OpenMed/multicare-articles huggingface dataset:
Case Report: Uncommon cause of limp in the 21st century
Authors: Stephanie Thiemann, Valeria Cimorelli, Nadia M Bajwa
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: ascorbic acid, children, limp, malnutrition, scurvy, vitamin c, weakness
MeSH terms: Anemia / etiology, Scurvy / complications, Scurvy / diagnosis, Case Reports, Arthralgia / complications, Ascorbic Acid, Child, Child, Preschool, Humans, Male, Nutritional Status, Ascorbic Acid

Scurvy results from a deficiency of ascorbic acid. This disease first appeared in children during the 19th century with the emergence of new dietary habits; in particular, heating milk that leads to a loss of ascorbic acid. Even though scurvy has become a rare condition in western countries, many cases are still reported in pediatric patients, especially in those who lack proper nutrition due to neurological or psychiatric illnesses. Symptoms include bleeding and swollen gums, loosening of teeth, bone abnormalities, arthralgia, delayed wound healing, anemia, petechiae, and purpura. Bone lesions are mainly irregularities of long bones metaphyses. We report the case of a five-year-old boy who presented with arthralgia and limb deformation (genu valgum). The patient was investigated for vitamin deficiencies to exclude rickets. The radiologic investigations revealed metaphyseal signs compatible with scurvy. During the hospitalization, the patient was observed to have abnormal eating patterns and the scurvy was attributed to malnutrition. Although the occurrence of scurvy is rare, it remains essential to detect this disease in children at risk of developing vitamin deficiencies. Without targeted treatment, the complications of scurvy can be serious and potentially fatal.
Secondary acute myeloid leukemia after successful treatment for osteosarcoma
Authors: Rakesh Mittal, N V Ramaswamy, R Pandita, S Al Bahar, N Khalifa, S Omar
Journal: Indian J Med Paediatr Oncol (2010)
Keywords: acute myeloid leukemia, chemotherapy, osteosarcoma, secondary malignancy
MeSH terms: Case Reports

Secondary acute myeloid leukemia (sAML) is a rare complication following chemotherapy for osteogenic sarcoma. However, the exact offending drug is difficult to prove as there is no consistent data. It usually develops 2 years after completion of therapy. We report a case of sAML that developed within 8 months of completing the treatment. The patient was treated with cisplatin, doxorubicin and high-dose methotreaxate followed by surgery (amputation). Eight months after completion of therapy, while on follow-up, he presented with leukocytosis and thrombocytopenia and confirmed to have AML.
Analysis of Treatment of 3 Patients with Acute-on-Chronic Liver Failure
Authors: Jun Lei, Yi-Lan Zeng, Lv-Ye Xu, Ying Wang
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Acute-on-chronic liver failure (ACLF) is an acute liver decompensation that occurs within 4 weeks on the basis of chronic liver disease. At present, the treatments of ACLF include general supportive treatment, etiological treatment, prevention and treatment of complications, artificial liver treatment, and liver transplantation. Many studies suggest that stem cell therapy may become a new treatment for patients with ACLF. Our department has also tried the application of this treatment. Now, there are three cases of stem cell therapy for patients with ACLF by our department which will be briefly reported.
Case Report: Relevance of an Accurate Diagnosis and Monitoring of Infective Dermatitis Associated With Human T-Lymphotropic Virus Type 1 in Childhood
Authors: Paula Benencio, Nicolás Ducasa, Lourdes Arruvito, Inés Irurzun, Laura Praino, Magdalena Lamberti, María Beraza, Carolina Berini, Mirna Biglione
Journal: Front Med (Lausanne) (2021)
Keywords: argentina, htlv-1, antibiotic, case report, infective dermatitis, pediatric
MeSH terms: Case Reports

Human T-lymphotropic virus type 1 (HTLV-1) is a neglected retrovirus distributed worldwide and the ethiological agent of several pathologies, such as adult T-cell leukemia/lymphoma (ATLL), a chronic myelopathy known as HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH). HTLV-1 presents tropism for CD4+ T cells and induces deregulation of the cytokine profile. IDH is a severe, chronic superinfected eczema generally associated with Staphylococcus aureus and/or Streptococcus beta haemolyticus infection that responds partially to antibiotic therapy but prompt recurrence develops upon treatment withdrawal. IDH could be a risk factor for progression toward both HAM/TSP and ATLL and, similarly to other diseases associated with HTLV-1, it is sub-diagnosed particularly in non-endemic areas. Here, we present a case of IDH in a young boy living in Buenos Aires with symptoms since 2010, at the age of 5. HTLV-1 infection was suspected and confirmed in 2016. The patient exhibited chronic dermatosis with exudative eruption involving mainly the scalp, retroauricular regions, neck and abdomen. Clinical evaluations, routine laboratory tests, full blood count, and HTLV-1 diagnosis for this case are included.
Case report: Distinct neurologic manifestation and cytokine profile of a child with COVID-19-associated acute fulminant encephalitis
Authors: Yu-Ming Chang, Cheng-Han Chen, Jieh-Neng Wang, Chao-Min Cheng, Yi-Fang Tu, Ching-Fen Shen
Journal: Front Med (Lausanne) (2023)
Keywords: covid-19, sars-cov-2, acute fulminant cerebral edema, cerebral edema, cytokine, encephalitis
MeSH terms: Case Reports

The neurologic manifestations of coronavirus disease 2019 (COVID-19) may range from mild symptoms such as headache or confusion to profound encephalopathy with variable outcomes and sequelae. Here, we reported a case of fatal COVID-19-associated encephalitis with acute fulminant cerebral edema, presenting first with visual hallucination and then a rapid progression into comatose status in a few hours. Serial brain computed tomography depicted cerebral edematous changes from bilateral ventral temporal lobe to the whole brain leading to brain herniation. Multiple cytokines in serum and cerebrospinal fluid (CSF) were increased, with a more prominent rise in the CSF. Therefore, we postulated a hypothesis regarding the mechanism of this fulminant encephalitis that the SARS-CoV-2 virus attacked ventral temporal lobes initially, triggered a severe cytokine storm, and then led to subsequent disruption of the blood-brain barrier, diffuse brain edema, and brain herniation. The trend of cytokine profiles over time may aid in diagnosing and evaluating the severity and prognosis of COVID-19-associated encephalitis.
Primary Mucinous Adenocarcinoma of the Urinary Bladder with Signet-Ring Cells: Description of an Uncommon Case and Critical Points in Its Management
Authors: Fabrizio Di Maida, Giuliano Amorim Aita, Daniele Amorim Aita
Journal: Case Rep Urol (2016)
MeSH terms: Case Reports

We present an uncommon case of mucinous adenocarcinoma of the bladder (MAB) with signet-ring cells extensively infiltrating prostate gland and pelvic/retroperitoneal lymph node stations and not responsive to usual systemic chemotherapy regimens. This case highlights the important features of MAB including the pattern of tumor spread, the tendency for initial misdiagnosis, and the importance of immunohistochemical study in order to define its primary origin from the bladder and choose the most appropriate treatment since the beginning.
Hereditary spherocytosis with successful splenectomy in a pregnant black South African lady: a case report
Authors: Khaled Elmezughi, Chukwuma Ekpebegh
Journal: Pan Afr Med J (2019)
Keywords: haemolytic anemia, south africa, hereditary spherocytosis, massive splenomegaly, pregnancy, splenectomy
MeSH terms: Anemia, Hemolytic / etiology, Spherocytosis, Hereditary / diagnosis, Splenectomy / methods, Case Reports, Black People, Female, Humans, Pregnancy, Pregnancy Complications, Hematologic / diagnosis, Pregnancy Complications, Hematologic / surgery, South Africa, Spherocytosis, Hereditary / complications, Spherocytosis, Hereditary / surgery, Splenomegaly / etiology, Splenomegaly / surgery, Young Adult

Hereditary spherocytosis is a rare cause of chronic haemolytic anaemia. It is rarer in the black population with extremely few cases reported. Initial assessment of a patient with suspected disease should include documenting clinical features of chronic haemolysis and a family history. Its management in pregnancy is challenging and needs a multidisciplinary team. We report on a black South African woman with hereditary spherocytosis and massive splenomegaly presenting with severe haemolytic anaemia at 23rd week of pregnancy. She had a successful splenectomy.
The approaches Hong Kong Chinese mothers adopt to teach their preschool children to prevent influenza: a multiple case study at household level
Authors: Winsome Lam, Cathrine Fowler, Angela Dawson
Journal: BMC Nurs (2016)
Keywords: parent-child interaction, parental teaching, seasonal influenza

Background:
In Hong Kong, the population is at risk of seasonal influenza infection twice a year. Seasonal influenza is significantly associated with the increased hospitalization of children. Maintaining personal hygiene and vaccination are the most effective measures to prevent influenza infection. Research demonstrates a positive relationship between the health practices applied by parents and the behaviour of their children highlighting the importance of parental heath education. However, there is minimal research that provides an understanding of how Hong Kong Chinese parents teach their children to prevent seasonal influenza.
Methods:
Mixed methods research was undertaken that employed a multiple-case study approach to gain an understanding of parental teaching practices regarding seasonal influenza prevention. Purposive intensity sampling was adopted to recruit twenty parents and their healthy children. A thematic analysis was employed to examine the qualitative interview data and the quantitative survey data were examined descriptively. These data were then integrated to provide a more rigorous understanding of parental teaching strategies. Comparisons were made across cases to reveal commonalities and differences.
Results:
Five major themes were identified: processes parents used to teach personal hygiene; parent-child interaction during teaching; approaches to managing children's health behaviours; enhancing children's healthy practices; and parents' perspective of the role of the nurse in health promotion.
Conclusions:
This study provided valuable insight into the approach of Hong Kong Chinese parents in teaching their children to prevent seasonal influenza. The results indicate that parents can be better supported to develop effective strategies to teach their preschool children hygiene practices for seasonal influenza prevention. Partnerships with community nurses can play a role in building effective parent-child interactions to enhance children's learning and adoption of healthy practices.
The Use of a Hybrid Pillar and Its Importance for Aesthetic Rehabilitation and Tissue Stability: A Clinical Report
Authors: Guilherme da Gama Ramos, Danilo Lazzari Ciotti, Samuel Rehder Wimmers Ferreira, Maide Rehder Wimmers Ferreira Margarido, Raquel Adriano Dantas, Marina Nottingham Guerreiro
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

In the past, aesthetics had a secondary role in implant rehabilitation. Nowadays, the search for a perfect and harmonious aesthetic has stimulated the development of new materials and techniques. Due to this aesthetic requirement, the hybrid abutment (titanium link + zirconia) emerged as an alternative to metallic pillars. The hybrid abutment made a more favorable aesthetic possible, provided reliable mechanical properties, and increased biocompatibility to the surrounding tissues. Additionally, the individual zirconia abutment improves the emergency profile and the final white aesthetics. The objective of this paper is to report a clinical case with a manufactured individualized hybrid abutment for a metal-free indirect restoration, showing the applicability, mechanical properties, and biocompatibility of the hybrid abutment.
Crohn's Disease Diagnosed in a Man with Sarcoidosis: Coincidence or Correspondence?
Authors: Krystal Mills, Shaheen Fatima, Norberto Fas
Journal: Case Rep Gastrointest Med (2022)
MeSH terms: Case Reports

Crohn's disease and sarcoidosis are characterized by noncaseating granulomas, but rarely do they present in the same patient. Their coexistence presents a diagnostic challenge as they are often classified as clinically separate, despite their similarities. We present a case of a 59-year-old man previously diagnosed with pulmonary sarcoidosis who presented to the emergency room with abdominal pain and diarrhea. Colonoscopy revealed multiple ulcers in the colon, with histology in keeping with newly diagnosed Crohn's colitis. The patient had a good clinical response to initiation of steroid therapy and a tumor necrosis factor (TNF) inhibitor.
A rare cause of specific cough in a child: the importance of following-up children with chronic cough
Authors: Richard Lloyd Barr, David John McCrystal, Christopher Francis Perry, Anne B Chang
Journal: Cough (2005)

For many years, the term 'specific cough' has been used as a clinical cough descriptor in children to signify the likelihood of an underlying disease causing the cough. In this case study, we describe a child with specific cough caused by a rare carcinoma, a mucoepidermoid carcinoma of the bronchus. The cough only totally resolved after the primary cause was successfully treated. This report highlights the importance of following up children with cough, especially those with specific cough.
Vulvar Lobular Capillary Hemangioma: A Rare Location for a Frequent Entity
Authors: F Abreu-Dos-Santos, S Câmara, F Reis, T Freitas, H Gaspar, M Cordeiro
Journal: Case Rep Obstet Gynecol (2016)

Lobular capillary hemangioma, or pyogenic granuloma, is an acquired hemorrhagic benign vascular lesion of the skin and mucous membranes. The pyogenic granuloma of the vulva is a rare finding and a limited number of case reports are available in the literature. To the best of our knowledge this is the first case described as a single pyogenic granuloma on the vulva.
Expectant Management of Monochorionic-Triamniotic Triplets Complicated by Selective In Utero Growth Restriction: Report of 2 Cases
Authors: Laurence Carmant, Sandrine Wavrant, Elisabeth Codsi
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

The optimal management of monochorionic-triamniotic (MCTA) triplet pregnancies is not clearly established, and there is no literature to guide management of MCTA complicated with selective intrauterine growth restriction (sIUGR). This gap in knowledge and the concern for higher risk of severe complications have led some medical societies to recommend selective termination of nontrichorionic triplet pregnancies. We sought to report the favourable outcomes of two MCTA complicated by sIUGR expectantly managed at Sainte-Justine Hospital, Montreal, Canada. The first case is of a 42-year-old woman with spontaneous MCTA triplets diagnosed at 18 weeks with type II sIUGR who opted for expectant management. The second patient was a 22-year-old woman with a spontaneous MCTA triplet pregnancy diagnosed at 18 weeks with type III sIUGR. Our experience shows that close serial ultrasounds could potentially allow physicians to foresee fetal deterioration. In our opinion, expectant management should be considered as a management option for MCTA complicated by sIUGR.
Gastric Adenocarcinoma in the Setting of IPEX Syndrome
Authors: David Steffin, Saleh Bhar, Douglas S Fishman, Nicholas L Rider, Bindi Naik-Mathuria, Caridad Martinez, Rajkumar Venkatramani
Journal: Case Reports Immunol (2021)
MeSH terms: Case Reports

Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare X-linked disorder caused by a loss of function mutation in the FOXP3 gene. It manifests early in infancy with clinical symptoms including autoimmune enteropathy, type 1 diabetes mellitus, and eczema. While aberrant FOXP3 expression has been associated with several types of cancer, little is known regarding the risk of cancer in patients with IPEX harboring the characteristic FOXP3 mutation. Here, we present a unique case of a primary signet ring gastric adenocarcinoma in a pediatric patient with IPEX syndrome.
Encouraging Clinical Evolution of a Pediatric Patient With Relapsed Diffuse Midline Glioma Who Underwent WT1-Targeting Immunotherapy: A Case Report and Literature Review
Authors: Yoshiko Hashii, Yoshihiro Oka, Naoki Kagawa, Naoya Hashimoto, Hiroyuki Saitou, Syogo Fukuya, Mizuki Kanegae, Sayaka Ikejima, Yusuke Oji, Keiichi Ozono, Akihiro Tsuboi, Haruo Sugiyama
Journal: Front Oncol (2020)
Keywords: elispot assay, wt1 peptide vaccine, wt1-specific cytotoxic t cells, delayed-type hypersensitivity, diffuse midline glioma, immunotherapy, relapse, tetramer assay
MeSH terms: Case Reports

Diffuse midline glioma (DMG) in children is a highly aggressive, malignant brain tumor that is fatal when relapsed. Wilms tumor 1 (WT1) is a high-priority antigen target for cancer immunotherapy. We hereby report on a pediatric patient who had DMG that regrew after chemoradiotherapy and underwent WT1 peptide vaccination. A 13-year-old Japanese boy presented with vertigo, diplopia, and right hemiplegia at the initial visit to another hospital, where he was diagnosed with DMG by magnetic resonance imaging (MRI); DMG was categorized to histological grade IV glioma. The patient underwent radiotherapy and chemotherapy with temozolomide. After three cycles of chemotherapy, MRI revealed tumor regrowth that translated into deteriorated clinical manifestations. Immunohistochemically, the H3.3K27M mutation in the biopsy specimen was confirmed and the specimen was positive for WT1 protein. The patient underwent WT1-targeting immunotherapy with the WT1-specific peptide vaccine because of having HLA-A*24:02. Consequently, his quality of life drastically improved so much as to the extent that the patient became capable of conducting nearly normal daily activities at weeks 8 to 12 of vaccination. MRI at week 8 of vaccination revealed an obvious reduction in the signal intensity of the tumor. Furthermore, betamethasone dose could be reduced successively (4, 1, and 0.5 mg/day at weeks 4, 5, and 7, respectively) without deteriorating clinical manifestations. Best response among responses assessed according to the Response Assessment in Neuro-Oncology criteria was stable disease. Overall survival was 6.5 months after vaccination onset and was 8.3 months after relapse; the latter was markedly longer than the reported median OS of 3.2 months for pediatric patients with relapsed DMG in the literature. Modified WT1 tetramer staining revealed the WT1 peptide vaccine-induced production of WT1-specific cytotoxic T cells, and the interferon-γ (IFN-γ) ELISpot assay of peripheral blood mononuclear cells disclosed the production of IFN-γ. Delayed-type hypersensitivity test became positive. Any treatment-emergent adverse events did not occur except injection site erythema. Our pediatric patient exhibited an encouraging clinical evolution as manifested by stable disease, improved clinical manifestations, steroid dose reductions, a WT1-specific immune response, and a good safety profile. Therefore, WT1-targeting immunotherapy warrants further investigation in pediatric patients with relapsed DMG.
Kidney Transplantation for Erdheim-Chester Disease
Authors: Jongwon Yoo, Cynthia Gunsteen, Sima Patel, Ted Clevy-Schneller, Sucha Nand, Divya Jain, Raquel Garcia-Roca, Amishi Desai, Sanjeev Akkina
Journal: Case Rep Transplant (2020)
MeSH terms: Case Reports

Erdheim-Chester disease is a rare inflammatory disease that infiltrates skeletal and extra-skeletal tissue. Chronic kidney disease (CKD) in Erdheim-Chester disease is usually attributed to retroperitoneal lesions that lead to urologic obstruction and hydronephrosis. In this report, we describe a patient diagnosed with Erdheim-Chester disease who eventually developed end-stage kidney disease (ESKD). After complete remission of Erdheim-Chester disease by vemurafenib therapy and 2 years of hemodialysis, the patient underwent a deceased donor kidney transplantation with basiliximab induction and tacrolimus/mycophenolic acid maintenance. After conversion of mycophenolic acid to azathioprine due to cost, acute cellular rejection had occurred, and he was treated with steroid therapy. The patient remained in complete remission from Erdheim-Chester disease and dialysis-free 16 months after transplant. Kidney transplantation is another treatment option for those patients with Erdheim-Chester disease who suffer from renal failure in the setting of complete remission.
Case report of unusual synchronous anal and rectal squamous cell carcinoma: clinical and therapeutic lesson
Authors: Davide Ciardiello, Sara Del Tufo, Paola Parente, Antonietta Gerarda Gravina, Francesco Selvaggi, Iacopo Panarese, Renato Franco, Michele Caterino, Giulia Martini, Fortunato Ciardiello, Roberto Grassi, Salvatore Cappabianca, Alfonso Reginelli, Erika Martinelli
Journal: Front Oncol (2023)
Keywords: hpv, scc, anal cancer, chemo-radiotherapy, rectal cancer
MeSH terms: Case Reports

Synchronous tumors of the rectum and anus are sporadic. Most cases in the literature are rectal adenocarcinomas with concomitant anal squamous cell carcinoma. To date, only two cases of concomitant squamous cell carcinomas of the rectum and anus are reported, and both were treated with up-front surgery and received abdominoperineal resection with colostomy. Here, we report the first case in the literature of a patient with synchronous HPV-positive squamous cell carcinoma of the rectum and anus treated with definitive chemoradiotherapy with curative intent. The clinical-radiological evaluation demonstrated complete tumor regression. After 2 years of follow-up, no evidence of recurrence was observed.
Saddle Pulmonary Embolism with Thrombus in Transit across a Patent Foramen Ovale
Authors: Fitzgerald Shepherd, Ashley White-Stern, Oloruntobi Rahaman, Damian Kurian, Karen Simon
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

This is the case of a 25-year-old obese man who presented with acute shortness of breath, chest pain, and palpitations. Of note, he lives a sedentary lifestyle and was recently hospitalized for incision and drainage of a left foot abscess. On presentation he was tachypnoeic, tachycardiac, and hypoxic but blood pressure was stable. Laboratory studies were significant for elevated D-dimer and mildly increased troponin. On further investigation he was found to have a saddle pulmonary embolism with massive clot burden. Echocardiogram revealed thrombus in transit and McConnell's sign. He underwent surgical embolectomy and closure of a patent foramen ovale. This is a particularly rare case, especially in such a young patient. Because this is a rare diagnosis, with insufficient data, there is no formally established treatment guideline. However, in patients who are good surgical candidates, studies have shown better outcome with surgical embolectomy as compared to anticoagulation alone or thrombolysis.
Kidney Transplantation in a Patient Affected by Sickle Cell Trait: A Case Report and State-of-the-Art Review
Authors: Daniela Picciotto, Elisabetta Bussalino, Francesca Viazzi, Ernesto Paoletti, Pasquale Esposito
Journal: Cureus (2023)
Keywords: hemoglobinopathy, hereditary nephropathies, immunological risk, infectious complications, kidney transplantation, sickle cell anemia, sickle cell trait, sickle hemoglobin
MeSH terms: Case Reports

Chronic kidney disease (CKD) is a common feature of sickle cell disease (SCD). The awareness of the clinical presentation and renal involvement in patients affected by hemoglobinopathies is greatly needed. Patient management is particularly complex, especially with kidney transplantation. We, therefore, report the case of a 56-year-old patient affected by sickle cell trait who underwent kidney transplantation. This case will underline all the various challenges the nephrologist must face in this clinical setting and their management.