OpenMed/multicare-articles huggingface dataset:
Intraoperative diagnosis of stanford type a dissection by transesophageal echocardiogram in a patient presenting for renal transplantation
Authors: William R Hand, John S Ikonomidis, Charles F Bratton, Thomas M Burch, Matthew D McEvoy
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

A 48-year-old patient with hypertensive end-stage renal disease presented for cadaveric renal transplantation. On physical exam, a previously undocumented diastolic murmur was heard loudest at the left lower sternal border. The patient had a history of pericardial effusions and reported "a feeling of chest fullness" when lying flat. As such, a transesophageal echocardiogram (TEE) was performed after induction of anesthesia to evaluate the pericardial space and possibly determine the etiology and severity of the new murmur. The TEE revealed a Stanford Type A aortic dissection. The renal transplant was cancelled (organ reassigned within region), and the patient underwent an urgent ascending and proximal hemiarch aortic replacement. This case demonstrates the importance of a thorough physical exam and highlights the utility of TEE for noncardiac surgical cases.
Foreign body granuloma: a diagnosis not to forget
Authors: I El Bouchti, F Ait Essi, I Abkari, M Latifi, S El Hassani
Journal: Case Rep Orthop (2012)
MeSH terms: Case Reports

Penetrating wounds of the foot are not uncommon. Many are caused by thorns or by fragments of wood that are retained in the foot, creating a foreign-body granuloma. The differential diagnosis for bony reaction to an unrecognised organic foreign body includes osteoid osteoma, chronic and acute osteomyelitis, tuberculosis granuloma, bone cyst, aneurysmal bone cyst, cortical fibrous defect, and neoplasm. We report the case of a boy suffering from a thorn inducing a lytic lesion of the fifth metatarsal that demonstrates the diagnosis difficulties of foreign body granuloma.
Sorafenib-Associated Heart Failure Complicated by Cardiogenic Shock after Treatment of Advanced Stage Hepatocellular Carcinoma: A Clinical Case Discussion
Authors: Candace Wu, Kamal Shemisa
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure. Four months prior to admission, he was started on sorafenib. Results. Our patient was treated with intravenous furosemide and guideline directed therapy. Clinical status was complicated by the development of low cardiac output and shock requiring inotropic support. Careful titration of heart failure medication led to hemodynamic improvement and discontinuation of dobutamine. Conclusion. Greater awareness of sorafenib cardiotoxicity is essential. As TKI usage grows for treatment of cancers, heart failure-related complications will increase. In our patient, routine heart failure management and cessation of sorafenib led to clinical improvement. Future studies on the treatment of sorafenib cardiotoxicity should be explored further in this unique patient population.
Development of low blood glucose readings in nine non-diabetic patients treated with tumor necrosis factor-alpha inhibitors: a case series
Authors: Jadwiga B Czajkowska, Brandon Shutty, Susan Zito
Journal: J Med Case Rep (2012)

Introduction:
Treatment with various biological agents in disease states such as rheumatoid arthritis has been associated with multiple side effects. Whereas many of these are frequently reported in the literature, hypoglycemia, a possible side effect of tumor necrosis factor-alpha inhibitors, may be underpublicized.
Case presentation:
We report nine cases of non-diabetic Caucasian women who were between 29 and 68 years of age and who developed low glucose readings after treatment with tumor necrosis factor-alpha inhibitors. We provide a more detailed discussion of existing evidence of the role of tumor necrosis factor-alpha in the pathogenesis of inflammation and its impact on glycemic equilibrium.
Conclusions:
Physicians using tumor necrosis factor-alpha inhibitors in the treatment of various rheumatic and other autoimmune diseases should be aware of the potential for the development of glycemic disturbance in these patients. A further role of tumor necrosis factor-alpha inhibitors in the glycemic equilibrium warrants larger controlled trials in patients with and those without a history of diabetes.
Acute Brucellosis with Splenic Infarcts: A Case Report from a Tertiary Care Hospital in Saudi Arabia
Authors: Mishal Alyousef, Mushira Enani, Mohammad Elkhatim
Journal: Case Rep Infect Dis (2015)

Splenic infarction is an extremely rare and unique presentation of brucellosis. Only few cases have been reported worldwide. We here report a case of a young man, presenting with acute onset of fever, left hypochondial pain, and vomiting. Further evaluation revealed multiple splenic infarcts and positive blood culture for brucellosis despite negative transesophageal echocardiography for endocarditis. Significant improvement in clinical symptoms and splenic lesions was achieved after six weeks of combination therapy against brucellosis.
Neck-Tongue Syndrome: Viewpoints on Etiology in a Patient with Bilateral Symptoms
Authors: Jonathan S Sidlow, Mark J Raden, Richard Sidlow
Journal: Case Rep Neurol Med (2018)
MeSH terms: Case Reports

Neck-Tongue Syndrome is a rare entity, and when it presents in the pediatric age group, it is usually due to osseous, ligamentous, or nervous anatomic variation. We present below a case involving a patient whose bilateral symptoms were intermittently present from the age of five to the age of twenty-one years and discuss this case in light of the present theories of the anatomic substrate underlying this syndrome.
Oral disorders related to acromegaly
Authors: Akram Belmehdi, Saliha Chbicheb
Journal: Pan Afr Med J (2019)
Keywords: oral disorders-acromegaly, growth hormones
MeSH terms: Acromegaly / diagnosis, Mandible / pathology, Maxilla / pathology, Tooth Diseases / etiology, Case Reports, Acromegaly / complications, Adult, Female, Humans

Acromegaly is a rare disease caused due to hyper secretion of growth hormone. Most of the cases of acromegaly are caused by pituitary adenoma which can be microadenoma or macroadenomas. This condition has a tendency toward overgrowth of the mandible, maxillary widening, tooth separation and skeletal malocclusion which compromises the aesthetics of an individual. Hence dentists have a role in diagnosing this disorder. The aim of this paper is to present a case report of acromegaly.
A three-year-old boy with hypodipsic hypernatremia syndrome
Authors: Bousayna Iraqi, Rachid Abilkassem, Nezha Dini, Aomar Agadr
Journal: Pan Afr Med J (2018)
Keywords: brain calcifications, child, hypodipsic hypernatremia syndrome
MeSH terms: Deamino Arginine Vasopressin / administration & dosage, Hypernatremia / diagnosis, Osmolar Concentration, Thirst, Case Reports, Antidiuretic Agents / administration & dosage, Brain / diagnostic imaging, Child, Preschool, Humans, Hypernatremia / therapy, Male, Sodium / blood, Syndrome, Tomography, X-Ray Computed / methods, Antidiuretic Agents, Sodium, Deamino Arginine Vasopressin

We describe a three-year-old boy who had a growth and psychomotor retardation associated with inappropriate lack of thirst and vasopressin secretion in the presence of chronic plasma hyperosmolarity. Computed brain tomography revealed bilateral supratentorial sub-ependymal and cortical calcifications. Dissociation in the plasma vasopressin response to osmotic change was demonstrated in this patient. Treatment with a vasopressin analogue, desamino-D-arginine vasopressin (DDAVP) and forced intake of water restored plasma osmolality and serum sodium levels to normal.
Migrated Mesh Plug Masquerading as a Bladder Tumor
Authors: Claudia Sevilla, Daoud Dajani, Monish Aron
Journal: J Endourol Case Rep (2017)
Keywords: bladder cancer, gross hematuria, mesh erosion, robotic surgery
MeSH terms: Case Reports

Background: The purpose of this case presentation is to demonstrate how erosion of mesh into the bladder can initially present with the same symptoms as bladder malignancy. Case Presentation: A 62-year-old Hispanic male presented with 2 years of hematuria along with imaging concerning for a bladder tumor. The patient underwent cystoscopy with biopsy of a lesion at the anterior bladder. It was ultimately determined that a mesh plug from a prior hernia repair had migrated into the bladder. The mesh plug was excised using the Da Vinci Si robot, which allowed for efficient mobilization of the bladder and other anatomic structures, as well as rapid recovery. Conclusion: Our case demonstrates the need to consider mesh erosion as a cause of hematuria and, furthermore, shows how the robotic approach can help facilitate excision of migrated mesh into the bladder.
Constrictive pericarditis in a post-renal transplant patient: a case report
Authors: Ranga M Weerakkody, Harshani D Perera, Chaminda Kularathne, Rezvi Sheriff
Journal: J Med Case Rep (2014)

Introduction:
Constrictive pericarditis is a rare complication in the post-renal transplant period. It poses a diagnostic dilemma even in the modern era. Its incidence is not known and tuberculosis is implicated in some of the cases.
Case presentation:
A 54-year-old Sri Lankan man, in the sixth year of transplant presented with resistant ascites, shortness of breath and elevated creatinine from the baseline. Pre-transplant he was empirically treated for tuberculosis pericarditis and was on isoniazid prophylaxis for 1 year following transplantation. Two-dimensional echocardiography and cardiac catheterization confirmed the diagnosis, and pericardiectomy was performed, which resulted in full resolution of the symptoms as well as the graft function. The histology or bacteriology failed to demonstrate features suggestive of tuberculosis in the surgical specimen.
Conclusion:
In constrictive pericarditis, a causative factor is difficult to find. Isoniazid prophylaxis shows benefit in preventing tuberculosis-associated constrictive pericarditis.
Facial cutaneous lesions of dental origin: A case series emphasizing the awareness of the entity and its medico-legal consequences
Authors: Mohammad M Al-Qattan, Muhammed I Almotairi
Journal: Int J Surg Case Rep (2018)
Keywords: dental origin, dental root infection, facial lesions, medico-legal, skin sinus

Introduction:
Facial cutaneous lesions of dental origin are rare and hence the correct diagnosis is usually missed on the initial presentation to the surgeon. We present the largest series in the surgical literature to increase the awareness to this entity and emphasize that the wrong diagnosis may lead to medico-legal claims.
Patients and methods:
This is a retrospective study of 28 patients seen between 1994 and 2017.
Results:
The series had one child and 27 adults. The presentation varied and included: a nodule, a subcutaneous soft mass, a sinus, an abscess, a cyst, a pigmented skin lesion and a scar. Thirteen cases had an initial wrong diagnosis and of these 4 had surgery to the lesion. Two out of the 4 surgically treated lesions ended with medico-legal claims.
Conclusions:
The surgeon should be aware of this rare entity and have a high index of suspicion. Dental treatment is curative and there is no need to operate the facial lesion. The wrong diagnosis and unnecessary surgery may lead to medico-legal claims.
The Ruptured Pericardial Cyst to the Right Atrium: A Case Report
Authors: Freidoun Sabzi, Reza Faraji
Journal: Iran J Parasitol (2020)
Keywords: mediastinal cyst, pericardial cyst (pc), pericardial effusion
MeSH terms: Case Reports

The pericardial cysts (PC) are rare congenital anomaly. They are usually asymptomatic or incidentally found during surgery or by an imaging modality. We report a 35-yr-old man referred to Imam Ali Hospital, Kermanshah, western Iran in 2017, with palpitation, chest pain and dyspnea and physical exam revealed sign and symptoms of right atrial compression and tamponade.
Abdominal Cocoon With Intestinal Perforation: A Case Report
Authors: Qiang Hu, Jianfeng Shi, Yuanshui Sun
Journal: Front Surg (2021)
Keywords: abdominal cocoon, abdominal disease, case report, intestinal perforation, surgery
MeSH terms: Case Reports

Introduction: Abdominal cocoon is a very rare abdominal disease. Abdominal cocoon mainly leads to intestinal obstruction, and abdominal cocoon with gastrointestinal perforation is rare. Case Presentation: We report a 63-year-old man who was admitted to our hospital with "persistent lower abdominal pain for one day". Abdominal CT examination revealed a small amount of free gas in the abdominal cavity, ascites, and gastrointestinal perforation. An emergency operation was performed. During the operation, the end of the right lower abdominal ileum was found to be conglutinated and twisted into a mass, a local intestinal dilatation, and obstruction, local intestinal wall was black and gangrene, and fecal effusion flowed out. The adhesions were carefully separated, and the necrotic small intestine was removed. The operation process went smoothly, and the patient recovered well after the operation. Conclusion: The cases of intestinal perforation caused by the abdominal cocoon are very rare. In clinical work, when we encounter patients with gastrointestinal perforation, we need to carefully ask the history. When the patients had no digestive system diseases in the past, we need to consider the possibility of the abdominal cocoon with perforation.
Challenges in diagnosis and management of neonatal hyperparathyroidism in a resource-limited country: a case series from a Sudanese family
Authors: Samar Sabir Hassan, Marlies Kempers, Dorien Lugtenberg, Asmahan Tajelsir Abdallah, Salwa Abdelbagi Musa, Areej Ahmed Ibrahim, Mohamed Ahmed Abdullah
Journal: Pan Afr Med J (2021)
Keywords: neonatal hyperparathyroidism, calcium sensing receptor, hypercalcemia, parathyroidectomy
MeSH terms: Hypercalcemia / diagnosis, Hypercalcemia / etiology, Hyperparathyroidism, Primary, Case Reports, Calcium, Humans, Infant, Newborn, Parathyroid Hormone, Parathyroidectomy, Receptors, Calcium-Sensing, Parathyroid Hormone, Receptors, Calcium-Sensing, Calcium

Neonatal hyperparathyroidism is a rare disease caused by a homozygous inactivating mutation in the calcium sensing receptor gene. It presents early in life with life threatening manifestations of hypercalcemia, if left untreated the condition may be lethal. This is the first case series reported from Sudan. Three Sudanese siblings presented with severe symptoms of hypercalcemia in the form of polyuria, failure to thrive and multiple bone fractures. Serum calcium and parathyroid hormone levels were very high with low phosphate and normal alkaline phosphatase levels. Ultrasonography and sestamibi scan were normal and did not assist in diagnosing their condition. Medical management was a great challenge due to unavailability of medications such as parentral bisphosphonates and calcimimetics. Parathyroidectomy was inevitable. Tissue biopsies revealed parathyroid hyperplasia and no adenoma. Gene sequencing revealed a homozygous missense mutation: c 2038 C T p (Arg680Cys) in two siblings, both parents were heterozygous for the same missense mutation. Our report reflects the challenges in diagnosis and management of neonatal hyperparathyroidism in resource limited countries. We also highlight the importance of genetic testing in the diagnosis and management of such cases in countries with high rates of consanguineous marriage.
Case report: Mohr-Tranebjaerg syndrome: hearing impairment as the onset of an insidious disorder with high recurrence risk
Authors: Eulalia Sousa, Maria Abreu, Nataliya Tkachenko, João Rocha, Cláudia Falcão Reis
Journal: Front Neurol (2023)
Keywords: mts, x-linked, deafness-dystonia syndrome, epilepsy, hearing loss
MeSH terms: Case Reports

Mohr-Tranebjaerg syndrome (MTS) is an X-linked recessive disorder caused by TIMM8A loss of function. It is characterized by sensorineural hearing loss in childhood, progressive optic atrophy in early adulthood, early onset dementia and psychiatric symptoms of variable expressivity. We present a family with 4 affected males, explore age-related and interfamilial variability and review the literature.
Case report:
A 31 years-old male developed psychiatric symptoms at age 18 and presented early onset dementia. Sensorineural hearing loss had been diagnosed in childhood. At 28yo, he developed dysarthria, dysphonia, dysmetria, limb hyperreflexia, dystonia, and spasticity following an acute encephalopathic crisis. WES revealed a hemizygous novel likely pathogenic variant in TIMM8A, c.45_61dup p.(His21Argfs*11), establishing the diagnosis of MTS. Genetic counseling of the family allowed the diagnosis of three other symptomatic relatives -3 nephews (11yo and two 6yo twins), children of a carrier sister. The oldest nephew had been followed since 4yo due to speech delay. Sensorineural hearing loss was diagnosed at 9yo, and hearing aids were prescribed. The two other nephews were monozygotic twins, and both had unilateral strabismus. One of the twins had macrocephaly and hypoplasia of the anterior temporal lobe, as disclosed by an MRI performed due to febrile seizures. Both had developmental delays, with the language being the most affected area. Their audiograms confirmed hearing loss. All three nephews were hemizygous for the familial TIMM8A variant.
Discussion:
Hearing loss, an early sign of MTS due to auditory neuropathy, can often be overlooked until more severe features of the disorder manifest. Recurrence risk is high for female carriers, and reproductive options should be offered. Early monitoring of hearing and vision loss and neurological impairment in MTS patients is mandatory since early interventions may positively impact their development. This family showcases the importance of performing a timely etiological investigation of hearing loss and its impact on genetic counseling.
Case report: Aseptic splenic abscesses in childhood-onset systemic lupus erythematosus
Authors: Shobashenee Sritharan, Peter Sie-Teck Lau, Kamilah Manan, Anand Mohan
Journal: Front Pediatr (2023)
Keywords: aseptic abscesses, children, differential diagnosis, splenic abscess, systemic lupus erythematosus
MeSH terms: Case Reports

Background:
Systemic lupus erythematosus (SLE) can involve any organ system and cause a wide range of manifestations. Noninfectious inflammatory lesions termed aseptic abscesses have been reported in some autoimmune and autoinflammatory conditions but not in childhood-onset SLE. In this report, we highlight the unusual finding of occult splenic abscesses in two children diagnosed with SLE who had no evidence of concomitant infection.
Case presentation:
An 8-year-old and an 11-year-old were admitted separately to the hospital with fever for 7 and 14 days, respectively. In the younger child, a generalized rash preceded the fever. Both had been well, with no significant past medical history prior to the onset of the illness. In both girls, abdominal ultrasonography showed multiple small hypoechoic lesions suggestive of abscesses scattered throughout the spleen. Their C-reactive protein and blood cultures were negative, and symptoms persisted despite intravenous antibiotics. Fulfilling the clinical and immunologic criteria for diagnosis, both were ultimately diagnosed with childhood-onset SLE. Rapid recovery of symptoms and complete resolution of the abscesses ensued with corticosteroids and immunosuppressive therapy.
Conclusions:
These two cases suggest that aseptic splenic abscesses may occur in childhood-onset SLE. Autoimmune conditions such as SLE should be included in the differential diagnosis of children with occult splenic abscesses.
Totally laparoscopic treatment of intestinal tuberculosis complicated with bowel perforation: The first case report in worldwide literature with a brief review
Authors: Giuseppe Di Buono, Roberta Vella, Giuseppe Amato, Giorgio Romano, Vito Rodolico, Marta Saverino, Giovanni De Lisi, Salvatore Buscemi, Antonino Agrusa
Journal: Front Surg (2022)
Keywords: abdominal tuberculosis, bowel perforation, intracorporeal anastomosis, laparoscopy, peritonitis
MeSH terms: Case Reports

Introduction:
Bowel perforation is a relatively rare presentation of abdominal tuberculosis, whose diagnosis is challenging but fundamental to minimize morbidity and mortality. Laparoscopy is considered an effective modality for diagnosis, but its role in surgical treatment is still not established. We reported the first worldwide case of totally laparoscopic treatment of intestinal tuberculosis complicated with bowel perforation.
Case presentation:
A 30-year-old man with a history of weight loss, preceded by 2 years of nonproductive cough, was admitted to the Infectious Disease Department with a presumed diagnosis of tuberculosis. A microbiological culture test confirmed the diagnosis, and the patient undertook quadruple antituberculous therapy. During hospitalization, he presented sudden abdominal pain, fever, and vomit. An abdominal CT scan showed small bowel perforation with granulomatous reaction. Laparoscopy was performed and revealed a 2 cm perforation on the medium ileum. Small bowel resection and totally intracorporeal side-to-side anastomosis were performed. No complication occurred until a clinical follow-up of 2 months.
Conclusion:
In consideration of the increasing incidence of intestinal TB in both underdeveloped and Western countries, the diagnosis of this pathology should be taken into account in high-risk patients. Probably, the diagnostic challenges and emergency settings of intestinal TB with perforation and peritonitis, together with the lack of standardized guidelines regarding surgical management, make the use of laparoscopy apparently arduous, but the known advantages of laparoscopy and its technical feasibility should make it a conceivable option for the treatment of complicated cases.
Case Report: PTEN Mutation Induced by anti-PD-1 Therapy in Stage IV Lung Adenocarcinoma
Authors: Junjie Teng, Kai Zhou, Dongxiao Lv, Changshun Wu, Hong Feng
Journal: Front Pharmacol (2022)
Keywords: erbb2 mutation, pten mutation, adenocarcinoma cell lung carcinoma, afatinib, immunotherapy
MeSH terms: Case Reports

Lung cancer is the most common solid tumor in the worldwide. Targeted therapy and immunotherapy are important treatment options in advanced non-small cell lung cancer (NSCLC). The association of PTEN mutation and tumor immunotherapy is less established for patients with NSCLC. We present the case of an Asian woman diagnosed with stage IV lung adenocarcinoma harboring an ERBB2 mutation. She received Nivolumab treatment when her disease progresses after previous chemotherapy and Afatinib treatment. However, the patient did not response to Nivolumab. PTEN mutation was detected by next-generation sequencing (NGS) after treatment with Nivolumab. PTEN, a secondary mutation, may be served as a biomarker of resistance to anti-PD-1 immunotherapy in lung adenocarcinoma. The relationship between PTEN mutation and immunotherapy is complex and needs further study.