OpenMed/multicare-articles huggingface dataset:
A Low Viral Dose in COVID-19 Patient: A Case Report
Authors: Yajuan Li, Xianwei Hu, Youhui Tu, Tao Wu, Bo Wang, Huan Ma, Weihong Zeng, Dan Zhao, Hylemariam Mihiretie Mengist, Arnaud John Kombe Kombe, Meijuan Zheng, Yuanhong Xu, Tengchuan Jin
Journal: Front Public Health (2020)
Keywords: covid-19 patient, iga, igg, igm, rt-qpcr
MeSH terms: COVID-19, Case Reports, Research Support, Non-U.S. Gov't, Humans, RNA, Viral / genetics, SARS-CoV-2, Serologic Tests, Viral Load, RNA, Viral

SARS-CoV-2 outbreak has attracted global attention. Verifying the presence of viral RNA is the gold standard for the diagnosis of COVID-19. However, RT-qPCR diagnosis often fails to catch infected patients, because of inconsistent swab sample collection. Here we report a case that showed 5 consecutive negative and 1 low-viral- dose RT-qPCR results during illness spanning over 20 days. Clinical symptoms suggest SARS-CoV-2 infection with typical ground glass like a lung in computed tomography. SARS-CoV-2 infection was serologically confirmed by the presence of anti-SARS-CoV-2 specific antibodies in patients' serum. Finally, a high level of protective IgG was produced after the patient recovered. Surprisingly, as a barber and a housewife staying at home for the first 2 weeks after the onset of illness, none of the close contacts were infected, showing a case of low viral load and low infectivity in this patient.
Adrenocortical Tumors in Children With Constitutive Chromosome 11p15 Paternal Uniparental Disomy: Implications for Diagnosis and Treatment
Authors: Emilia Modolo Pinto, Carlos Rodriguez-Galindo, Catherine G Lam, Robert E Ruiz, Gerard P Zambetti, Raul C Ribeiro
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: beckwith-wiedemann syndrome, tp53, upd, adrenocortical cancer, chromosome 11p15, hemihypertrophia
MeSH terms: Adrenal Cortex Neoplasms / genetics, Adrenocortical Adenoma / genetics, Adrenocortical Carcinoma / genetics, Uniparental Disomy, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Adrenal Cortex / pathology, Adrenal Cortex Neoplasms / diagnosis, Adrenal Cortex Neoplasms / pathology, Adrenal Cortex Neoplasms / therapy, Adrenocortical Adenoma / diagnosis, Adrenocortical Adenoma / pathology, Adrenocortical Adenoma / therapy, Adrenocortical Carcinoma / diagnosis, Adrenocortical Carcinoma / pathology, Adrenocortical Carcinoma / therapy, Child, Child, Preschool, Chromosomes, Human, Pair 11, Female, Humans, Infant, Male, Uniparental disomy of 11

Pediatric adrenocortical tumors (ACTs) are rare and heterogeneous. Approximately 50% of children with ACT carry a germline TP53 variant; however, the genetic underpinning of remaining cases has not been elucidated. In patients having germline TP53 variants, loss of maternal chromosome 11 and duplication of the paternal copy [paternal uniparental disomy, (UPD)] occurs early in tumorigenesis and explains the overexpression of IGF2, the hallmark of pediatric ACT. Beckwith-Wiedemann syndrome (BWS) is also associated with overexpression of IGF2 due to disruption of the 11p15 loci, including segmental UPD. Here, we report six children with ACT with wild type TP53 and germline paternal 11p15 UPD. Median age of five girls and one boy was 3.2 years (range 0.5-11 years). Two patients met the criteria for BWS before diagnosis of ACT. However, ACT was the first and only manifestation of paternal 11p15 UPD in four children. Tumor weight ranged from 21.5 g to 550 g. Despite poor prognostic features at presentation, such as pulmonary metastasis, bilateral adrenal involvement, and large tumors, all patients are alive 8-21 years after cancer diagnosis. Our observations suggest that children with ACT and wild type TP53, irrespective of their age, should be screened for germline abnormalities in chromosome 11p15.
Aesthetic Surgical Crown Lengthening Procedure
Authors: Pablo Santos de Oliveira, Fabio Chiarelli, José A Rodrigues, Jamil A Shibli, Vincenzo Luca Zizzari, Adriano Piattelli, Giovanna Iezzi, Vittoria Perrotti
Journal: Case Rep Dent (2015)

The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.
Concurrent presentation of IgG4-related tubulointerstitial nephritis and ANCA MPO crescentic glomerulonephritis
Authors: Henry H L Wu, Claire C Y Wang, Alexander Woywodt, Arvind Ponnusamy
Journal: Clin Nephrol Case Stud (2022)
Keywords: anca, igg4, mpo, crescentic glomerulonephritis, tubulointerstitial nephritis
MeSH terms: Case Reports

Concurrent IgG4-related tubulointerstitial nephritis and anti-neutrophil cytoplasmic antibodies (ANCA) myeloperoxidase (MPO) crescentic glomerulonephritis is an uncommon scenario, and the link between the two conditions, if any, is incompletely understood. We report the case of a 58-year-old woman who presented with a 2-month history of malaise and joint pain and was found to have acute kidney injury and hemato-proteinuria. Initial immunological tests revealed positive anti-neutrophil cytoplasmic antibodies with a peri-nuclear pattern (pANCA). An enzyme-linked immunoassay (ELISA) for anti-MPO antibodies was also positive, leading to a tentative diagnosis of ANCA-associated small vessel vasculitis with renal involvement. Steroid treatment was commenced, and an urgent kidney biopsy was performed. This showed crescentic glomerulonephritis, but also demonstrated concurrent tubulointerstitial nephritis with a dominance of IgG4-producing plasma cells. Serum IgG4 levels were also elevated. The patient was initially treated with intravenous cyclophosphamide and steroids and then switched to rituximab. When last seen, she was well after 1 dose of rituximab, with kidney function, inflammatory parameters, and serum IgG4 levels returning to normal levels. The concurrent presentation of ANCA-associated vasculitis and IgG4 renal disease is rare with only few cases reported in the literature. More work is needed to understand pathophysiology, outcomes, and management options for this complex scenario.
Tacrolimus-induced Ascites after Liver Transplant
Authors: M Hosseini, M Aliakbarian, K Akhavan-Rezayat, O Shadkam, S Milani
Journal: Int J Organ Transplant Med (2018)
Keywords: ascites, immunosuppressive agents, liver transplantation, tacrolimus
MeSH terms: Case Reports

Massive post-transplantation ascites is a rare but serious condition following liver transplantation. Although, many etiologies are suggested as the cause of this complication, in some cases the definitive etiology remains unknown. Drug-induced post-transplantation ascites is one of the possible etiologies. In this study we present a case of ascites caused by tacrolimus in the post-liver transplantation period. A 49-year-old man with hepatitis B virus cirrhosis underwent liver transplantation and received tacrolimus, mycophenolate and prednisolone, as the immunosuppressive regimen. Progressive ascites developed after 10 days, in spite of a normal liver function. Various studies, including liver biopsy, were performed but we could not find any etiology for this complication. The tacrolimus was switched to rapamune. Ascites was completely disappeared and up to the last follow-up visit, the patient remained asymptomatic for more than two years. We concluded that after ruling out other etiologies, tacrolimus as a rare cause of post-transplantation ascites should be taken into account. The treatment is discontinuation of the drug.
Outcome and Complications of Frontal Sinus Stenting: A Case Presentation and Literature Review
Authors: Mohammed A Khan, Waleed A Alshareef, Osama A Marglani, Islam R Herzallah
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

Introduction:
Frontal sinus surgery remains challenging to manage because of its complex anatomy and narrow outflow tract. A number of studies suggest the success of frontal sinus stenting to reduce postoperative complications in endoscopic frontal sinus surgery. However, failure and complications of frontal sinus stenting may occur.
Method:
We present a case of frontal sinus stenting with migration of the stent and erosion of the lamina papyracea together with a granulomatous reaction around the stent. PubMed and Medline search was also conducted to study the current evidence on frontal sinus stenting benefits and complications.
Results:
Still there are no guidelines or universally accepted indications for the use of frontal sinus stenting in the literature. A limited number of studies suggest the success of frontal sinus stenting to reduce postoperative stenosis in endoscopic frontal sinus surgery. However, failure and complications of frontal sinus stenting may occur. Infection, pain, edema, and stent obstruction may also occur. Our case report also highlights the potential of orbital complications as well as the consequences of inducing a granulomatous reaction.
Conclusion:
The value of frontal sinus stenting is still a subject of debate. Complications of frontal sinus stenting are not uncommon and thus necessitate regular follow-up.
Case Report: Neuroblastoma Breakpoint Family Genes Associate With 1q21 Copy Number Variation Disorders
Authors: Lijuan Zhu, Xiaoji Su
Journal: Front Genet (2021)
Keywords: 1q212, olduvai domain, congenital heart disease, hearing loss, microduplication
MeSH terms: Case Reports

Microduplications and reciprocal microdeletions of chromosome 1q21. 1 and/or 1q21.2 have been linked to variable clinical features, but the underlying pathogenic gene(s) remain unclear. Here we report that distinct microduplications were detected on chromosome 1q21.2 (GRCh37/hg19) in a mother (255 kb in size) and her newborn daughter (443 kb in size), while the same paternal locus was wild-type. Although the two microduplications largely overlap in genomic sequence (183 kb overlapping), the mother showed no clinical phenotype while the daughter presented with several features that are commonly observed on 1q21 microduplication or microdeletion patients, including developmental delay, craniofacial dysmorphism, congenital heart disease and sensorineural hearing loss. NBPF15 and NBPF16, two involved genes that are exclusively duplicated in the proband, may be the cause of the clinical manifestations. This study supports an association between NBPF genes and 1q21 copy number variation disorders.
Systemic Embolization and Myocardial Infarction due to Clinically Unrecognized Left Atrial Myxoma
Authors: Britta Vogel, Dierk Thomas, Derliz Mereles, Wolfgang Rottbauer, Hugo A Katus
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Myxomas are the most common primary tumors of the heart. We report an extraordinary severe case of left atrial myxoma, presenting with stroke, myocardial infarction, and multiple arterial embolism including aorta, splenic and renal arteries, and several peripheral arteries. The patient had previously been diagnosed with systemic vasculitis, a typical but less common finding caused by multiple emboli mimicking vasculitis. The myxoma was removed and atrial septum reconstruction was performed. In summary, early diagnostic differentiation of myxoma from vasculitis is critical, and immediate surgical removal of myxoma is required as the probability of thromboembolic complications increases over time.
The Side Effects of Facial Implants
Authors: Adela Ioana Uta, Claudia Elena Uta, Lia Anguelova Valentinova, Carlos Isanta Pomar
Journal: Case Rep Med (2016)

This case report is about a 64-year-old woman who presented at the Emergency Walk-in Center with palpebral edema as well as various erythematous plaques in supraciliary and malar areas that have been gradually worsening a couple of days prior to presentation. While talking about history, the patient mentioned she was attending, for about four months, an Esthetic Private Clinic, where she was injected in various sessions with Metacrill®, as a facial lift, for beauty purpose. Due to suspecting an allergic reaction to the Metacrill and the failure of the initial treatments, she was referred to the dermatologist. After failed attempts to treat the patient with corticosteroids and antibiotics, the patient was sent for autoimmunity consultation at the hospital where she received an immunosuppressive treatment with Tacrolimus and was not presenting new symptoms ever since.
Extremely high infiltration of CD8+PD-L1+ cells detected in a stage III non-small cell lung cancer patient exhibiting hyperprogression during anti-PD-L1 immunotherapy after chemoradiation: A case report
Authors: Changshun Wu, Kai Zhou, Yan Zheng, Dongxiao Lv, Miaoqing Zhao, Yue Hu, Fei Qi, Xin Wang, Hong Feng
Journal: Front Oncol (2022)
Keywords: cd8+pd-l1+, pd-l1, durvalumab, hyperprogressive disease, non-small cell lung cancer
MeSH terms: Case Reports

In recent years, immune checkpoint inhibitors (ICIs), represented by PD-1/PD-L1 monoclonal antibodies, have become a research hotspot in the field of oncology treatment. Immunotherapy has shown significant survival advantages in a variety of solid tumors. However, the phenomenon of hyperprogressive disease (HPD) in some patients treated with immunotherapy is gradually getting more attention and focus. An early understanding of the characteristics of HPD is crucial to optimize the treatment strategy. We report a patient with unresectable stage III lung adenocarcinoma who developed HPD with metastasis during consolidation therapy with durvalumab after chemoradiation. To further investigate the potential mechanism of HPD after anti-PD-L1 treatment, primary lung baseline tissue, baseline plasma, post-immunotherapy plasma, and liver metastasis samples of the patient were detected via next-generation sequencing (NGS). Then, multiplex immunohistochemistry (mIHC) was performed on primary lung baseline tissue and liver metastasis samples. KRAS and p.G12C were identified as the major driver mutation genes. With a low tumor mutation burden (TMB) value, the patient presented a very high percentage of CD8+PD-L1+ T cells that infiltrated in the baseline tissue, with 95.5% of all CD8+ cells expressing PD-L1 and a low percentage of CD8+ T cells expressing PD-1. After the emergence of HPD from immunotherapy, liver metastases were similarly infiltrated with an extremely high proportion of CD8+PD-L1+ T cells, with 85.6% of all CD8+ cells expressing PD-L1 and almost no CD8+ T cells expressing PD-1. The extreme infiltration of PD-L1+CD8+ T cells in the tumor microenvironment of baseline tissue might be associated with the aggressive tumor growth observed in anti-PD-L1 treatment for related HPD and could be a potential biomarker for HPD development.
Intra-articular osteoid osteoma of tempromandibular joint: A case report
Authors: Sabah Abdulaziz Issa, Hussein Ali Abdulnabi, Ahmed Salih Hussien Alshewered
Journal: Int J Surg Case Rep (2019)
Keywords: case report, craniofacial neoplasm, osteoblastoma, osteoid osteoma, temporo-mandibular joint

Introduction:
An osteoid osteoma is a benign bone neoplasm with limited growth potential, characterized by significant nocturnal pain that usually responds to non-steroidal anti-inflammatory drugs (NSAIDs). The tumor may occur in any part of the skeleton, most commonly in the lower extremities and vertebrae.
Presentation of case:
A 46-year-old female was diagnosed with a rare case of an intra-articular variant of osteoid osteoma, involving the articular eminence and glenoid fossa of the temporo-mandibular joint (TMJ).
Discussion:
The tumor presented as a painful progressive swelling in the right pre-auricular area that had lasted for more than 2 years and which had been previously treated as a TMJ disorder. Computed tomography revealed a well-defined heterogeneous nidus involving the articular eminence of the TMJ. Surgical excision was performed and histological examination confirmed the diagnosis. In this article, in addition to describing the case, all cases of osteoid osteoma of the jaws and TMJ reported in the English-language literature are reviewed.
Conclusion:
Osteoid osteoma involving the TMJ is a rare presentation and may exhibit ambiguous symptoms, which could lead to misdiagnosis and delayed treatment.
Visual recovery after perinatal stroke evidenced by functional and diffusion MRI: case report
Authors: Mohamed L Seghier, François Lazeyras, Slava Zimine, Sonja Saudan-Frei, Avinoam B Safran, Petra S Huppi
Journal: BMC Neurol (2005)
MeSH terms: Recovery of Function / physiology, Stroke / physiopathology, Vision, Ocular / physiology, Visual Pathways / blood supply, Visual Pathways / physiopathology, Case Reports, Research Support, Non-U.S. Gov't, Asphyxia Neonatorum / diagnosis, Asphyxia Neonatorum / physiopathology, Brain Mapping, Diffusion Magnetic Resonance Imaging, Humans, Infant, Infant, Newborn, Magnetic Resonance Imaging, Male, Stroke / diagnosis, Stroke / etiology

Background:
After perinatal brain injury, clinico-anatomic correlations of functional deficits and brain plasticity remain difficult to evaluate clinically in the young infant. Thus, new non-invasive methods capable of early functional diagnosis are needed in young infants.
Case presentation:
The visual system recovery in an infant with perinatal stroke is assessed by combining diffusion tensor imaging (DTI) and event-related functional MRI (ER-fMRI). All experiments were done at 1.5T. A first DTI experiment was performed at 12 months of age. At 20 months of age, a second DTI experiment was performed and combined with an ER-fMRI experiment with visual stimuli (2 Hz visual flash). At 20 months of age, ER-fMRI showed significant negative activation in the visual cortex of the injured left hemisphere that was not previously observed in the same infant. DTI maps suggest recovery of the optic radiation in the vicinity of the lesion. Optic radiations in the injured hemisphere are more prominent in DTI at 20 months of age than in DTI at 12 months of age.
Conclusion:
Our data indicate that functional cortical recovery is supported by structural modifications that concern major pathways of the visual system. These neuroimaging findings might contribute to elaborate a pertinent strategy in terms of diagnosis and rehabilitation.
Diabetic mastopathy as a radiographically occult palpable breast mass
Authors: Uma Thanarajasingam, Beiyun Chen, Cindy L Tortorelli, James W Jakub, Karthik Ghosh
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Diabetic mastopathy is an uncommon, benign disease of the breast that can occur in women with diabetes and clinically mimic breast cancer. We describe a patient with long-standing type 1 diabetes who presented with a palpable breast mass with negative imaging findings on mammography, ultrasonography, and breast MRI. Surgical biopsy and histopathology confirmed diabetic mastopathy. We use this case to highlight the recognition, radiographic features, pathology, and management of this benign breast condition and emphasize that, in diabetic patients, the differential diagnosis of a new breast mass should include diabetic mastopathy.
Alfa-Fetoprotein-Producing Female Primary Urethral Adenocarcinoma with Neuroendocrine Differentiation
Authors: Takao Natsuyama, Yozo Mitsui, Masato Uetani, Shigeyuki Ohta, Masafumi Inoue, Koichiro Akakura
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

We report an extremely rare case of an alpha-fetoprotein- (AFP-) producing female primary urethral adenocarcinoma with neuroendocrine differentiation (NED). The patient was a 65-year-old woman with a 2-year history of urinary frequency and voiding difficulty. Enhanced computed tomography showed an approximately 3.0×5.0-cm mass around the proximal urethra and bladder neck. Of examined tumor markers, serum AFP was elevated (48.3 ng/mL), while others including carcinoembryonic antigen were within a normal range. Transurethral resection of the tumor led to a diagnosis of carcinosarcoma of the urethra, with a radical cystourethrectomy and ileal conduit formation subsequently performed. The pathological assessment was poorly differentiated adenocarcinoma in the urethra. Immunostaining showed tumor cells strongly positive for AFP. In addition, some cancer cells were positive for CD56, chromogranin A, and synaptophysin, indicating focal NED. The tumor was finally diagnosed as an AFP-producing urethral adenocarcinoma with NED. Serum AFP was immediately normalized after surgery and no sign of tumor recurrence has been noted 2 years postoperatively.
Carcinoma buccal mucosa underlying a giant cutaneous horn: a case report and review of the literature
Authors: Sunil Kumar, Priyank Bijalwan, Sunil K Saini
Journal: Case Rep Oncol Med (2014)

Cutaneous horn is a conical, dense, and hyperkeratotic protrusion that often appears similar to the horn of an animal. Giant cutaneous horns are rare; no incidence or prevalence has been reported. The significance of cutaneous horns is that they occur in association with, or as a response to, a wide variety of underlying benign, premalignant, and malignant cutaneous diseases. A case of giant cutaneous horn of left oral commissure along with carcinoma left buccal mucosa is reported here as an extremely rare oral/perioral pathology.
Case Report: Repeated esophageal obstruction in a patient with type 3C diabetes mellitus
Authors: Katsumasa Koyama, Takatoshi Anno, Haruka Takenouchi, Tomohiko Kimura, Kohei Kaku, Hideaki Kaneto
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: diabetic neuropathy, esophageal candidiasis, esophageal obstruction, gastrointestinal motility disorders, type 3c diabetes mellitus
MeSH terms: Candidiasis, Diabetes Mellitus, Diabetic Neuropathies / diagnosis, Gastrointestinal Diseases, Case Reports, Humans

Although diabetic neuropathy is a well-known cause of gastrointestinal motility disorders, it is rare that diabetic neuropathy brings about esophageal obstruction. Here, we report a case with Type 3C diabetes mellitus (DM) lasting over 15 years and repeated esophageal obstruction resulting in chicken-meat-induced esophageal obstruction and candidiasis. This case highlights the importance of management of DM to prevent the development of complications such as diabetic neuropathy and associated symptoms.
Mucocutaneous Leishmaniasis with Rare Manifestation in the Nasal Mucosa and Cartilage Bone Septal
Authors: Nicole Casalle, Laís de Barros Pinto Grifoni, Ana Carolina Bosco Mendes, Sérgio Delort, Elaine Maria Sgavioli Massucato
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

Backgroud. Leishmaniasis is an infectious disease caused by protozoan of the genus Leishmania that can affect mucosal or cutaneous surfaces. It can manifest via buccal mucosa, associated with a skin lesion or as a secondary effect. Over the last 20 years, the number of cases of this disease is progressively increasing in Brazil. Therefore, the knowledge of this disease by health professionals is important in order to achieve a correct and early diagnosis, manly to prevent the deformities it may cause to the face. Case presentation. The aim of the present study was to report a case of mucocutaneous leishmaniasis with lesions on the palatine and pharyngeal mucosa in a patient with a previous report of rare lesions in the nasal mucosa and cartilage bone septal. Conclusions. We believe that the disclosure of such cases may be important for the correct and early diagnosis of these secondary injuries that may affect the oral mucosa.