OpenMed/multicare-articles huggingface dataset:
Case Report: Infusion-Related Reactions to Intravenous Infliximab and Subcutaneous Ustekinumab in Pediatric Crohn's Disease
Authors: Toshihiko Kakiuchi, Sakiko Kimura, Motohiro Esaki, Muneaki Matsuo
Journal: Front Pediatr (2021)
Keywords: l-histidine, allergic reactions, biological agent, infliximab, infusion-related reactions, pediatrics, ustekinumab
MeSH terms: Case Reports

Background: Although the biological agent ustekinumab (UST) is reported to be effective for Crohn's disease (CD) in pediatric as well as adult patients, data on the efficacy and safety of UST in pediatric patients with CD are limited. Here, we describe the case of a pediatric patient who showed an allergic reaction to UST after subcutaneous (SC) maintenance injections but not immediately after initial intravenous (IV) injection. Case Presentation: A 9-year-old boy presented to our hospital with diarrhea lasting 2 years and weight loss, leading to the diagnosis of CD. After prednisolone (PSL) was tapered and discontinued, he promptly relapsed. According to our institution's protocol, we introduced the biological agent infliximab (IFX) with premedication. Coughing and vomiting was observed after the second dose of IFX and it was changed to adalimumab (ADA). However, the effect of ADA gradually disappeared after 18 months; therefore, it was discontinued and he was treated using UST. The first IV UST dose was given after administering hydrocortisone (HDC), an antiallergic and antipyretic analgesic, as premedication, and no obvious adverse reaction was observed. After 8 weeks, UST was subcutaneously injected without premedication. The patient then complained of nausea, dizziness, and headache within 15 min of UST administration. Therefore, for the third dose of UST, HDC was administered again as premedication. However, nausea, dizziness, and headache presented 10 min after UST administration, resulting in discontinuation of further UST treatment. Conclusion: Careful distinction between "true" infusion-related reactions (IRRs) and anaphylaxis or allergic reactions is necessary to determine whether biological agents can be continued after the development of "so-called" IRRs. For true IRRs, it may be possible to continue using the biological agent with appropriate premedication; however, in cases of anaphylaxis, the biological agent itself should be changed.
Case Report: Herceptin as a Potentially Valuable Adjuvant Therapy for a Patient With Human Epidermal Growth Factor Receptor 2-Positive Advanced Esophageal Squamous Cell Carcinoma
Authors: Li Han, Chi Pan, Qingtao Ni, Tao Yu
Journal: Front Oncol (2021)
Keywords: chemotherapy, esophageal squamous cell carcinoma, herceptin, human epidermal growth factor receptor 2 (her2) positive, targeted therapy
MeSH terms: Case Reports

Esophageal cancer is one of the most common cancers with a low overall 5-year relative survival rate of approximately 20%. Trastuzumab (Herceptin®) targets HER2 and is an effective therapeutic strategy in HER2-positive breast cancer. However, few reports have described targeted therapy for treating esophageal squamous cell carcinoma (ESCC). A patient with advanced ESCC who had received chemotherapy, radiotherapy, and had undergone a clinical study is described here. The tumor had not been controlled. Herceptin and chemotherapy were used as salvage therapy in this patient because of high HER2 expression. Good therapeutic results were observed in this patient. Therefore, Herceptin is a potential target therapy for patients with HER2-positive advanced ESCC. A study with a large population and a prospective random study are necessary to validate these results.
The Combination of Gastroschisis, Jejunal Atresia, and Colonic Atresia in a Newborn
Authors: Zachary Bauman, Victor Nanagas Jr
Journal: Case Rep Pediatr (2015)

We encountered a rare case of gastroschisis associated with jejunal atresia and colonic atresia. In our case, the jejunal atresia was not discovered for 27 days after the initial abdominal wall closure. The colonic atresia was not discovered for 48 days after initial repair of the gastroschisis secondary to the rarity of the disorder. Both types of atresia were repaired with primary hand-sewn anastomoses. Other than the prolonged parenteral nutrition and hyperbilirubinemia, our patient did very well throughout his hospital course. Based on our case presentation, small bowel atresia and colonic atresia must be considered in patients who undergo abdominal wall closure for gastroschisis with prolonged symptoms suggestive of bowel obstruction. Our case report also demonstrates primary enteric anastomosis as a safe, well-tolerated surgical option for patients with types of intestinal atresia.
Pseudo (platelet-type) von Willebrand disease in pregnancy: a case report
Authors: Neetu Grover, Vincent Boama, Munazzah Rifat Chou
Journal: BMC Pregnancy Childbirth (2013)
MeSH terms: Pregnancy Complications, Hematologic / diagnosis, Prenatal Care / methods, Thrombocytopenia / diagnosis, von Willebrand Diseases / diagnosis, Case Reports, Adult, Delivery, Obstetric / methods, Diagnosis, Differential, Factor VIII / therapeutic use, Female, Humans, Platelet Transfusion, Pregnancy, Pregnancy Complications, Hematologic / therapy, von Willebrand Diseases / therapy, Factor VIII, Von Willebrand disease, platelet type

Background:
Pseudo (platelet-type)-von Willebrand disease is a rare autosomal dominant bleeding disorder caused by an abnormal function of the glycoprotein lb protein; the receptor for von Willebrand factor. This leads to an increased removal of VWF multimers from the circulation as well as platelets and this results in a bleeding diathesis. Worldwide, less than 50 patients are reported with platelet type von Willebrand disease (PT-VWD).
Case presentation:
We describe the management of platelet type von Willebrand disease in pregnancy of a 26 year old Caucasian primigravida. The initial diagnosis was made earlier following a significant haemorrhage post tonsillectomy several years prior to pregnancy. The patient was managed under a multidisciplinary team which included obstetricians, haematologists, anaesthetists and neonatologists. Care plans were made for the ante- natal, intra-partum and post-partum periods in partnership with the patient. The patient's platelet count levels dropped significantly during the antenatal period. This necessitated the active exclusion of other causes of thrombocytopenia in pregnancy. A vaginal delivery was desired and plans were made for induction of labour at 38 weeks of gestation with platelet cover in view of the progressive fall of the platelet count. The patient however went into spontaneous labour on the day of induction. She was transfused two units of platelets before delivery. She had an unassisted vaginal delivery of a healthy baby. The successful antenatal counselling has encouraged the diagnosis of the same condition in her mother and sister. We found this to be a particularly interesting case as well as challenging to manage due to its rarity. Psuedo von Willebrand disease in pregnancy can be confused with a number of other differential diagnoses, such as gestational thrombocutopenia, idiopathatic thrombocytopenia, thrombotic thrombocytopenic purpura and pre-eclampsia; all need consideration during investigations even in a case such as this where the diagnosis of platelet type von Willebrand disease was known before pregnancy.
Conclusion:
Management of pseudo von Willebrand disease in pregnancy involves the co-operation of multidisciplinary teams, regular monitoring of platelet levels and factor VIII and replacement as appropriate. This case report highlights this rare condition and the need to exclude all the other differential diagnoses of thrombocytopenia in pregnant women with thrombocytopenia.
Poorly differentiated squamous cell carcinoma arising in tattooed skin
Authors: Deba P Sarma, Renee B Dentlinger, Amanda M Forystek, Todd Stevens, Christopher Huerter
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Introduction. Tattoos have increasingly become accepted by mainstream Western society. As a result, the incidence of tattoo-associated dermatoses is on the rise. The presence of a poorly differentiated squamous cell carcinoma in an old tattooed skin is of interest as it has not been previously documented. Case Presentation. A 79-year-old white homeless man of European descent presented to the dermatology clinic with a painless raised nodule on his left forearm arising in a tattooed area. A biopsy of the lesion revealed a poorly differentiated squamous cell carcinoma infiltrating into a tattoo. The lesion was completely excised and the patient remains disease-free one year later. Conclusion. All previous reports of squamous cell carcinomas arising in tattoos have been well-differentiated low-grade type or keratoacanthoma-type and are considered to be coincidental rather than related to any carcinogenic effect of the tattoo pigments. Tattoo-associated poorly differentiated invasive carcinoma appears to be extremely rare.
Nonsyndromic Bilateral Posterior Maxillary Supernumerary Teeth: A Report of Two Cases and Review
Authors: Ravi Kumar Mahto, Shantanu Dixit, Dashrath Kafle, Aradhana Agarwal, Michael Bornstein, Sanad Dulal
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Supernumerary tooth/hyperdontia is defined as those teeth which are present in excess of the usual distribution of twenty deciduous and thirty-two permanent teeth. It can be seen in both syndromic and nonsyndromic patients. In Nepalese population, prevalence of supernumerary tooth is documented to be 1.6%. To the best of our knowledge, no studies from Nepal have reported the incidence of bilateral maxillary paramolars or the combination of unilateral maxillary paramolar and distomolar till date. Hence, we are reporting these two cases with a brief review of literature to put emphasis on incidence, prevalence, proposed hypothesis for etiology, and management of supernumerary teeth.
Penetration and Perforation of Terminal Ileum Diverticulitis
Authors: Fumito Saijo, Kentaro Sawada, Ryohei Nomura, Mitsuhisa Mutoh, Yoichi Narushima, Noriyuki Iwama, Fumie Nakayama, Hiromi Tokumura
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Background:
Terminal ileum diverticulitis is a rare clinical disease. It can frequently mimic other processes, such as acute appendicitis. Diagnosis and therapeutic decision making (surgical or conservative treatment) can be complex. We report four interesting cases of terminal ileum diverticulitis. Case Presentation. Case 1: a 55-year-old male presented to us with a 3-day history of severe right lower quadrant pain. Computed tomography (CT) showed penetration of terminal ileum diverticulitis. Following a 7-day conservative treatment, he underwent ileocecal resection. Pathology results revealed a false diverticulum and two in five points of perforated terminal ileum diverticulum. Case 2: a 77-year-old male presented to us with severe right lower quadrant pain and unconsciousness. CT showed penetration of terminal ileum diverticulitis and air in the mesentery. Ileocecal resection was performed 2 days postadmission. Pathology results revealed a false diverticulum and penetrated terminal ileum diverticulum. Case 3: a 61-year-old male presented to us with a right lower quadrant pain for 10 days and fever for 6 days. CT showed penetration of terminal ileum diverticulitis and abscess of the psoas muscle. Puncture and drainage of abscess were performed. Laparoscopic ileocecal resection was performed 30 days postadmission. Pathology results revealed a false diverticulum and penetrated terminal ileum diverticulum. Case 4: a 39-year-old female presented to us with right lower quadrant pain for 9 days, suspicious of appendicitis. CT showed abscess of pericecal area. Puncture and drainage were performed. A drainage tube was located into the cecum through the terminal ileum. Conservative therapy was effective, and she was discharged 23 days postadmission.
Conclusions:
All four cases had right lower quadrant pain. Three cases were diagnosed by CT, whereas one was diagnosed by abscess drainage. Two cases required surgical treatment within 3 days, one within about 1 month, and one case did not require surgery. The decision of whether to manage a patient surgically or conservatively is difficult. It is critical not to delay the decision of performing a surgical treatment until each patient reaches a stable general condition.
Impact of HSP90 α, CEA, NSE, SCC, and CYFRA21-1 on Lung Cancer Patients
Authors: Wenwen Zhou, Yanhong Yang, Zhenzhen Wang, Yan Liu, Moslem Lari Najafi
Journal: J Healthc Eng (2021)
MeSH terms: Carcinoembryonic Antigen, Lung Neoplasms / diagnosis, Antigens, Neoplasm, Humans, Keratin-19, Antigens, Neoplasm, Carcinoembryonic Antigen, Keratin-19, antigen CYFRA21.1

Lung cancer is a lethal disease, and early diagnosis with the aid of biomarkers such as HSP90α protein can certainly assist the doctors to start treatment of patient at the earliest and can save their lives. To analyse the diagnostic value of HSP90α expression in lung cancer patients by collecting data of patients through IoT devices to avoid delay in treatments, a study has been presented in this paper where the significance of HSP90α biomarker is highlighted in early diagnosis of patients suffering from lung cancer. The second objective of the research study is to examine the correlation between the appearance level of HSP90α biomarker and the clinicopathological features of lung cancer. It is also evaluated whether the changes in HSP90α index are indicative or noteworthy before and after surgery of lung cancer patients. An observatory study of 78 patients with lung cancer in Qinhuangdao Hospital is presented in this paper where the samples were collected from June 2018 to March 2020. Their data were collected through IoT devices used in the latest healthcare facilities of the hospital. The ELISA method was utilized to identify the level of plasma HSP90 and to analyse HSP90 levels between the lung cancer group and healthy group of people. The relationship between HSP90 and the clinical pathological features of 78 patients suffering from lung cancer was analysed. An electrochemical luminescence method was used to detect CEA, NSE, SCC, and CYFRA21-1 levels. ROC curve and box plots were used to determine the analytic value of HSP90 and other biomarkers used in lung cancer diagnosis. Forty-two patients with moderate to early stage lung cancer with surgical correction were selected, and paired sample T test was used to analyse HSP90 levels before and after surgery. The plasma HSP90 level of lung cancer patients was quite higher as compared to the group of healthy people as per the values depicted in the research study. Second, HSP90 levels are substantially higher in pathologic type, differentiation degree, stage, and the existence of the lung, liver, and bone metastases (P < 0.05). The level of HSP90 expression was largely impacted by a few factors such as sex, age, smoking, and tumour location (P > 0.05). The ROC value for HSP90 was 0.599, while the area under the curve of HSP90 combined with other four tumour markers was 0.915 in the presented case study, indicating the presence of lung cancer. Patients with lung cancer had statistically significant differences in HSP90 expression levels before and after surgery (P < 0.05). It is concluded that the expression level of plasma HSP90α in lung cancer patients increases remarkably; therefore, HSP90 can be used to monitor presence of lung cancer before and after surgery in the patients.
Varicella Zoster meningitis as a mimicker of pseudotumor cerebri in an immunocompetent patient: A case report and literature review
Authors: Yousra Ali, Mhd Baraa Habib, Abeer Safan, Bisher Sawaf, Abdelnaser Elzouki
Journal: Qatar Med J (2022)
Keywords: herpes zoster, meningitis, viral, headache, intracranial hypertension

Varicella-zoster (VZ) meningitis is uncommon in patients with immunocompetence and usually presents with typical rash and fever. However, VZ meningitis can rarely present with symptoms of intracranial hypertension without the classic manifestations. Herein, we describe a 17-year-old female teen who presented with intractable headache and vomiting and diagnosed with VZ meningitis. Her symptoms remarkably improved after a lumbar puncture and acyclovir therapy.
Incidence and Etiology of Stroke among Hospitalized Children: A Case-Series Study
Authors: Zarin Taj Keihani Doust, Fatemeh Noori Sari, Parvin Akbari Asbagh, Zahra Farahani, Fatemeh Tehrani, Mamak Shariat
Journal: Iran J Child Neurol (2019)
Keywords: adult children, cerebral blood flow, infant, stroke

Objectives:
Stroke is a sudden blockage or rupture of brain vessels resulting neural defect or impairment. We aimed to investigate the incidence and causes of stroke in hospitalized children (Tehran-Iran, 2008-2013).
Materials & methods:
This case series study was carried out in pediatric ward of tertiary care Vali-Asr Hospital, Imam Khomeini Hospitals Complex (Tehran- Iran) from 2008 to 2013. One month to 15 yr old admitted children due to stroke were enrolled into this case series study. Diagnosis was confirmed with brain imaging. Participants' demographic data, potential risk factors and neuroimaging findings were obtained from Hospital Reporting System. Recorded data were studied and considered regarding the incidence of stroke and its causes. Indeed we investigated cardiological causes as well as different items related to hematological disorders.
Results:
Of 20000 admitted subjects in Imam Hospital during 5 yr, stroke was diagnosed in 15 cases. The incidence among the population study was 0.75 per 100000 children. Stroke was more frequent in males than females ( 1.14 1 ). The most common age of stroke was 4-6 yr and the mean age of stroke was 58.8 months equal to 4.9 year. The most frequent stroke was hemorrhagic stroke (26%), followed by vascular (20%) and coagulopathy disorders (20%).
Conclusion:
The incidence of stroke in children was 0.75 per 100000. Hemorrhagic stroke due to major trauma, coagulopathy and vasculopathy were observed as most frequent causes that necessitate implementing some strategies for prevention, earlier diagnosis, and treatment.
Deterioration of duodenal lymphangiectasia after radiotherapy for gastric MALT lymphoma
Authors: Masaya Iwamuro, Takehiro Tanaka, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Yoshiaki Iwasaki, Hiroyuki Okada
Journal: Ecancermedicalscience (2017)
Keywords: duodenal lymphangiectasia, gastric neoplasms, gastrointestinal lymphoma, radiotherapy
MeSH terms: Case Reports

A 68-year-old Japanese woman underwent radiotherapy for gastric lymphoma. Although lymphangiectasia was sparsely observed in the second portion of the duodenum before radiotherapy, the number of pinpoint white spots obviously increased after the treatment. Although the duodenal lymphangiectasia gradually progressed, the patient had no features of protein-losing enteropathy. This case highlights the importance of endoscopic observation of the duodenum after irradiation to the abdomen as radiotherapy may secondarily cause intestinal lymphangiectasia.
Case report: Two individuals with AEBP1-related classical-like EDS: Further clinical characterisation and description of novel AEBP1 variants
Authors: Chloe Angwin, Neeti Ghali, Fleur Stephanie van Dijk
Journal: Front Genet (2023)
Keywords: aebp1, ehlers–danlos syndrome, classical-like eds type 2, connective tissue disease, hair loss
MeSH terms: Case Reports

Introduction: AEBP1-related classical-like EDS (clEDS type 2) is a rare type of Ehlers-Danlos syndrome (EDS) that was first reported in 2016. There are overlapping clinical features with TNXB-related classical-like EDS (or clEDS type 1), including skin hyperextensibility, joint hypermobility, and easy bruising. There are currently nine reported individuals with AEBP1-related clEDS type 2. This report confirms previous findings and provides additional clinical and molecular data on this group of individuals. Materials and methods: Two individuals (P1 and P2), with features of a rare type of EDS, were clinically assessed in the London national EDS service and underwent genetic testing. Results: Genetic testing in P1 revealed likely pathogenic AEBP1 variants: c.821del:p. (Pro274Leufs*18) and c.2248T>C:p. (Trp750Arg). In P2 pathogenic AEBP1 variants, c.1012G>T:p. (Glu338*) and c.1930C>T:p. (Arg644*) were identified. Discussion: These two individuals increased the reported number of individuals with AEBP1-related clEDS to 11 (six females and five males). There are shared features with previously reported individuals, including hypermobility (11/11), skin hyperextensibility (11/11), presence of atrophic scarring (9/11), and easy bruising (10/11). In P1, a chronic right vertebral artery dissection, mild dilatation of the splenic artery, aberrant subclavian artery, and tortuous iliac arteries were observed at the age of 63 years. Cardiovascular disease has been reported, including mitral valve prolapse (4/11), peripheral arterial disease (1/11), and aortic root aneurysm requiring surgical intervention (1/11). Hair loss has been reported in 6/11 individuals (five females and one male), only one of which was documented to have a formal diagnosis of androgenetic alopecia, while other individuals were described as having thinning of hair, male pattern hair loss, or unspecified alopecia. Conclusion: The clinical features of individuals with AEBP1-related EDS have not been fully elucidated yet. Hair loss is present in 6/11 individuals with AEBP1-related clEDS and appears to be a feature of this condition. This is the first time hair loss has been formally reported as a characteristic feature in a rare type of EDS. Cardiovascular surveillance seems warranted in this condition because 2/11 individuals have evidence of arterial aneurysm and/or dissection. Further descriptions of affected individuals are necessary to update diagnostic criteria and management guidelines.
False-positive FDG PET CT Scan in Vertebral Hemangioma
Authors: Shrikant Vasantrao Solav, Shailendra Vasant Savale, Abhijit Mahaveer Patil
Journal: Asia Ocean J Nucl Med Biol (2019)
Keywords: bone scan, ct, fdg pet ct, tumor induced osteomalacia, vertebral hemangioma
MeSH terms: Case Reports

FDG PET CT scan is considered to be a sensitive tool to detect skeletal metastasis in known malignancies. However, it's high sensitivity and low specificity may account for false positive diagnosis in cases of trauma, infection, inflammation and other benign conditions. Skeletal hemangioma is one of the common benign conditions which are typically ametabolic on FDG PET CT with no uptake on bone scan. However, rarely they may have atypical imaging features and appear hypermetabolic. Other imaging modalities such as MRI and CT scan have typical imaging findings for hemangioma and can be used for evaluation of focal hypermetabolic skeletal lesions. There are atypical imaging characteristics in each of these modalities. Hence when used judiciously they can complement each other and avoid a false positive test result. This case report highlights the importance of bone scan and CT scan in excluding pathological involvement of skeleton with false positive FDG PET scan result.