OpenMed/multicare-articles huggingface dataset:
Post-COVID central hypersomnia, a treatable trait in long COVID: 4 case reports
Authors: Clémence Morelli-Zaher, Andrea Vremaroiu-Coman, Nicolas Coquoz, Léon Genecand, Marco Altarelli, Alzbeta Binkova, Isabelle Frésard, Pierre-Olivier Bridevaux, Grégoire Gex
Journal: Front Neurol (2024)
Keywords: sars-cov-2, central hypersomnia, idiopathic hypersomnia, long covid, methylphenidate, narcolepsy, post-covid condition, treatment
MeSH terms: Case Reports

Introduction:
Fatigue is the most commonly reported post-COVID symptom. A minority of patients also report excessive daytime sleepiness, which could be a target for treatment.
Methods:
Among 530 patients with a post-COVID condition, those with excessive daytime sleepiness were systematically assessed for objective central hypersomnia, with exclusion of all cases not clearly attributable to SARS-CoV-2 infection.
Results:
Four cases of post-COVID central hypersomnia were identified, three fulfilling the criteria of the 3rd International Classification of Sleep Disorders for idiopathic hypersomnia, and one for type II narcolepsy. We report here their clinical history, sleep examination data and treatment, with a favorable response to methylphenidate in three cases and spontaneous resolution in one case.
Conclusion:
We highlight the importance of identifying cases of post-COVID central hypersomnia, as it may be a treatable trait of a post-COVID condition.
Cerebrotendinous xanthomatosis tremor successfully controlled post-ventral intermediate nucleus-deep brain stimulation: a case report
Authors: Alyson M Rich, Ema V Karakoleva, James McInerney, Elana Farace, Sol De Jesus
Journal: Front Neurol (2023)
Keywords: cerebrotendinous xanthomatosis (ctx), deep brain stimulation (dbs), hyperkinetic movement disorder, lipid storage disease, tremor
MeSH terms: Case Reports

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disorder caused by a deficiency of the sterol 27-hydroxylase enzyme. This deficiency results in excess production and accumulation of cholestanol, which can lead to many clinical findings within the first three decades of life, including progressive neurological dysfunction. This is a treatable condition with improvements in neurological and non-neurological symptoms upon the early initiation of replacement therapy. This case report details a 42 years-old left-handed male in whom deep brain stimulation (DBS) intervention was pursued due to a limiting tremor related to delayed diagnosis and treatment of CTX at 22 years old. The application of DBS in treating tremors in a CTX patient has not previously been reported. For our patient, application of DBS led to meaningful and longstanding tremor control benefits that have required minimal changes to stimulation parameters post-DBS. These improvements to tremor were achieved without negative impact to his other CTX related comorbidities.
Case report: A dual case study of how clinical feedback can be a communication aide and influence therapeutic work
Authors: Marianne Magnesdotter Helleseth, Andrew Athan McAleavey, Christian Moltu
Journal: Front Psychol (2023)
Keywords: case study, clinical feedback, psychotherapeutic alliance, psychotherapy, routine outcome monitoring
MeSH terms: Case Reports

Background:
While routine outcome monitoring and clinical feedback may improve outcomes after psychotherapy, results from efficiency studies have been mixed. Moreover, how clinical feedback is implemented influences how it works for patients and clinicians, and working mechanisms are hitherto not thoroughly explored. Researchers have argued that inviting and using feedback from patients is best conceived of as a clinical skill. In this paper, we use case study methodology to explore and describe feedback's functions within three clinical skill themes: actualizing alliance work, concretizing change and stagnation and verbalizing the non-verbal.
Case presentation:
Sonja is a young adult patient with a trauma background. She has a history of serious suicide attempts and distrust in relationships. She attended psychotherapy for eight months. Harald is a middle-aged man with a stable family. Traumatic events in his past has made him conceal own needs and developing depression. He attended psychotherapy for 19 months. Case material include the patient's clinical feedback over a range of life areas, medical health notes and the therapist's process notes.
Conclusion:
Clinical feedback can be a positive supplement to the therapeutic work and process. The importance of making this as a joint tool between the client and the therapist is significant.
A Case Series on Acenocoumarol and Linezolid Drug Interaction
Authors: Indrani Sarma, Narendra Sharma, Bhabananda Das, Jyoti Kalita
Journal: Cureus (2024)
Keywords: acenocoumarol, drug, interaction, linezolid, raised inr
MeSH terms: Case Reports

Acenocoumarol is one of the most common drugs used as a part of the management of patients undergoing cardiac surgery. Linezolid, on the other hand, is an antibiotic prescribed post-operatively. Reports of any interaction between the two are very few. Here, we are presenting four case reports of patients admitted to the Cardio Thoracic and Vascular Surgery Department of a tertiary healthcare center in North East India. Drug-drug interactions can lead to long-term and life-threatening effects, and also hamper the management of patients post-operatively. Due to the limited literature, assessing such interactions is difficult. The cases reported here were treated with fresh frozen plasma, and the patients responded well to the treatment and were discharged without further complications.
A rare concomitance of Wilson's disease and systemic lupus erythematosus in a teenage girl: a case report and literature review
Authors: Zigui Yang, Yashuang Su, Meilu Liu, Lijun Sun, Fengxiao Zhang, Wei Lin
Journal: Front Pediatr (2024)
Keywords: wilson's disease, case report, diagnosis, liver cirrhosis, systemic lupus erythematosus
MeSH terms: Case Reports

Background:
Wilson's disease (WD) is an inherited disorder characterized by impaired biliary excretion of copper and excessive copper accumulation in multiple organs, primarily leading to hepatic, neurological, and psychiatric manifestations. The coexistence of WD and systemic lupus erythematosus (SLE) has rarely been reported, posing challenges in accurately diagnosing these two conditions because of overlapping clinical symptoms.
Case presentation:
We presented the case of a 17-year-old girl initially suspected of having SLE due to positive anti-nuclear antibodies and lupus anticoagulants, decreased platelet count, hypocomplementemia, and pleural effusion. However, the patient also exhibited an unusual manifestation of decompensated liver cirrhosis, which is not typical of SLE. Further investigation revealed low serum ceruloplasmin levels, high 24-h urine copper levels, the presence of Kayser-Fleischer rings, and a compound heterozygous mutation in the ATP7B gene, confirming the diagnosis of WD.
Conclusion:
The co-occurrence of WD and SLE poses a significant diagnostic challenge, often leading to misdiagnosis and delayed diagnosis. Therefore, in patients with well-controlled SLE presenting with unexplained liver fibrosis, neurological involvement, or psychiatric symptoms, it is crucial to consider the possibility of WD. However, further studies are required to elucidate the underlying pathophysiological mechanisms.
Conservative Management of LVAD-Associated Ventricular Pseudoaneurysm
Authors: Marvin Kajy, Connor C Kerndt, Paul C Weber, Marzia Leacche, Renzo Y Loyaga Rendon
Journal: Methodist Debakey Cardiovasc J (2024)
Keywords: heartmate-iii left ventricular assist device, advanced heart failure, heart assist device, left ventricular assist device, pseudoaneurysm
MeSH terms: Aneurysm, False / diagnostic imaging, Aneurysm, False / etiology, Aneurysm, False / therapy, Heart-Assist Devices, Case Reports, Aorta, Conservative Treatment, Humans, Quality of Life

Left ventricular assist devices (LVAD) are surgically implanted mechanical support devices utilized with increasing frequency as a bridge to myocardial recovery, destination therapy, and heart transplantation. While the use of such devices in patients with advanced heart failure has shown significant survival benefits and improved quality of life, they bear their own risks and complications.1 Bleeding, infection, pump thrombosis, and stroke are just some of the serious complications associated with LVADs.2 LVAD-associated pseudoaneurysms are rare, with prior reports of occurrence at the left ventricular apex and at the anastomosis site of the outflow graft to the ascending aorta.3,4 Typically, this device-related complication requires surgical repair and, if at all feasible, heart transplantation. However, in cases of difficult anatomy, unfavorable position, and significant comorbidities, surgery may be contraindicated due to high surgical risk. This case portrays a patient suffering from a left ventricular pseudoaneurysm after HeartMate-III implantation that was not amenable to surgical repair due to heightened surgical risk. We document the first pseudoaneurysm associated with the HeartMate-III in available literature and describe a novel management strategy of documented nonoperative course of LVAD-associated pseudoaneurysm, with the patient surviving 56+ months with medical optimization and management.
Open Repair of Posterior Cruciate Ligament Tibial Bony Avulsion With Metal Anchor: A Case Report
Authors: Giovanni Bonaspetti, Stefano Tonolini, Giovanni Dib, Alessia Piovani
Journal: Case Rep Orthop (2024)
Keywords: knee injury, posterior cruciate ligament bony avulsion, posterior cruciate ligament injury, suture anchor fixation
MeSH terms: Case Reports

Introduction: The posterior cruciate ligament (PCL) is the largest and strongest intra-articular ligament of the knee joint and the primary posterior stabilizer. PCL injuries are less frequent than other knee ligament injuries and are typically combined with meniscal and chondral injuries or in the context of multiligamentous injuries. It is critical to properly diagnose and treat these lesions in order to avoid the risk of PCL insufficiency, subsequent knee instability, and early osteoarthritis. Surgical management can vary, and the ideal fixation device is still debated. Suture anchors are an unusual mean of fixation of PCL tibial bony avulsion. We report on two patients treated with open anchor fixation for PCL tibial bony avulsion with a follow-up of 3 years. Case Presentation: A 15-year-old male and a 65-year-old male were treated with open anchor fixation for bony tibial avulsion of the PCL. Surgical treatment was performed at 5 weeks and 3 weeks after the trauma, respectively. Diagnosis was made with an X-ray followed by CT and MR scans. Repair was achieved by reinserting the PCL bony fragment to its posterior tibial eminence with suture anchors through an open posterior approach. Both patients recovered full knee stability and a pain-free full range of motion (ROM) within 4 months and returned to their previous activities with a high satisfaction. The patient has been followed up for 3 years, and no complications were observed. Conclusion: PCL bony avulsions are rare, and their optimal treatment remains a significant subject of debate, particularly in the skeletally immature patient. We believe that open repair with metal anchors could be a good choice to repair PCL bony tibial avulsion in patients without concomitant intra-articular lesions and immature growth plates or severe fragmentation.
Case report: Desquamating dermatitis, bilateral cerebellar lesions in a late-onset methylmalonic acidemia patient
Authors: Qihua Chen, Jianguang Tang, Hainan Zhang, Lixia Qin
Journal: Front Neurol (2023)
Keywords: cerebellum, cobalamin c deficiency, desquamating dermatitis, genes, skin lesions
MeSH terms: Case Reports

Introduction:
Cobalamin C (cblC) deficiency is a rare hereditary disorder affecting intracellular cobalamin metabolism, primarily caused by mutations in MMACHC. This condition is characterized by combined methylmalonic acidemia and hyperhomocysteinemia, displaying a wide range of clinical manifestations involving multiple organs. Owing to its uncommon occurrence and diverse clinical phenotypes, diagnosing cblC deficiency is challenging and often leads to delayed or missed diagnoses.
Case description:
In this report, we present a case of late-onset cblC deficiency with brown desquamating dermatitis on the buttocks. Magnetic resonance imaging (MRI) of the brain revealed bilateral cerebellar abnormalities. The suspicion of an inherited metabolic disorder was raised by abnormal serum amino acid and acylcarnitine levels, along with increased urine methylmalonic acid and serum homocysteine levels. Whole-exome sequencing helped identify a homozygous variant (c.482G>A) in MMACHC, confirming the diagnosis of cblC deficiency. However, despite receiving treatment with hydroxocobalamin and betaine, the patient did not experience clinical improvement, which may be attributed to the delayed diagnosis as indicated by the declining homocysteine and methylmalonic acid levels.
Conclusion:
Collectively, we emphasize the significance of recognizing the skin lesions and observing serial MRI changes in patients with cblC deficiency. Our case underscores the importance of early diagnosis and timely therapeutic intervention for this severe yet frequently manageable condition.
Case report: Chylopericardium secondary to dialysis catheter related jugular venous thrombosis in two dogs receiving long-term hemodialysis
Authors: Dennis J Woerde, Carrie A Palm, Laetitia M Duler, Larry D Cowgill, Marisa K Ames, William T N Culp
Journal: Front Vet Sci (2024)
Keywords: canine, chylous, clopidogrel, dialysis, pericardial, tissue plasminogen activator
MeSH terms: Case Reports

Chylopericardium is a rare entity in veterinary medicine. In this report we document the development of chylopericardium in two dogs undergoing chronic hemodialysis. An 11-year-old female spayed Labrador retriever (Case 1) presented with acute coughing and lethargy 2 months following initial dialysis catheter placement and initiation of dialysis therapy for severe azotemia. Echocardiography demonstrated severe pericardial effusion and cardiac tamponade. Pericardial fluid analysis was consistent with chylous effusion. The dog underwent a subtotal pericardiectomy with thoracic duct ligation, and a PleuralPort™ was placed. The patient continued to receive outpatient hemodialysis therapy after pericardiectomy for several months until she died acutely at home. A 4-year-old male neutered Doberman (Case 2) was being treated for 2 months with outpatient hemodialysis for management of chronic kidney disease. On presentation for the 17th hemodialysis treatment, the patient had increased respiratory rate. Echocardiography demonstrated pleural and pericardial effusions, and fluid analysis in both cavities was consistent with chylous effusion. Use of tissue plasminogen activator (TPA), clot removal and replacement of the catheter was attempted; however pleural and pericardial effusion continued. The patient was euthanized after 25 hemodialysis sessions as owners elected not to pursue more procedures. In both cases, the cause of the chylopericardium was suspected to be secondary to catheter-associated thrombosis and/or stenosis based on multiple imaging modalities. Despite use of rivaroxaban and clopidogrel concurrently in each case, the chylous effusion persisted. This case report describes clinical details of a rare complication of long-term indwelling dialysis catheters in two dogs.
Case Report: A novel TP53 mutation in a patient with quadruple wild-type gastrointestinal stromal tumor
Authors: Yuhong Chen, Junyong Chen, Liansheng Long, Leng Han, Xiaohui Mi, Yanfang Song, Huanqing Cheng, Yanrui Zhang, Liyang Cheng
Journal: Front Oncol (2023)
Keywords: tp53 mutation, case report, next-generation sequencing, p53-targeted therapy, quadruple wt gist
MeSH terms: Case Reports

In this report, we present a case study of a 64-year-old female who was diagnosed with gastrointestinal stromal tumors (GISTs) and subsequently developed liver metastases despite undergoing radical resection. Next-generation sequencing (NGS) assays indicated that the tumor lacked KIT/PDGFRA/SDH/RAS-P (RAS pathways, RAS-P) mutations, thereby classifying this patient as quadruple WT GIST (qGIST). Treatment with imatinib was initiated, and after 2.5 months, recurrence of the tumor and multiple metastases around the surgical site were observed. Consequently, the patient was switched to sunitinib treatment and responded well. Although she responded well to sunitinib, the patient died of tumor dissemination within 4 months. This case study highlights the potential efficacy of imatinib and the VEGFR-TKI sunitinib in treating qGIST patients harboring a TP53 missense mutation.
Incidental Finding of Triple Ectopic Thyroid: Case Report and Review of the Literature
Authors: Fatima Zeineddine, Gerard El-Hajj, Marie-Ange Hajj, Rita Chahinian
Journal: Asia Ocean J Nucl Med Biol (2024)
Keywords: developmental anomaly, technetium-99m pertechnetate, triple ectopic thyroid, ultrasonography
MeSH terms: Case Reports

Ectopic thyroid tissue is a rare congenital anomaly, with the presence of three simultaneous ectopic foci being exceedingly rare. We describe a case of a totally asymptomatic 26-year-old male discovered to have triple ectopic thyroid following incidental elevated thyroid-stimulating hormone (TSH) levels. Subsequent ultrasonography of the neck showed an absent thyroid gland in its conventional location. A Technetium-99m pertechnetate (Tc-99m) thyroid scan showed three distinct foci of radiotracer uptake in the upper cervical, lingual, and sublingual regions, corresponding to triple ectopic thyroid. An extensive review of the literature was conducted to provide a broader understanding and deeper insights into this uncommon condition. This case underscores the pivotal role of Technetium-99m thyroid scanning in diagnosing triple ectopic thyroid, particularly in instances where the orthotopic thyroid gland is absent. A comprehensive understanding of this rare entity is indispensable for radiologists and clinicians, enabling accurate diagnosis and informed decision-making regarding the appropriate therapeutic strategies.
A Pediatric Case of Fusobacterium necrophorum Mastoiditis and Meningitis Case Report in a Healthy Child and Review of the Literature
Authors: Elizabeth Feenstra, Aalt Van Roest, Juul Boes, Tom Spiritus, Sandra Kenis, Els L I M Duval, Stephanie Vanden Bossche, Koen Vanden Driessche, Philippe G Jorens
Journal: Case Rep Pediatr (2024)
MeSH terms: Case Reports

In infants and children, bacterial meningitis caused by anaerobic bacteria is rare. However, a serious infection with the anaerobe Fusobacterium necrophorum can occur in previously healthy children with a peak incidence in preschool children and in adolescents. As the clinical presentation can be very similar to meningitis caused by aerobic bacteria, one should consider Fusobacterium necrophorum as the causative agent when preceded by or associated with otitis media with purulent otorrhea or mastoiditis, in combination with minimal or no improvement on empiric antibiotic treatment. As this pathogen can be difficult to culture, anaerobic cultures should be obtained. Prompt treatment with a third-generation cephalosporin and metronidazole should be initiated once suspected or confirmed. Surgical source control is often necessary, but even with adequate and prompt treatment, the morbidity and mortality in children with a Fusobacterium necrophorum meningitis remains high. In this report, we describe a case of Fusobacterium necrophorum meningitis in a previously healthy child and review the available literature.
Mixed thyrotropin-secreting pituitary neuroendocrine tumor coexisting with Graves' disease: a case report
Authors: Yijing Huang, Xiaoming Wen, Xinxin Liang, Lingling Xu
Journal: Front Med (Lausanne) (2024)
Keywords: graves' disease, autoimmune thyroid disease, mixed pituitary neuroendocrine tumor, thyroid antibodies, thyrotropin-secreting pituitary neuroendocrine tumor
MeSH terms: Case Reports

Background:
Thyrotropin (TSH)-secreting pituitary neuroendocrine tumors (PitNETs) are recognized as a rare disease. Mixed TSH PitNETs account for 20-25% of TSH PitNETs. This study aimed to report an extremely rare case of a mixed TSH PitNET coexisting with Graves' disease (GD) and also to review the literature.
Case presentation:
A 36-year-old male patient presented with elevated levels of free triiodothyronine (FT3), free thyroxine (FT4), and insulin-like growth factor 1 (IGF-1) but a non-suppressed thyroid-stimulating hormone (TSH) level. His anti-thyroglobulin antibody (TgAb), anti-thyroid peroxidase autoantibody (TPOAb), and thyrotropin receptor antibody (TRAb) tests were positive. Symptoms of palpitations, hyperhidrosis, heat intolerance, and irritability appeared 2 years before his admission. However, he showed neither any signs nor any symptoms of acromegaly. The contrast-enhanced pituitary magnetic resonance imaging (MRI) showed enlargement of the pituitary fossa, with an irregular abnormal signal mass. The patient underwent endoscopic pituitary tumor resection via a transsphenoidal approach. The postoperative pathology suggested a mixed pituitary adenoma. At 8 months after the surgery, the patient had a postoperative recurrence of hyperthyroidism, and methimazole (MMI) was then administered. The recurrence of the TSH PitNET was confirmed by the positron emission tomography-computed tomography (PET-CT), which was performed 11 months after the surgery, and treatment with lanreotide was initiated. Gradually, his levels of FT3, FT4, TSH, TPOAb, and TgAb became normal and the levels of TRAb and IGF-1 improved.
Conclusion:
When the circulating levels of both FT4 and FT3 were upregulated, non-suppressed TSH levels and positive thyroid antibodies were found. TSH PitNETs coexisting with GD should be carefully taken into account to avoid the potential risk of treatment-induced tumor progression.
A Saudi Woman with Ceftriaxone Induced Fixed Drug Eruption
Authors: Rehab Y Al-Ansari, Leena Abdulrahman Almuhaish, Khaled Abdullah Hassan, Tawasoul Fadoul, Alexander Woodman
Journal: Case Rep Dermatol Med (2024)
MeSH terms: Case Reports

Background:
A fixed drug eruption (FDE) is an immunological cutaneous adverse reaction, classified as a cutaneous adverse drug reaction (CADR) and characterized by well-defined lichenoid lesions that occur at the same site each time. Ceftriaxone is a third-generation antibiotic of cephalosporin antibiotics of the beta-lactam antibiotic family, which has typical in vitro activity against many Gram-negative aerobic bacteria. This is the first clinical case from Saudi Arabia and the fifth in the world to document a woman's experience with recurrent FDE after repeated ceftriaxone use. Case Report. A 25-year-old Saudi woman with a known case of sickle cell anemia (SCA) with a history of avascular necrosis of the right hip after replacement was hospitalized with a pain crisis triggered by an upper respiratory tract infection. The patient denied having a history of allergy previously. Due to fever, leukocytosis, and active follicular tonsillitis, ceftriaxone was started. However, a few hours later she developed lip edema and a fixed drug eruption measuring 7 × 11 cm on the left side of her back. The lesion reformed over a hyperpigmented lesion (4 × 8 cm) that the patient did not report upon initial examination. It turned out that this was due to the intravenous administration of ceftriaxone, a year ago in another hospital. An allergy to ceftriaxone was considered, and steroids and antihistamines were started. The case was labeled as ceftriaxone induced FDE.
Conclusion:
Ceftriaxone induced FDE is an uncommon type of allergic reaction that has been reported infrequently. Understanding this condition and the mechanism by which FDE becomes recurrent with the same previous fixed lesion is of great importance for both academic and future research purposes.