MeSH terms: Case Reports

Background:
Angiotensin II receptor blockers are a class of antihypertensive agent that is developed to exclude the adverse effects of angiotensin converting enzyme inhibitors. However, as angiotensin II receptor blockers have begun to be more widely prescribed, cases of angiotensin II receptor blocker-induced angioedema have been reported. Rare cases of angioedema following surgery in patients using angiotensin converting enzyme inhibitors have been published.
Case presentation:
A 38-year-old man with past history of hypertension was admitted for an elective lumbosacral spine surgery. He had been taking Valsartan 160 mg a day for the past 4 years.At the end of the surgical procedure and turning the patient into supine position, we noticed severe swelling in the neck and the face with.an edematous tongue, floor of the mouth, glottis, and supraglottic areas. A diagnosis of drug induced angioedema was made and intravenous dexamethasone, diphenhydramine and ranitidine were given. The patient remained intubated and was transferred to the intensive care unit. The valsartan was suspected to be the precipitating factor for the angioedema and was therefore discontinued.The swelling started to regress after 2 h, and resolved completely by the third day.
Conclusion:
The precise mechanism of angiotensin II receptor blocker-induced angioedema is still unknown and should be thoroughly investigated. This report demonstrates a unique case of intraoperative angiotensin II receptor blocker-induced angioedema. Potential differential diagnoses of postoperative facial edema are discussed in detail, including the prolonged prone positioning for posterior spine surgery. Anesthesiologists should be aware of such rare, but potentially dangerous, perioperative adverse reaction that can occur with angiotensin II receptor blockers use.
Emergency laparoscopic repair of an incarcerated obturator hernia, a case report
Authors: Francis Zheng Yi Yee, Aik Yong Chok, Ting Hway Wong
Journal: Int J Surg Case Rep (2020)
Keywords: case report, laparoscopic repair, obturator hernia
MeSH terms: Case Reports

Obturator hernias are rare hernias with high morbidity and mortality if not diagnosed and treated promptly. Various minimally invasive techniques have been reported in literature. Here we describe a novel technique of repairing an obturator hernia complicated by small bowel incarceration and obstruction, via a laparoscopic trans-abdominal approach.
A Case Report of Post-Operative Jöd-Basedow Phenomennon Following Oral and IV Iodine Contrast Administration
Authors: Maureen Higgs, Erroll Hull, Eugenio Lujan
Journal: Case Rep Endocrinol (2014)

This is a case of thyrotoxicosis, due to the Jöd-Basedow phenomenon following administration of oral and IV iodinated contrast in a patient with history of gastrointestinal stromal tumor (GIST) and small bowel obstruction. The patient developed atrial fibrillation and had an extended stay in the intensive care unit. Given the aging population with possible subclinical hyperthyroidism, multinodular goiter, and the rise in contrast administration for routine diagnostic studies, this case serves to raise awareness of the risks of "routine" tests administered to our aging patient population.
Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome
Authors: Sungeeta Agrawal, Robert Gensure, Lawrence Milner, Julie Nicoletta, Abdollah Sadeghi-Nejad
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Glucocorticoids are typically prescribed for the treatment of idiopathic nephrotic syndrome of childhood. In selected patients with refractory focal segmental glomuerulosclerosis (FSGS), adrenocorticotropin (ACTH) can be used to induce remission and decrease the progression of the disease. We report a 6 8/12-year-old girl with recurrent proteinuria, resistant to standard immunotherapy. She underwent related renal transplant but again developed proteinuria and was started on ACTH. She subsequently developed peripheral precocious puberty (PPP), presumably from peripheral aromatization of adrenal androgens. She was started on an aromatase inhibitor, and her ACTH dose was slowly decreased. She then developed central precocious puberty (CPP). We hypothesize that treatment of her peripheral precocious puberty with an aromatase inhibitor may have triggered central precocious puberty.
Concurrent Germline and Somatic Mutations in FLCN and Preliminary Exploration of Its Function: A Case Report
Authors: Tao Wang, Yang Yang, Huayi Feng, Bo Cui, Zheng Lv, Wenlei Zhao, Xiangyi Zhang, Xin Ma
Journal: Front Oncol (2022)
Keywords: birt-hogg-dube (bhd) syndrome, tfeb/tfe3, folliculin (flcn), mutation, renal cancer
MeSH terms: Case Reports

Birt-Hogg-Dube syndrome is an autosomal dominant condition that arises from germline folliculin (FLCN) mutations. It is characterized by skin fibrofolliculomas, lung cysts, pneumothorax, and renal cancer. Here, we present the case of a 36-year-old woman with asymptomatic, multiple renal tumors and a history of spontaneous pneumothorax. Genetic analysis revealed a hotspot FLCN germline mutation, c.1285dupC (p.H429fs), and a novel somatic mutation, c.470delT (p.F157fs). This information and the results of immunohistochemical analysis of the renal tumors indicated features compatible with a tumor suppressor role of FLCN. Two transcription factors, oncogenic TFEB and TFE3, were shown to be regulated by FLCN inactivation, which results in their nuclear localization. We showed that a deficiency in the tumor suppressor FLCN leads to deregulation of the mammalian target of rapamycin signaling (mTOR) pathway. A potential link between FLCN mutation and ciliary length was also examined. Thus, the mutation identified in our patient provides novel insights into the relationship among FLCN mutations, TFEB/TFE3, mTOR, and cilia. However, an in-depth understanding of the role of folliculin in the molecular pathogenesis of renal cancer requires further study.
A rare presentation of appendicitis as groin swelling: a case report
Authors: Maheswaran Pitchaimuthu, Stephen Dace
Journal: Cases J (2009)

Background:
Appendicitis in femoral hernia is a rare condition, which raises diagnostic challenge.
Case report:
A 40-year-old man presented with painful right-sided groin swelling of 1-week duration. The area was explored, with presumpted diagnosis of inguinal abscess. At exploration a femoral hernia was found which contained a mildly inflammed appendix. Appendicectomy and hernia repair was done. Post surgical course was uneventful. We present this case with brief summary of literature pertaining to such lesions.
Discussion:
The rare occurrence of femoral hernia containing appendix may be explained by different degrees of intestinal rotation during development or variation in its attachment to the caecum. Inflammation is due to tight femoral ring. Preoperative diagnosis is difficult. Management options are diverse.
Conclusion:
We present this case because of rarity. Early surgery prevents complications.
Trio Clinical Exome Sequencing in a Patient With Multicentric Carpotarsal Osteolysis Syndrome: First Case Report in the Balkans
Authors: Aleksandra Stajkovska, Sanja Mehandziska, Margarita Stavrevska, Kristina Jakovleva, Natasha Nikchevska, Zan Mitrev, Ivan Kungulovski, Gjorgje Zafiroski, Velibor Tasic, Goran Kungulovski
Journal: Front Genet (2018)
Keywords: balkan, case report, exome sequencing, multicentric carpotarsal osteolysis syndrome, next-generation sequencing
MeSH terms: Case Reports

Exome sequencing can interrogate thousands of genes simultaneously and it is becoming a first line diagnostic tool in genomic medicine. Herein, we applied trio clinical exome sequencing (CES) in a patient presenting with undiagnosed skeletal disorder, minor facial abnormalities, and kidney hypoplasia; her parents were asymptomatic. Testing the proband and her parents led to the identification of a de novo mutation c.188C>T (p.Pro63Leu) in the MAFB gene, which is known to cause multicentric carpotarsal osteolysis syndrome (MCTO). The c.188C>T mutation lies in a hotspot amino acid stretch within the transactivation domain of MAFB, which is a negative regulator of RANKL-induced osteoclastogenesis. MCTO is an extremely rare autosomal dominant (AD) disorder that typically arises spontaneously and causes carpotarsal osteolysis, often followed by nephropathy. To the best of our knowledge, this is the first study reporting genetically diagnosed MCTO in the Balkans.
Bilateral adrenal haemorrhages: a crucial incidental finding
Authors: Soo-Min Cho, Peter Bye
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Adrenal haemorrhage is a rare condition that has the potential to cause life-threatening adrenal insufficiency, especially if it affects both the adrenal glands. The difficulty in diagnosing adrenal haemorrhages lies in the non-specific clinical presentation including hypotension and abdominal pain. The following case report demonstrates the possible clinical presentations of non-traumatic adrenal haemorrhages and the method of diagnosing and treating adrenal insufficiency. In a medical era where overdiagnosis and "incidentalomas" are becoming more prevalent, this case nicely demonstrates the fortunate use of imaging to detect a potentially life-threatening condition.
Definitive Obturator Fabrication for Partial Maxillectomy Patient
Authors: M Singh, I K Limbu, P K Parajuli, R K Singh
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Maxillectomy defects can result in oroantral communication that causes difficulty in mastication and deglutition, impaired speech, and facial disfigurement. The prosthodontist plays an important role in the rehabilitation of such defects with obturators. This paper describes a clinical report of fabricating a definitive obturator with a cast metal framework using a single flask and one-time processing method for an acquired maxillary defect. A tripodal design was selected for this case. Rest was placed on the premolars and molars of both quadrants of the maxilla. Complete palate as the major connector was designed to ensure maximum distribution of the functional load to the tissue. Indirect retainer was planned on the right first premolar. Direct retention was provided by the I-bar clasp placed on the left first premolar, circumferential clasp on the right first premolar, and embrasure clasp between the right first and second molars. Thus, this definitive prosthesis rehabilitated the patient by providing better masticatory efficiency, improving the clarity of speech and quality of life of the patient.
Fusarium napiforme systemic infection: case report with molecular characterization and antifungal susceptibility tests
Authors: Marcela de Souza, Tetsuhiro Matsuzawa, Luzia Lyra, Ariane Fidelis Busso-Lopes, Tohru Gonoi, Angélica Zaninele Schreiber, Katsuhiko Kamei, Maria Luiza Moretti, Plínio Trabasso
Journal: Springerplus (2014)
Keywords: fusariosis, immunocompromised host, opportunistic infections

Introduction:
During the last decades, Fusarium spp. has been reported as a significant cause of disease in humans, especially in immunocompromised patients, who have high risk of invasive life-threatening disease. Fusarium species usually reported as cause of human disease are F. solani, F. oxysporum and F. verticillioides.
Case description:
We describe the second case in the literature of disseminated fusariosis caused by Fusarium napiforme, that occurred in a 60-year-old woman with multiple myeloma after subsequent cycles of chemotherapy.
Discussion and evaluation:
We identified the F. napiforme not only by standard morphologic criteria by macroscopic and microscopic characteristics, but also confirmed by molecular biology methods, including sequencing. The antifungal susceptibility of the F. napiforme isolates were tested to seven antifungal drugs; the azoles were the most active drug against all the isolates tested.
Conclusions:
Fusarium spp. are of relevance in medical mycology, and their profiles of low susceptibility to antifungal drugs highlight the importance for faster and more accurate diagnostic tests, what can contribute to an earlier and precise diagnosis and treatment.
Aftermath histopathological findings of 2019 novel Coronavirus (COVID-19) pneumonia
Authors: Mohammad Ranaei, Seyed Sina Taheri, Fatemeh Rojaei, Faezeh Zabihi
Journal: Caspian J Intern Med (2022)
Keywords: covid-19 pneumonia, novel coronavirus, pathology
MeSH terms: Case Reports

Background:
There have been several studies describing clinicoradiological features of the novel coronavirus SARS-CoV-2 infection. It seems that we still should know more about pathological features in the different stages of this infection.
Case presentation:
A 77 year-old man with cough and respiratory distress was admitted to the intensive care unit. Real-time PCR on nasopharyngeal swab was done for him and it was positive for SARS-CoV-2.He was treated with oxygen therapy, hydroxychloroquine and antibiotic therapy and was discharged from the hospital with brief improvement of clinical symptoms. However, due to persistent dyspnea, the patient was admitted to the hospital again and throracotomy and wedge biopsy were performed for about 3 months from the onset of symptoms.
Conclusion:
Pathological examination revealed diffuse alveolar damage, fibroblastic hyperplasia, infiltration of inflammatory cells and hyaline membrane formation.
Idiopathic autoimmune hemolytic anemia due to lecithin overdose: a case report
Authors: Ioannis Lentzas, Panagiotis Papagiannopoulos, Ioannis Nikolaidis, Vasiliki Garmiri, Demosthenes Vatides, Athanasia Papathanasiou, Andreas Melidonis, Georgios Tsiros, Panagiota Voila, Christos Lionis
Journal: Cases J (2009)

Introduction:
Idiopathic Autoimmune Hemolytic Anemia is a potentially fatal condition which requires prompt and potent treatment. Diagnosis of idiopathic autoimmune hemolytic anemia requires both serologic evidence of autoantibody presence and hemolysis. Although most of the times it is considered idiopathic, several underlying causes have been identified, like autoimmune and connective tissue diseases, viral infections, drugs or hyper function of the immune system. To our knowledge, this is the first case in the international literature describing lecithin-induced autoimmune hemolytic anemia.
Case presentation:
This case report is to highlight a rare but dangerous adverse reaction to overdose of lecithin. A 38 year old white female from Greece, presented to our emergency room with progressive fatigue over a period of ten days and icteric discoloration of her skin and conjunctiva. The patient had been taking lecithin supplements (1200 mg, 3 capsules a day) over a period of ten days for weight loss. She reports that the last 3 days, prior to the examination, she took 5 capsules/day, so that the supplement would take effect more rapidly. Her past medical, social and family history showed no disturbance. Relatives of the patient were requested to submit any blood-tests taken over a period of 20 days prior to the onset of symptoms caused by Lecithin. All tests proved that all functions were within normal scale. Her physical examination revealed pallor and jaundice without palpable hepatosplenomegaly. Blood biochemistry tests showed total bilirubin 7.5 mg/dl, with indirect bilirubin 6.4 mg/dl and complete blood count showed hemoglobin 7.6 g/dl with blood levels 21.4%.
Conclusion:
In every case of idiopathic autoimmune hemolytic anemia the administration of pharmaceutical substances should always be examined, except for the standard reasons that cause it. In this case the cause of hemolysis was attributed to the excessive intake of lecithin capsules for the loss of body weight. It is important that clinicians and immunologists are aware of this adverse effect.
A Giant Mucinous Adenocarcinoma Arising within a Villous Adenoma of the Urachus: Case Report and Review of the Literature
Authors: Steven Joniau, Evelyne Lerut, Hein Van Poppel
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

We present an exceptional case of a giant urachal tumor, consisting of both villous adenoma and mucinous adenocarcinoma of the urachus. The tumor was incidentally discovered during investigations for renal failure. Initial transurethral biopsies showed only a villous adenoma of the urachus. Although the biopsies showed no malignancy, a radical cystoprostatectomy and broad excision of the urachus and umbilicus were performed. At the same time, a bilateral nephroureterectomy was performed because of reflux-nephropathy and renal failure. The indication for surgery was based on the typical imaging aspects, raising the suspicion of an underlying urachal adenocarcinoma (size and location). Indeed, at final histopathology a concomitant well-differentiated adenocarcinoma of the urachus confined to the urachal mucosa was found. The patient remained free of disease for 50 months of follow-up. Only three previous cases of urachal adenocarcinoma associated with villous adenoma have been described.
Clinical identification and endodontic management of furcation canals: a case series
Authors: Pierre Kuoch, Martin Biosse Duplan, Fleur Berès, Éric Bonte, Cauris Couvrechel
Journal: Braz Dent J (2023)
MeSH terms: Dental Pulp Cavity, Periodontium, Disinfection, Periodontal Ligament

In the case of endodontic infection, the presence of furcation canals can be at the origin of a periodontal lesion located in the furcation. The furcation being very close to the marginal periodontium, this type of lesion can be favorable to the genesis of an endo-periodontal lesion. These furcation canals are lateral canals located on the pulp chamber floor and constitute one of the many physiological communication pathways between endodontic and periodontal tissues. These canals are most often difficult to localize, shape, and to fill because of their small diameter and length. The disinfection of the pulp chamber floor with sodium hypochlorite solution may contribute to the disinfection of furcation canals when they are not identified, shaped, and/or filled. This case series illustrates the endodontic management of visible furcation canals associated with an endo-periodontal lesion. These furcation canals had a large diameter which allowed their identification during the endodontic treatment.
Diagnosing the frontal variant of Alzheimer's disease: a clinician's yellow brick road
Authors: Russell P Sawyer, Federico Rodriguez-Porcel, Matthew Hagen, Rhonna Shatz, Alberto J Espay
Journal: J Clin Mov Disord (2017)
Keywords: behavioral disorder, frontal variant of alzheimer’s disease, frontotemporal dementia, movement disorders, parkinsonism
MeSH terms: Review

Background:
Disruption of the frontal lobes and its associated networks are a common consequence of neurodegenerative disorders. Given the wide range of cognitive, behavioral and motor processes in which the frontal lobes are involved, there can be a great variety of manifestations depending on the pathology distribution. The most common are the behavioral variant of frontotemporal dementia (bvFTD) and the frontal variant of Alzheimer's disease (fvAD), which are particularly challenging to disentangle. Recognizing fvAD from bvFTD-related pathologies is a diagnostic challenge and a critical need in the management and counseling of these patients.
Case presentation:
Here we present three pathology-proven cases of Alzheimer's disease initially misdiagnosed as bvFTD and discuss the distinctive or less overlapping historical, examination, and laboratory findings of fvAD and bvFTD, deriving analogies for mnemonic endurance from the Wizard of Oz worldview.
Conclusion:
The Yellow Brick Road to diagnosing these disorders may be served by the metaphor of fvAD as the irritable, paranoid, and tremulous Scarecrow and bvFTD the heartless, ritualistic, and rigid Tin Man. An Oz-inspired creative license may help the clinician recognize the differential disease progression, caregiver burden, and treatment response of fvAD compared with bvFTD.
Primary leiomyosarcoma of the adrenal gland: a case report with immunohistochemical study and literature review
Authors: Murat Tolga Gulpinar, Asif Yildirim, Berrin Gucluer, Ramazan Gokhan Atis, Cengiz Canakci, Cenk Gurbuz, Turhan Caskurlu
Journal: Case Rep Urol (2014)

Primary adrenal leiomyosarcoma is extremely rare tumor. We report a case with adrenal leiomyosarcoma. Our case was a 48-year-old man who presented with lower urinary tract symptoms. Ultrasonography and magnetic resonance imaging revealed approximately 9 cm solid mass originating from right adrenal gland. He underwent right adrenalectomy. Pathology of the specimen showed histologic and immunohistochemical features of adrenal leiomyosarcoma.
Case Report: Interventricular Septal Hematoma Complicating Left Bundle Branch Pacing Lead Implantation
Authors: Rujie Zheng, Shengjie Wu, Songjie Wang, Lan Su, Kenneth A Ellenbogen, Weijian Huang
Journal: Front Cardiovasc Med (2021)
Keywords: his bundle pacing, cardiac pacing, complication, interventricular septal hematoma, left bundle branch pacing
MeSH terms: Case Reports

Background: Left bundle branch pacing (LBBP) is a novel physiological pacing and previous studies have confirmed the feasibility and safety of it. The incidence of complications in LBBP is relatively low as reported. Here we present a case of interventricular septal hematoma complicating LBBP lead implantation. Case summary: LBBP was achieved for treatment of high-grade atrioventricular block in a 67-year-old female. Chest pain began 1 h after implantation when the electrocardiogram showed ST-T changes. Then bedside echocardiography confirmed the formation of interventricular septal hematoma. Urgent coronary angiography showed the contrast agent retention and overflow in the interventricular septum. The symptom was relieved half an hour later. Echocardiogram performed 2 h later revealed the size of the hematoma was the same as before. The electrocardiography, coronary angiography and CTA confirmed the resolution of the hematoma at 1-month follow-up. Pacing parameters and cardiac function remained stable during 6-month follow-up. Conclusion: This is the first reported case describing the clinic features and management of interventricular septum hematoma complicating LBBP. The importance of routine echocardiograms after implantation for identifying the hematoma should be highlighted.
Imaging findings in a case of stand up paddle surfer's myelopathy
Authors: M E Klontzas, A Hatzidakis, A H Karantanas
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Stand up paddle (SUP) surfing, a variant of ocean surfing, is becoming very popular because it can be performed at any level of difficulty and thus attracts athletes from a wide range of ages. Unlike ocean surfing, limited data exist on injuries related to SUP surfing. We report the first case of a 28-year-old athlete who developed myelopathy during his first SUP surfing session. Clinical examination revealed severe neurological deficit, which had not subsided fully at the 28-month follow-up.