OpenMed/multicare-articles huggingface dataset:
Acute Psychosis Due to Anti-N-Methyl D-Aspartate Receptor Encephalitis Following COVID-19 Vaccination: A Case Report
Authors: Patrick Flannery, Ingrid Yang, Madjid Keyvani, George Sakoulas
Journal: Front Neurol (2021)
Keywords: covid-19, nmda-receptor, encephalitis, psychosis, vaccine
MeSH terms: Case Reports

Anti-N-methyl D-aspartate (NMDA) receptor (anti-NMDAR) encephalitis has been reported after SARS-CoV-2 infection, but not after SARS-CoV-2 vaccination. We report the first known case of anti-NMDAR encephalitis after SARS-CoV-2 immunization in a young female presenting with acute psychosis, highlighting a rare potential immunological complication of vaccination against SARS-CoV-2 that is currently being distributed worldwide. The patient presented initially with anxiety and hypochondriacal delusions which progressed to psychosis and catatonia but returned to baseline with aggressive immunomodulatory therapy consisting of intravenous immunoglobulin, high-dose glucocorticoids, and rituximab. This study highlights that the workup of acute psychosis should include establishing a history of recent vaccination followed by a thorough neurological assessment, including for anti-NMDAR antibodies in blood and cerebrospinal fluid.
Optic nerve hemangioblastoma: a case report
Authors: Holly Zywicke, Cheryl Ann Palmer, Michael S Vaphiades, Kristen O Riley
Journal: Case Rep Pathol (2012)
MeSH terms: Case Reports

Hemangioblastomas are World Health Organization (WHO) grade I tumors of uncertain histologic origin. These central nervous system tumors are most often found in the posterior fossa, brainstem, and spinal cord. There are fewer than 20 reported cases of optic nerve hemangioblastomas in the literature. We present a patient with visual decline found to have a mass arising from within the posterior orbital canal that grossly involved the optic nerve sheath. Neuropathologic evaluation showed hemangioblastoma. Although not a common tumor in this location, consideration of hemangioblastoma in the differential diagnosis is important as they can have a more aggressive course than other tumors of this region and have a detrimental effect on visual prognosis.
Inflammatory myofibroblastic tumor of the lung: A rare endobronchial mass
Authors: Merian E Kuipers, Hans Dik, Luuk N A Willems, Bart P C Hoppe
Journal: Respir Med Case Rep (2020)
Keywords: inflammatory myofibroblastic tumor, inspiratory wheeze, respiratory medicine, rigid bronchoscopy, tumor pathology
MeSH terms: Case Reports

A 42-year old male was referred with a 6-week history of new onset dyspnea. The patient had normal vital signs, no relevant medical history and the only abnormality was a left sided inspiratory wheeze. No abnormalities were seen on the chest X-ray. A bronchoscopy was performed which showed a well-circumscribed hypervasculated mass in the left main bronchus. A biopsy was taken, which was complicated after the procedure by dislocation of the mass and coughed up by the patient. Both samples were send for pathologic review. A contrast CT was performed which showed a localized remaining mass in the left main bronchus and no lymph node involvement. Pathological evaluation showed spindle-shaped cell proliferation with mitotic activity in the second larger tissue which could be consistent with an inflammatory myofibroblastic tumor (IMT), whereas the first biopsy sample only showed granulomatous inflammation. Following multidisciplinary review the diagnosis of IMT was made and a treatment plan was decided. Because of the localized position of the mass the patient was treated with laser coagulation via rigid bronchoscopy instead of surgery. Bronchoscopic review afterwards showed complete resolution of the mass and the dyspnea had resolved. This case highlights the difficulty of making the IMT-diagnosis and the option of treating it with laser coagulation via rigid bronchoscopy.
Leucine-Rich Glioma Inactivated-1 and Voltage-Gated Potassium Channel Autoimmune Encephalitis Associated with Ischemic Stroke: A Case Report
Authors: Marisa McGinley, Sarkis Morales-Vidal, Sean Ruland
Journal: Front Neurol (2016)
Keywords: autoimmune encephalitis, ischemic stroke, leucine-rich glioma inactivated-1, limbic encephalitis, voltage-gated potassium channel
MeSH terms: Case Reports

Autoimmune encephalitis is associated with a wide variety of antibodies and clinical presentations. Voltage-gated potassium channel (VGKC) antibodies are a cause of autoimmune non-paraneoplastic encephalitis characterized by memory impairment, psychiatric symptoms, and seizures. We present a case of VGKC encephalitis likely preceding an ischemic stroke. Reports of autoimmune encephalitis associated with ischemic stroke are rare. Several hypotheses linking these two disease processes are proposed.
Metastatic Follicular Thyroid Carcinoma Secreting Thyroid Hormone and Radioiodine Avid without Stimulation: A Case Report and Literature Review
Authors: Syed A Abid, Brendan C Stack Jr, Donald L Bodenner
Journal: Case Rep Endocrinol (2014)

Introduction. This is an extremely rare case of a patient with metastatic follicular thyroid cancer who continued to produce thyroid hormone and was iodine scan positive without stimulation after thyroidectomy and radioiodine (I-131) therapy. Patient Findings. A 76-year-old Caucasian male was diagnosed with metastatic follicular thyroid carcinoma on lung nodule biopsy. Total thyroidectomy was performed and he was ablated with 160 mCi of I-131 after recombinant human thyrotropin (rhTSH) stimulation. Whole body scan (WBS) after treatment showed uptake in bilateral lungs, right sacrum, and pelvis. The thyroglobulin decreased from 2,063 to 965 four months after treatment but rapidly increased to 2,506 eleven months after I-131. Thyroid stimulating hormone (TSH) remained suppressed and free T4 remained elevated after I-131 therapy without thyroid hormone supplementation. He was treated with an additional 209 mCi with WBS findings positive in lung and pelvis. Despite I-131, new metastatic lesions were noted in the left thyroid bed and large destructive lesion to the first cervical vertebrae four months after the second I-131 dose. Conclusions. This case is exceptional because of its rarity and also due to the dissociation between tumor differentiation and aggressiveness. The metastatic lesions continued to secrete thyroid hormone and remained radioiodine avid with rapid progression after I-131 therapy.
Achilles Tendon Allograft with Semitendinosus Autograft Reinforcement Is a Successful Treatment for Chronic Patellar Tendon Rupture: Report of Two Cases
Authors: Lucie Regennass, Mathieu Boissard, Alban Fouasson-Chailloux, Ronan Guillou, Cecile Toanen, Vincent Crenn
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Rupture of the patellar tendon must be diagnosed urgently because reconstruction of the extensor mechanism produces better results when it is performed in acute conditions. Reconstruction of chronic extensor mechanism rupture on the contrary is very challenging. Several surgical techniques have been described using a variety of graft choices and fixation methods, but the optimal approach is still under debate. We report our experience of two cases of chronic patellar tendon rupture reconstruction using an Achilles tendon allograft reinforced by a vascularized ipsilateral semitendinosus tendon frame. The rapid functional recovery of the range of motion, only three months postoperatively, showed us that this reconstruction technique was effective.
Key Characteristics of Nitrous Oxide-Induced Neurological Disorders and Differences Between Populations
Authors: Juanjuan Zhang, Dandan Xie, Yanfeng Zou, Xuen Yu, Yang Ji, Chengyou Wang, Xinyi Lv, Nong Zhou, Xiao Jiang, Kai Wang, Yanghua Tian
Journal: Front Neurol (2021)
Keywords: homocysteine, nitrous oxide, peripheral nervous system diseases, spinal cord disease, vitamin b12

Background: Nitrous oxide (N2O), commonly known as laughing gas, is inhaled recreationally because it produces the feelings of euphoria and freedom from pain. The risk of neurological dysfunction secondary to N2O abuse and its clinical diagnosis are, however, not yet sufficiently recognized, especially in China. Here, we have summarized the key clinical characteristics of N2O-induced neurological disorders. Materials and Methods: We recruited 20 patients with N2O-induced neurological disorders and analyzed their clinical features, laboratory data, magnetic resonance imaging and electromyography. We also carried out a literature review and compared 99 previously reported patients with our case series to confirm our results. Subgroup analysis was performed to explore the difference in demographical and clinical characteristics of N2O abuse between Asian and non-Asian patients. Results: The most common initial symptoms of N2O-induced neurological disorders were weakness and/or paresthesia. Most patients presented with myelopathy and/or peripheral neuropathy. The most commonly involved segment of the spinal cord was the cervical spinal cord, extending over 4-6 vertebral levels, but more than half of the patients with myelopathy had no sensory change at the corresponding spinal level. Homocysteine was found to be the most sensitive and practical indicator for diagnosis. Subgroup analysis showed that the Asian patients (median: 22.0 years old, Q1-Q3:19.0-26.0 years old) with N2O abuse were younger than non-Asian patients [26.0 (22.3-31.0) years old, P = 2.8 × 10-4]. The incidence of myelopathy combined with peripheral neuropathy was significantly higher in Asian patients than in non-Asian patients, who had myelopathy or peripheral neuropathy (P = 2 × 10-5). Conclusions: Key clinical characteristics of N2O abuse are longitudinally extensive cervical myelopathy and peripheral neuropathy. Recognition of these traits in young people in the age group of 20-30 years will provide important guidance for accurate diagnosis of neurological disease associated with N2O abuse. The clinical manifestations differ in Asian patients and non-Asian patients.
Anesthesia management of a morbidly obese patient in prone position for lumbar spine surgery
Authors: Vaibhavi Baxi, Shashank Budhakar
Journal: J Craniovertebr Junction Spine (2010)
Keywords: anesthesia management, lumbar spine, morbid obesity, prone position
MeSH terms: Case Reports

A morbidly obese, 45-year-old woman with a body mass index of 47 kg/m(2) , presented with a prolapsed intervertebral disc of the lumbar spine for decompression and fixation. Anesthesia and surgical positioning of morbidly obese patient carries 3 main hazards, namely, morbid obesity, prone position, and airway preservation problems. Morbid obesity has its own hazards of deep vein thrombosis and pulmonary embolus. Here we describe anesthetic management, successfully dealing with the specific problems of this patient due to obesity.
A Case of Pathological Complete Response Following FOLFIRINOX Therapy for Pancreatic Adenocarcinoma with Synchronous Distant Lymph Node Metastases
Authors: Masanori Tsujie, Soichi Fumita, Tomoko Wakasa, Shigeto Mizuno, Hajime Ishikawa, Kotaro Kitani, Shumpei Satoi, Kaoru Okada, Keisuke Inoue, Shuichi Fukuda, Hironobu Manabe, Noriko Ichimura, Shinya Ueda, Takao Tamura, Toshihiko Kawasaki, Masao Yukawa, Yoshio Ohta, Masatoshi Inoue
Journal: Int J Surg Case Rep (2020)
Keywords: brca1/2 mutation, case report, conversion surgery, distant metastasis, folfirinox, unresectable pancreatic cancer
MeSH terms: Case Reports

Introduction:
We report a case of conversion surgery for pancreatic ductal adenocarcinoma (PDAC) with synchronous distant metastases showing pathological complete response (pCR) after FOLFIRINOX therapy.
Presentation of case:
A 46-year-old woman with obstructive jaundice was referred to our hospital. A CT scan revealed a hypo-vascular mass in the head of the pancreas with multiple para-aortic lymph nodes and a Virchow's node swollen. The serum CA 19-9 level was 71795.1 U/mL. The result of tumor biopsy from the biliary stenotic site was concordant with adenocarcinoma. She was diagnosed with PDAC with distant metastases. After 10 courses of FOLFIRINOX followed by 4 courses of FOLFIRI, a CT scan showed that distant lymph node swellings disappeared, and CA19-9 level became almost normal. She underwent pancreaticoduodenectomy with dissection of para-aortic lymph nodes 8 months after the initiation of chemotherapy. Pathologically, no evidence of residual adenocarcinoma was observed in neither pancreas nor lymph nodes. Adjuvant chemotherapy using S-1 was administered for 6 months, and no recurrence has been observed 4 years after surgery. BRCA1/2 mutations were not detected in patient's DNA.
Discussion:
With the induction of intensive chemotherapies such as FOLFIRINOX, an increasing number of patients with synchronous distant metastases could become suitable candidates for surgery of the primary lesion because of the potential complete response of metastatic lesions.
Conclusion:
This case presented a rare occurrence of pCR in a patient with unresectable PDAC with distant metastases who received FOLFIRINOX. The feasibility and benefits of conversion surgery in such patients must be investigated in future trials.
Chordoid Glioma of the Third Ventricle: A Case Report and a Treatment Strategy to This Rare Tumor
Authors: Xiao Chen, Benyan Zhang, Sijian Pan, Qingfang Sun, Liuguan Bian
Journal: Front Oncol (2020)
Keywords: gamma knife radiosurgery, chordoid, chordoid glioma, glioma, histopathology, third ventricle
MeSH terms: Case Reports

Chordoid glioma (CG) of the third ventricle is a rare type of brain tumor. Here, we present a case, review of the literature and proposed a treatment strategy for this rare tumor. Here, A 33-years-old woman presented with the menstrual disorder and progressive obesity. Magnetic resonance imaging showed a large irregularly circular tumor in the third ventricle. The tumor was subtotally resected by microsurgery via the right modified port approach. Immunohistochemical staining was positive for glial fibrillary acidic protein (GFAP), Vimentin and transcription termination factor-1 (TTF-1), and the Ki-67 proliferation index was low (5%), which indicating CG. Residual tumor decreased after treated by Gamma Knife radiosurgery (GKRS) with a dose of 15 Gy. During 30 months of follow-up, the tumor did not recur, and the patient suffered no complications. The diagnosis of CG requires a combination of clinical presentation, neuroimaging, and pathology. The ideal therapy is gross total resection (GTR) of the tumor. However, GTR is usually difficult and carries a high risk of postoperative complications because of the tumor location. This case indicates that planed subtotal resection followed by GKRS with a proper marginal dose could be a good treatment strategy for CG.
A Case Report of Acute Severe Necrotizing Pancreatitis following the Johnson & Johnson Vaccine against the Novel SARS-CoV-2
Authors: Ayrton I Bangolo, Mahabuba Akhter, Auda Auda, Rahina Akram, Vignesh K Nagesh, Donnee Athem, Reenu Thomas, Ligaya Tibalan, Mansi Trivedi, Saima Mushtaq, Neha Singh, Pracheta Bagale, Georgemar V Arana Jr, Tayyaba Khan, Shelja Sharma, Swetha Mynedi, Dhara D Patel, Mandeep Saini, Madhurya R Chinthakuntla, Kareem Ahmed, Mary Gad, Srikara Dheer D R Gondhi, Georgemar Arana, Rohini B Gurumoorthy, Simcha Weissman
Journal: Case Rep Infect Dis (2023)
MeSH terms: Case Reports

Acute pancreatitis is an inflammatory condition, which is a leading gastrointestinal cause of hospitalization in the United States. Several conditions are associated with acute pancreatitis. More recently, there have been a few cases reported of acute pancreatitis following the Pfizer-BioNTech COVID-19 mRNA vaccine. To our knowledge, no cases of acute pancreatitis have been yet reported following the Johnson & Johnson's Janssen COVID-19 vaccine (J& J vaccine). Herein we report a 34-year-old male with no significant past medical history admitted with acute necrotizing pancreatitis, the day following the receipt of the J&J vaccine. Based on the Naranjo and the modified Naranjo scale, the patient met the requirements for probable drug induced pancreatitis. This case report has the objective to raise awareness of a potentially severe side effect of the J&J vaccine. We hope to use this case to support screening all patients for previous history of acute pancreatitis before administration of the J& J vaccine.
Non alcoholic fatty liver disease in a young male with celiac disease
Authors: Zain Majid, Ghous Bux Somoro, Muhammad Manzoor Ul Haque, Raja Taha Yaseen, Shoaib Ahmed Khan, Inamullah Khan Achakzai, Muhammad Ali Khalid, Nasir Hassan Luck
Journal: Pan Afr Med J (2019)
Keywords: bmi, celiac disease, nash, gluten free diet
MeSH terms: Celiac Disease / physiopathology, Emaciation / etiology, Non-alcoholic Fatty Liver Disease / diagnosis, Nutrition Therapy / methods, Case Reports, Diarrhea / etiology, Emaciation / therapy, Humans, Male, Non-alcoholic Fatty Liver Disease / therapy, Weight Loss, Young Adult

A young emaciated male, known case of celiac disease came with complaints of diarrhea along with 5kgs of weight loss in 3 months' time. He had severe electrolyte abnormalities along with low albumin, low calcium and a high phosphate with deranged liver function test. Ultrasound abdomen had shown fatty liver. Nutrition consult was sought and he was found to have a BMI of 6.8kg/m2. He was started on nutrition support along with supportive therapy, which resulted in weight gain and improvement in his condition.
Successful on-ECLS Repair of CDH and Omphalocele in a Newborn
Authors: Frank Fideler, Migdad Mustafi, Hans-Joachim Kirschner, Ines Gerbig, Jörg Fuchs, Michael Hofbeck, Matthias Kumpf, Oliver Kagan, Jörg Michel, Walter Jost, Felix Neunhoeffer
Journal: European J Pediatr Surg Rep (2023)
Keywords: cdh and omphalocele, on-ecls repair, newborn surgery
MeSH terms: Case Reports

Both congenital diaphragmatic hernias (CDHs) and omphaloceles show relevant overall mortality rates as individual findings. The combination of the two has been described only sparsely in the literature and almost always with a fatal course. Here, we describe a term neonate with a rare high-risk constellation of left-sided CDH and a large omphalocele who was successfully treated on extracorporeal life support (ECLS). Prenatally, the patient was diagnosed with a large omphalocele and a left CDH with a lung volume of ∼27% and an observed to expected lung-to-head ratio of 30%. Due to respiratory insufficiency, an ECLS device was implanted. As weaning from ECLS was not foreseeable, the female infant underwent successful surgery on ECLS on the ninth day of life. Perioperative high-frequency oscillatory ventilation and circulatory and coagulation management under point-of-care monitoring were the main anesthesiological challenges. Over the following 3 days, ECLS weaning was successful, and the patient was extubated after another 43 days. Surgical treatment on ECLS can expand the spectrum of therapy in high-risk constellations if potential risks are minimized and there is close interdisciplinary cooperation.
Case Report: A Difficult-to-Diagnose Case of Hyperinsulinemic Hypoglycemia Surgically Treated After Developing Acute Pancreatitis
Authors: Chisa Inoue, Kota Nishihama, Aoi Hayasaki, Yuko Okano, Akinobu Hayashi, Kazuhito Eguchi, Mei Uemura, Toshinari Suzuki, Taro Yasuma, Takeshi Inoue, Tohru Yorifuji, Shugo Mizuno, Esteban C Gabazza, Yutaka Yano
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: abcc8, congenital hyperinsulinism, diazoxide, hypoglycemia, insulinoma
MeSH terms: Hyperinsulinism / surgery, Hypoglycemia / surgery, Pancreatectomy / methods, Pancreatitis / complications, Splenectomy / methods, Case Reports, Adult, Humans, Hyperinsulinism / etiology, Hyperinsulinism / pathology, Hypoglycemia / etiology, Hypoglycemia / pathology, Male, Prognosis

The patient is a 28-year-old Japanese man diagnosed with severe congenital hyperinsulinemic-hypoglycemia six months after birth. Clinical records revealed no imaging evidence of pancreatic tumor at the time of diagnosis. Subsequently, he had developmental disorders and epilepsy caused by recurrent hypoglycemic attacks. The patient's hypoglycemia improved with oral diazoxide. However, he developed necrotizing acute pancreatitis at 28 years of age, thought to be due to diazoxide. Discontinuation of diazoxide caused persistent hypoglycemia, requiring continuous glucose supplementation by tube feeding and total parenteral nutrition. A selective arterial secretagogue injection test revealed diffuse pancreatic hypersecretion of insulin. He underwent subtotal distal (72%) pancreatectomy and splenectomy. There was no intraoperative visible pancreatic tumor. His hypoglycemia improved after the surgical procedure. The histopathological study revealed a high density of islets of Langerhans in the pancreatic body and tail. There were large islets of Langerhans and multiple neuroendocrine cell nests in the whole pancreas. Nests of neuroendocrine cells were also detected in lymph nodes. The pathological diagnosis was grade 1 neuroendocrine tumor (microinsulinomas) with lymph node metastases. This patient is a difficult-to-diagnose case of hyperinsulinemic hypoglycemia surgically treated after developing acute pancreatitis. We believe this is a unique case of microinsulinomas with lymph metastases diagnosed and treated as congenital hyperinsulinemic hypoglycemia for almost 28 years.
Novel and recurrent mutations of WISP3 in two Chinese families with progressive pseudorheumatoid dysplasia
Authors: Jing Sun, Weibo Xia, Shuli He, Zhen Zhao, Min Nie, Mei Li, Yan Jiang, Xiaoping Xing, Ou Wang, Xunwu Meng, Xueying Zhou
Journal: PLoS One (2012)
MeSH terms: Arthropathy, Neurogenic / genetics, CCN Intercellular Signaling Proteins / genetics, Genetic Predisposition to Disease / genetics, Mutation, Case Reports, Research Support, Non-U.S. Gov't, Arthropathy, Neurogenic / diagnostic imaging, Base Sequence, Child, Preschool, China, DNA Mutational Analysis, Family Health, Female, Heterozygote, Humans, Joint Diseases / congenital, Male, Mutagenesis, Insertional, Mutation, Missense, Pedigree, Radiography, Sequence Deletion, Young Adult, CCN Intercellular Signaling Proteins, CCN6 protein, human, Arthropathy, progressive pseudorheumatoid, of childhood

Background:
The WNT1-inducible signaling pathway protein 3 (WISP3), which belongs to the CCN (cysteine-rich protein 61, connective tissue growth factor, nephroblastoma overexpressed) family, is a secreted cysteine-rich matricellular protein that is involved in chondrogenesis, osteogenesis and tumorigenesis. WISP3 gene mutations are associated with progressive pseudorheumatoid dysplasia (PPD, OMIM208230), an autosomal recessive genetic disease that is characterized by the swelling of multiple joints and disproportionate dwarfism.
Methodology/principal findings:
Four PPD patients from two unrelated Chinese families were recruited for this study. The clinical diagnosis was confirmed by medical history, physical examinations, laboratory results and radiological abnormalities. WISP3 mutations were detected by direct DNA sequence analysis. In total, four different mutations were identified, which consisted of two missense mutations, one deletion and one insertion that spanned exons 3, 5 and 6 of the WISP3 gene. One of the missense mutations (c.342T>G/p.C114W) and a seven-base pair frameshift deletion (c.716_722del/p.E239fs*16) were novel. The other missense mutation (c.1000T>C/p. S334P) and the insertion mutation (c.866_867insA/p.Q289fs*31) had previously been identified in Chinese patients. All four cases had a compound heterozygous status, and their parents were heterozygous carriers of these mutations.
Conclusions/significance:
The results of our study expand the spectrum of WISP3 mutations that are associated with PPD and further elucidate the function of WISP3.