OpenMed/multicare-articles huggingface dataset:
Diltiazem is a useful and effective medication for reversal of coronary artery spasm-induced complete atrioventricular block: A case report
Authors: Jin Zhang, Li Liu, Chengwei Liu, Min Han, Chengyi Xu, Rujie Qiu
Journal: Front Cardiovasc Med (2023)
Keywords: calcium channel blocker, complete atrioventricular block, coronary artery spasm, diltiazem, fatal arrhythmia
MeSH terms: Case Reports

Coronary artery spasm (CAS) is characterized by reversible diffuse or focal vasoconstriction, a phenomenon that plays an important role in the pathogenesis of ischemic heart disease. Fatal arrhythmias, such as ventricular tachycardia/fibrillation and complete atrioventricular block (AV-B), are very common in patients with CAS. Nondihydropyridine calcium channel blockers (CCBs) such as diltiazem were recommended as first-line medications for treating and preventing CAS episodes. However, its use remains controversial in CAS patients with AV-B as this type of CCB can also cause AV-B itself. Here, we present the use of diltiazem in a patient with complete AV-B caused by CAS. The patient's chest pain was rapidly relieved, and complete AV-B was promptly restored to sinus rhythm following the administration of intravenous diltiazem without any adverse effects. In this report, we highlight the useful and effective application of diltiazem for treating and preventing complete AV-B caused by CAS.
Middle segment-preserving pancreatectomy for recurrent metastasis of renal cell carcinoma after pancreatoduodenectomy: a case report
Authors: Aiyama Takeshi, Inagaki Mitsuhiro, Akabane Hiromitsu, Yanagida Naoyuki, Shibaki Taiichiro, Shomura Hiroki, Kudo Takeaki, Shonaka Tatsuya, Oikawa Futoshi, Sakurai Hiroharu, Nakano Shiro
Journal: Case Rep Surg (2014)

Many cases of surgical resection of metastatic pancreatic tumors originating from renal cell carcinoma have been reported; however, cases of reresection of recurrent pancreatic metastasis of renal cell carcinoma in the remnant pancreas are rare. We performed a second resection for recurrent pancreatic metastasis of renal cell carcinoma six years after pancreatoduodenectomy with pancreaticogastrostomy reconstruction. By performing middle segment-preserving pancreatectomy, we were able to successfully spare the exocrine and endocrine pancreatic function compared to that observed after total pancreatectomy, with no signs of recurrence for two years after the surgery.
Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2
Authors: Carvallo-Venegas Mauricio, Fuentes-López Elsa Angélica, Andrade-Ortega Antonio de Jesús, Torres-Baranda José Rodrigo, Carrasco-Carrizosa Aldo, Cerrillos-Gutierrez José Ignacio, Andrade-Sierra Jorge
Journal: Case Rep Transplant (2022)
MeSH terms: Case Reports

Introduction:
Infection with SARS-CoV-2 increases the risk of acute graft dysfunction (AGD) in renal transplant recipients (RTR), and the risk of concurrently presenting with opportunistic infections is also increased. There is no current consensus on the management of immunosuppression during SARS-CoV-2 infection in RTR. Case Presentation. A 35-year-old male RTR from a living related donor presented with SARS-CoV-2 infection (January 2021). Two months later, despite alterations to his immunosuppression regimen (tacrolimus (TAC) was reduced by 50%, and the mycophenolic acid (MMF) was suspended with the remission of symptoms), the patient presented with pulmonary tuberculosis, pneumonia due to respiratory syncytial virus (RSV), cytomegalovirus (CMV) pneumonitis, and histoplasmosis (HP). Management was initiated with antituberculosis medications, ganciclovir, antibiotics, and liposomal amphotericin B, and the immunosuppressants were suspended, yet the patient's evolution was catastrophic and the outcome fatal.
Conclusion:
We recommend that in RTR post-COVID-19, the immunosuppression regimen should be gradually reinstated along with strict vigilance in observing for highly prevalent coinfections (TB, HP, and CMV).
Acute forearm compartment syndrome in the setting of acquired hemophilia A
Authors: Giscard Joel Adeclat, Monique Hayes, Michael Amick, Joseph Kahan, Andrea Halim
Journal: Case Reports Plast Surg Hand Surg (2022)
Keywords: compartment syndrome, acquired hemophilia, activated prothrombin complex concentrate, congenital hemophilia, factor eight inhibitor bypass activity, fasciotomy
MeSH terms: Case Reports

Patients with acquired or congenital hemophilia are at risk for Acute Compartment Syndrome (ACS) and pose a diagnostic challenge and a treatment risk with post-fasciotomy hemostasis of critical importance. We present the case of a woman with ACS of the forearm in the setting of newly diagnosed acquired hemophilia A.
Case report: Responses to the combination of gemcitabine with sirolimus in two patients with TSC-mutated sarcomas
Authors: Elise F Nassif, Cissimol P Joseph, Rossana Lazcano, Jocelyn T Joseph, Prapassorn Thirasastr, Alexander J Lazar, Neeta Somaiah
Journal: Front Oncol (2023)
Keywords: pecoma, tsc, gemcitabine, mtor - mammalian target of rapamycin, nab-sirolimus, sarcoma
MeSH terms: Case Reports

TSC-mutated sarcomas are rare molecular and histologic types of sarcoma. Due to the presence of their specific oncogenic driver mutation, these sarcomas are particularly sensitive to mTOR inhibitors. Recently, nab-sirolimus, an albumin-bound mTOR inhibitor, was approved by the Food and Drug Administration (FDA) for PEComas, which harbor a TSC mutation, and this drug remains the only FDA-approved systemic treatment for these tumors. We report on two cases of patients with TSC-mutated sarcomas who experienced significant responses to the combination of gemcitabine and sirolimus, after progression on prior gemcitabine-based chemotherapy and single agent mTOR inhibition with nab-sirolimus. Preclinical and clinical data support rationale for a synergistic effect of the combination. This combination may represent a valid therapeutic option after failure of nab-sirolimus in these patients, with no standard-of-care treatment options.
Case report of renal cell carcinoma in automobile manufacturing factory worker due to trichloroethylene exposure in Korea
Authors: June-Hee Lee, Inah Kim, Hongdeok Seok, Inhyo Park, Jungho Hwang, Jae-Oh Park, Jong-Uk Won, Jaehoon Roh
Journal: Ann Occup Environ Med (2015)
Keywords: automobiles, carcinoma, korea, occupational disease, renal cell, trichloroethylene
MeSH terms: Case Reports

Background:
The aim of this paper was report first case of renal cell carcinoma developed in a worker who worked in an automobile manufacture line which handles trichloroethylene in Korea.
Case presentation:
To clarify the relationship between the onset of renal cell carcinoma in 52-years old male worker and the exposure to trichloroethylene, document studies and work environment measurement were done. Past work environment exposure data were reviewed and medical history and surgery records of the worker were also reviewed. The patient had no personal risk factor related to renal cell carcinoma except for his smoking habit of quarter a pack per day for twenty years, and since trichloroethylene was not part of measurement criteria, past work environment risk assessment data could not verify the exposure. The exposure level is deduced by analyzing material exposure level of work environments which has similar processes in data from revised research of chemical exposure standard and work environment validity assessment. Evaluation Committee of Epidemiologic Survey decided that there are relevant relationship between the exposure and the disease, though we do not have exact data during that period, most experts agree that in every factories they used trichloroethylene without any direction.
Conclusions:
From the relevant medical history and the results of the usage of trichloroethylene in the relevant industries, and initial discovery of renal cell carcinoma at health inspection sonogram in 2001, it can be concluded that suggests significant causal relationship between the exposure to trichloroethylene and renal cell carcinoma onset, thus reporting it to be the first domestic case declared to be occupational disease.
Idiopathic intramural hematoma of the right colon. A case report and review of the literature
Authors: Rosario Vecchio, Emma Cacciola, Michele Figuera, Renato Catalano, Giuseppe Giulla, Emanuele Rosario Distefano, Eva Intagliata
Journal: Int J Surg Case Rep (2019)
Keywords: case report, intestinal hematoma, intestinal obstruction, large bowel hematoma, mesenteric hemorrhagic effusion

Introduction:
Intestinal hematoma is usually observed after an abdominal trauma or in patients treated with anticoagulant therapy. Conversely, idiopathic bowel hematoma is very rare, being colon involvement sporadic with few reports in the Literature.
Presentation of case:
The Authors report a case of idiopathic spontaneous large bowel hematoma. A 48-year-old man was admitted for a thoraco-abdominal pain and signs of acute abdomen and fever. After ruling out heart diseases, a CT scan revealed a marked thickening of the ascending colon wall, obstructing the bowel lumen. Leukocytosis was observed. In an emergency setting, an explorative laparotomy was performed. Hemoperitoneum and a large hematoma involving the caecum and the ascending colon were detected, together with intramesenteric and retroperitoneal blood effusion. A right hemicolectomy was accomplished. Histopathology confirmed the diagnosis of large bowel hematoma. Post-operative molecular diagnostic testing for coagulative disorders failed to demonstrate any genetic variation associate with hemorrhagic predisposition. In the post-operative course, the patient experienced a left basal bronco-pneumonia with increased unilateral pleural effusion, successfully treated by a thoracic drain and antibiotic therapy.
Discussion:
The reported case and Literature data show that diagnosis of idiopathic colon intramural hematoma is challenging, especially in the emergency setting. Although conservative therapy is the first line treatment, surgery still has an important role when the diagnosis is uncertain, medical treatment fails or a complication, such untreatable bleeding, perforation or occlusion occur.
Conclusion:
The Authors report a very rare case of spontaneous intramural hematoma of the right colon. Surgery still has a role in selected cases.
Pegylated liposomal doxorubicin (PLD): enhanced skin toxicity in areas of vitiligo
Authors: Y Yuan, S J Orlow, J Curtin, A Downey, F Muggia
Journal: Ecancermedicalscience (2008)
MeSH terms: Case Reports

Pegylated liposomal doxorubicin (PLD, Doxil, Caelyx) is widely used for the treatment of ovarian cancer. It is a stable formulation encapsulating doxorubicin in a 'Stealth' (i.e., pegylated) liposome with a half-life of about 72 hours. This drastically altered pharmacology confers on it a considerably lower risk of cardiotoxicity, no acute emesis, and near absence of alopecia or problems with extravasation necrosis. On the other hand, PLD's dose-limiting toxicity is cutaneous. Since the original phase I report, cutaneous toxicities reported with PLD fall into four common categories: the well known hand-foot syndrome (also called palmoplantar erythrodysesthesia, or PPE), a diffuse follicular rash, intertrigo-like eruption, and hyperpigmentation including melanotic macules.
Multiple Liver Nodules Mimicking Metastatic Disease as Initial Presentation of Multiple Myeloma
Authors: Andrew C Tiu, Rashmika Potdar, Vivian Arguello-Gerra, Mark Morginstin
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Multiple myeloma is a malignant clonal proliferation of plasma cells in the bone marrow preceded by monoclonal gammopathy of undetermined significance. Initial presentation of multiple myeloma as extramedullary spread in soft tissues particularly in the liver is uncommon. We report a case of a 74-year-old African American female who presented with epigastric pain, hematemesis, elevated alkaline phosphatase, and gamma-glutamyl transferase. Initial impression was peptic ulcer disease; however, ultrasound and CT scan of the abdomen showed multiple liver nodules and perihepatic lymphadenopathy suggestive of metastatic disease. Biopsy of the liver nodules showed CD138 and kappa light chain-restricted positive cells consistent with extramedullary spread of multiple myeloma to the liver. The patient achieved partial response after 6 months of treatment with Velcade, cyclophosphamide, and dexamethasone (VCD). Due to severe neutropenia from cyclophosphamide, regimen was switched to Velcade, Revlimid, and dexamethasone (VRD) which resulted to very good partial response in 1 year which eventually persisted after 4 years. No controlled prospective studies have defined the standard treatment for multiple myeloma with extramedullary spread particularly to the liver. Treatment of multiple myeloma with extramedullary disease follows guidelines for multiple myeloma.
Posttransplant Intrarenal Lymphangiectasia
Authors: Ali Kord, Enrico Benedetti, James T Bui
Journal: Case Rep Transplant (2020)
MeSH terms: Case Reports

Renal lymphangiectasia is an extremely rare benign condition in the setting of transplanted kidneys. We describe a 50-year-old female with a past medical history of lupus nephritis and renal transplants who presented with right lower quadrant pain and was found to have intrarenal lymphangiectasia on imaging and laboratory tests. The patient was treated with percutaneous drainage initially and then wide peritoneal fenestration and omentoplasty. An extremely rare adult case with intrarenal lymphangiectasia thirteen months after kidney transplant was described in this study. Imaging, particularly computed tomography (CT) and magnetic resonance imaging (MRI), plays a key role in the diagnosis of renal lymphangiectasia.
CD5-Positive Intravascular Large B-Cell Lymphoma in a Patient with Wilson's Disease: Case Report and Review of the Literature
Authors: Neha Gupta, Chrystalle Katte Carreon, Filiz Sen, Peter Farmer, Xinmin Zhang, Silvat Sheikh-Fayyaz, Nina Haghi
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Intravascular large B-cell lymphoma (IVLBCL) is a rare extra-nodal B-cell lymphoma that proliferates within small/intermediate blood vessels and capillaries while sparing large blood vessels and organ parenchyma. Clinical presentation is highly variable and may include B symptoms, neurological deficits, and/or cutaneous findings. The diagnosis of IVLBCL is difficult due to multiorgan involvement and nonspecific symptoms. We describe the case of a 68-year-old male who presented with progressive weakness, confusion, and falls. He had a past medical history of liver cirrhosis secondary to Wilson's disease. Physical exam and laboratory results revealed a lethargic man with jaundice, hepatic encephalopathy, and abnormal liver/kidney function tests. He expired after a short hospital course in the setting of hepatic and renal failure. Postmortem examination revealed large neoplastic lymphoid cells involving multiple organ blood vessels; however skin and neurologic involvement was absent. The neoplastic cells demonstrated B-cells positive for CD5, rendering a diagnosis of IVLBCL. Our case represents the occurrence of IVLBCL with CD5-positivity in a patient with Wilson's disease, diagnosed at autopsy demonstrating the challenging nature of diagnosing IVLBCL.
Long Upper Pouch in Esophageal Atresia: A Rare Variant
Authors: Enono Yhoshu, Jai Kumar Mahajan, Vedarth Dash
Journal: J Neonatal Surg (2016)
Keywords: esophageal atresia, esophageal stenosis, upper pouch
MeSH terms: Case Reports

The earliest clinical sign of esophageal atresia (EA) is excessive salivation and the diagnosis is made by failure to pass an infant feeding tube (IFT) into the stomach. The diagnostic errors may occur due to presence of an unusually long upper pouch, when the IFT seems to pass into the stomach. We describe one such case and review the relevant literature.
Anterior Shoulder Dislocation With an Ipsilateral Humeral Shaft Fracture: A Case Report
Authors: Abdulmalik B Albaker, Ahmad Abdullah A Alsaleh, Mishari Malik Alshammari, Hatim Abdullah Akkasi, Hazzaa Abdullah Hazza Alharbi, Norah Ibrahim S Alqurmulah
Journal: Cureus (2023)
Keywords: intramedullary nail, midshaft humerus fractures, radial nerve injury, road traffic injuries, shoulder anterior dislocation
MeSH terms: Case Reports

Anterior shoulder dislocation is the most common type of shoulder dislocation but if accompanied by an ipsilateral humeral shaft fracture, it becomes extremely rare. There was no clear approach for dealing with these cases. We would like to present a case of a 17-year-old medically free male who was brought to the emergency department by ambulance after a road traffic accident. The patient was conscious, alert, and oriented. His Glasgow Coma Scale (GCS) was 15/15. He had multiple bruises all over his body with obvious swelling in his right arm with an inability to move the arm. There was tenderness over the right arm but an intact distal neurovascular exanimation. X-ray and CT scan showed anterior shoulder dislocation with an ipsilateral humeral shaft fracture of the right arm. There is no specific approach for such cases. However, open reduction with an intramedullary nail showed good outcomes with fewer postoperative neurovascular complications.
Vascular injury accompanying displaced proximal humeral fractures: two cases and a review of the literature
Authors: Martijn Hofman, Jochen Grommes, Gabriele A Krombach, Bernhard Schmidt-Rohlfing
Journal: Emerg Med Int (2011)
MeSH terms: Case Reports

We present two cases in which displaced proximal humeral fractures are accompanied by vascular injury. These Injuries are very rare but severe and the accompanying vascular impairment can have great clinical consequences. Therefore, we try to emphasize on the importance of thorough and accurate diagnostics, because it is obligatory for early diagnosis and improving the eventual outcome of these injuries. The specific order in treatment (internal fixation first or vascular repair first) depends on the severity of the accompanying vascular injury. The increasing use of endovascular procedures to treat vascular lesions is a very interesting development with several advantages, especially in elderly and multimorbid patients.
Solitary pelvic kidney encountered during laparoscopic colectomy
Authors: Kazuhiro Sakamoto, Yutaka Kojima, Ryohei Takeda, Kiyoshi Terai, Mitsuhiro Matsuda
Journal: J Minim Access Surg (2005)
Keywords: laparoscopic colectomy, operative complications, renal ectopia, unilateral renal agenesis
MeSH terms: Case Reports

We report a case of solitary pelvic kidney encountered during laparoscopic colectomy. A 55-year-old man was admitted to undergo laparoscopic colectomy for an early sigmoid colon cancer, which had been detected after a polypectomy. The kidneys were not clearly visualized in their normal position by ultrasonography. During the operation, anomalous vessels in the presacral space and a mass covered with fatty tissue were identified. We converted the operation to a mini-laparotomy, and on performing intraoperative ultrasonography a solitary pelvic kidney was detected. An anterior resection was performed without operative complications. Laparoscopic ultrasonography (LUS) and hand-assisted laparoscopic surgery (HALS) should be considered as feasible adjuvants, when difficult situations arise during laparoscopic colectomy. In case of uncertainty about anatomical orientation or identification, it is prudent to convert to open surgery thereby preventing intraoperative complications such as injury to anomalous vessels or the ureter.
Pulmonary Nocardiosis in the Immunocompetent Host: Case Series
Authors: Inderjit Singh, Frances Mae West, Abraham Sanders, Barry Hartman, Dana Zappetti
Journal: Case Rep Pulmonol (2015)

Pulmonary nocardiosis is commonly recognized as an opportunistic infection in patients with predisposing immunosuppressive conditions. However, reports of pulmonary nocardiosis in the immunocompetent host are rare. Here, we report a case series of four patients with pulmonary nocardiosis without a predisposing condition.
A Fascioliasis Case: a not Rare Cause of Hypereosinophilia in Developing Countries, Present in Developed too
Authors: Ismail Necati Hakyemez, Gülali Aktaş, Haluk Savli, Abdülkadir Küçükbayrak, Safiye Gürel, Tekin Taş
Journal: Mediterr J Hematol Infect Dis (2012)
MeSH terms: Case Reports

Fascioliasis is a worlwide parasitic zoonosis, endemic in south-east mediterranean area, but uncommon in other areas. Clinical signs are usually non-specific. A 32 year old male patient was admitted to our hospital with complaints of abdominal pain, diarrhea, fatigue, nausea, lost of appetite, itching, cough, night sweats and weight loss. Complete blood count revealed hypereosinophilia. The abdominal ultrasound scan was normal. But computed tomography scan revealed irregular nodular lesions in periportal area of the liver. Based on these clinical and radiological signs and continuous hypereosinophilia, the patient was serologically investigated for Fasciola hepatica infection. F. hepatica indirect hemagglutination test in serum was positive at a titer of 1/1280. Single dose Triclabendasole 10mg/kg was administered and repeated two weeks later. Clinical and laboratory signs were completely resolved after treatment. Serological tests for fascioliasis should be included in all patients with hypereosinophilia and abnormal liver CT.
Typhoid Fever due to Extended Spectrum β-Lactamase-Producing Salmonella enterica Serovar Typhi: A Case Report and Literature Review
Authors: Abdul Azeez Ahamed Riyaaz, Vindya Perera, Sabaratnam Sivakumaran, Nelun de Silva
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Emergence of cephalosporin-resistant strains of Salmonella enterica serovar Typhi is a cause of concern in the management of enteric fever. Cephalosporin resistance in Salmonella species is mainly due to the production of extended-spectrum β-lactamases (ESBLs). The majority of ESBLs in Salmonella enterica serovar Typhi are derivatives of the TEM, SHV, and CTX-M β-lactamase families. Of these, CTX-M appears to be predominant. This paper discusses the detection and molecular characterization of an ESBL-producing Salmonella enterica serovar Typhi strain isolated from a patient who was admitted to a private hospital in Sri Lanka. The three main types of β-lactamases such as TEM, SHV, and CTX-M were identified in this isolate. This case report from Sri Lanka contributes to the knowledge of the increasingly reported cases of typhoid fever due to Salmonella enterica serovar Typhi resistant to β-lactamase by ESBL production.
Giant cell tumor of lower end of tibia
Authors: Monish Bami, Ashok R Nayak, Shreepad Kulkarni, Avinash Kulkarni, Rupali Gupta
Journal: Case Rep Orthop (2013)

Introduction. Giant cell tumor of bones is an unusual neoplasm that accounts for 4% of all primary tumors of bone, and it represents about 10% of malignant primary bone tumors with its different grades from borderline to high grade malignancy. Case Report. A 35-year-old patient presented with complains of pain and swelling in left ankle since 1 year following a twisting injury to his left ankle. On examination, swelling was present over the distal and anterior part of leg and movements of ankle joint were normal. All routine blood investigations were normal. X-ray and CT ankle showed morphology of subarticular well-defined expansile lytic lesion in lower end of left tibia suggestive of giant cell tumor. Histopathology of the tissue shows multinucleated giant cells with uniform vesicular nucleus and mononuclear cells which are spindle shaped with uniform vesicular nucleus suggestive of GCT. The patient was treated by excision, curettage, and bone cement to fill the defect. Conclusion. The patient at 12-month followup is doing well and walking without any pain comfortably and with full range of motion at ankle joint with articular congruity maintained and no signs of recurrences.