OpenMed/multicare-articles huggingface dataset:
Hypersensitivity Pneumonitis Associated with Red-Vented Bulbul: A New Encounter of Bird Related Hypersensitivity Pneumonitis
Authors: W D N L Amarasinghe, R Jayasekara, B D W Jayamanne, T D K Nalaka, W A D L Amarasiri, R Punchihewa, A Fernando
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

Bird related hypersensitivity pneumonitis (HP) is becoming more common than other forms of HP around the world. We present two cases of HP, associated with exposure to visiting birds which had nested within their homes in semi urban areas of Colombo, Sri Lanka. A 65-year-old female (case 1) and a 61-year-old male (case 2) presented to the chest clinic complaining of gradually progressive and persistent chronic dry cough and dyspnoea during the year 2018. Both were found to have close contact with red-vented bulbuls (Konda kurulla) in their homes for more than 6 months prior to onset of symptoms and denied any other risk exposures in detail history taking. In both patients, high-resolution computed tomography chest (HRCT) showed centrilobular nodules of ground glass density with significant lobular air trapping. Video-assisted thoracoscopic (VATs) lung biopsy of case 1 showed patchy and focal interstitial thickening with lymphocytic infiltrate, minimal fibrosis, and few noncaseating granulomata within the interstitium. Transbronchial lung biopsy of case 2 showed thickened alveolar septae with lympho-histiocytic infiltrate and occasional neutrophils and eosinopils. Both showed severe reduction in forced vital capacity (FVC) at presentation. Multidisciplinary diagnosis of HP associated with red-vented bulbuls was made. Both achieved good improvement in clinical, lung function, and radiological assessment following removal of offending antigen exposure and treatment with oral corticosteroids.
Clinical application of development of nonantibiotic macrolides that correct inflammation-driven immune dysfunction in inflammatory skin diseases
Authors: Carmen Rodriguez-Cerdeira, Elena Sanchez-Blanco, Alberto Molares-Vila
Journal: Mediators Inflamm (2012)
MeSH terms: Anti-Bacterial Agents / therapeutic use, Inflammation / drug therapy, Macrolides / therapeutic use, Skin Diseases / drug therapy, Review, Calcineurin, Drug Discovery, Humans, TOR Serine-Threonine Kinases / antagonists & inhibitors, Anti-Bacterial Agents, Macrolides, TOR Serine-Threonine Kinases, Calcineurin

Background:
Inflammation-driven immune dysfunction supports the development of several chronic human disorders including skin diseases. Nonantibiotic macrolides have anti-inflammatory and/or immunomodulatory activity that suggests the exploitation of these in the treatment of skin diseases characterized by inflammatory disorders.
Materials and methods:
We performed an extensive review of the nonantibiotic macrolide literature published between 2005 and 2012, including cross-references of any retrieved articles. We also included some data from our own experience.
Results:
Calcineurin antagonists such as tacrolimus and ascomycins (e.g., pimecrolimus) act by inhibiting the activation of the nuclear factor for activated T cells (NFAT). There are new applications for these macrolides that have been available for several years and have been applied to skin and hair disorders such as atopic dermatitis, oral lichen planus, vitiligo, chronic autoimmune urticaria, rosacea, alopecia areata, pyoderma gangrenosum, Behcet's disease, neutrophilic dermatosis, and lupus erythematosus. We also reviewed new macrolides, like rapamycin, everolimus, and temsirolimus. In addition to the literature review, we report a novel class of nonantibiotic 14-member macrocycle with anti-inflammatory and immunomodulatory effects.
Conclusions:
This paper summarizes the most important clinical studies and case reports dealing with the potential benefits of nonantibiotic macrolides which have opened new avenues in the development of anti-inflammatory strategies in the treatment of cutaneous disorders.
Microwave Thermal Ablation in an Unusual Case of Malignant and Locally Advanced Rare Tumor of Pancreas in ASA IV Old Male Patient and Literature Review
Authors: Francesco D'Amico, Michele Finotti, Chiara Di Renzo, Alessio Pasquale, Alessandra Bertacco, Giorgio Caturegli, Gabriel E Gondolesi, Umberto Cillo
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Pancreatic intraductal papillary-mucinous neoplasm is a rare primary neoplasm of unknown pathogenesis. This kind of tumor represents 0.2-2.7% of all pancreatic cancers and they may proceed to malignant lesions. In this study, we describe a case of pancreatic intraductal papillary-mucinous tumor (4.3 cm) with normal tumoral markers and nuclear atypia. We perform also a systematic review of the literature on MEDLINE and find only one relevant study that used microwave ablation for the palliative treatment of pancreatic tumor. We describe the case of a 70-year-old Caucasian male who was diagnosed with a pancreatic tumor with biliary tree dilatation. The patient underwent computed tomography (CT), percutaneous biopsy, and an endoscopic positioning of prosthesis in the biliary tree. Due to the worsening of jaundice and cholestasis, and considering the severe systemic disease status, palliative surgery with microwave thermoablation in the head of pancreas was performed. No complications were observed. The hospitalization lasted for 11 days after surgery, with normal liver and pancreatic lab tests at discharge. The patient followed a line of chemotherapy for 6 months with a complete response for 8 months. One month after the treatment, a staging CT scan was performed showing the size of the cephalopancreatic lesion had decreased from 43 to 35 mm with signs of complete ablation. The patient had a total response at the imaging of 10 months. One year later, a CT scan follow-up showed progression of the pancreatic disease. The disease remained stable for 18 months. The patient died due to cardiovascular complications with an overall survival of 30 months. Microwave ablation in our case report has been demonstrated to be feasible and safe without complications. It can be used as a phase of multimodality treatment in patients with severe systemic disease status and advanced intraductal papillary-mucinous neoplasm.
Atrioventricular Conduction Abnormalities in Multisystem Inflammatory Syndrome in Children
Authors: Carlos A Carmona, Fatma Levent, Kelvin Lee, Bhavya Trivedi
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Cardiac manifestations in multisystem inflammatory syndrome in children (MIS-C) can include coronary artery aneurysms, left ventricular systolic dysfunction, and electrocardiographic disturbances. We report the clinical course of three children with MIS-C while focusing on the unique considerations for managing atrioventricular conduction abnormalities. All initially had normal electrocardiograms but developed bradycardia followed by either PR prolongation or QTc elongation. Two had mild left ventricular ejection fraction dysfunction prior to developing third-degree heart block and/or a junctional escape rhythm; one had moderate left ventricular systolic dysfunction that normalized before developing a prolonged QTc. On average, our patients presented to the hospital 4 days after onset of illness. Common presenting symptoms included fevers, abdominal pain, nausea, and vomiting. Inflammatory and coagulation factors were their highest early on, and troponin peaked the highest within the first two days; meanwhile, peak brain-natriuretic peptide occurred at hospital days 3-4. The patient's lowest left ventricular ejection fraction occurred at days 5-6 of illness. Initial electrocardiograms were benign with PR intervals below 200 milliseconds (ms); however, collectively the length of time from initial symptom presentation till when electrocardiographic abnormalities began was approximately days 8-9. When comparing the timing of electrocardiogram changes with trends in c-reactive protein and brain-natriuretic peptide, it appeared that the PR and QTc elongation patterns occurred after the initial hyperinflammatory response. This goes in line with the proposed mechanism that such conduction abnormalities occur secondary to inflammation and edema of the conduction tissue as part of a widespread global myocardial injury process. Based on this syndrome being a hyperinflammatory response likely affecting conduction tissue, our group was treated with different regimens of intravenous immunoglobulin, steroids, anakinra, and/or tocilizumab. These medications were successful in treating third-degree heart block, prolonged QTc, and a junctional ectopic rhythm.
Carotid Thrombosis in a Crack Cocaine Smoker Woman
Authors: Mattia Cosenza, Luigi Panza, Anna Paola Califano, Carolina Defendini, Maria D'Andria, Roberto Romiti, Antonio Fabio Massimo Vainieri, Sergio Morelli
Journal: Case Rep Vasc Med (2020)
MeSH terms: Case Reports

Introduction:
We report a case of stroke in a crack smoker with occlusion of the middle cerebral artery and a large thrombus in the carotid artery. Case Presentation. A 34-year-old female presented with left upper arm weakness, associated with paresthesia with onset of symptoms more than 24 hours before. Angio-RM sequences showed an area of ischemia, with occlusion of the M2 segment of the middle cerebral artery. Carotid ultrasound showed a soft plaque with distal end floating. Anticoagulant treatment was started, and seriated ultrasound evaluations showed its gradual dissolution.
Conclusions:
In atherothromboembolic stroke from carotid thrombosis, repeated ultrasound studies may be useful for either diagnosis and monitoring the efficacy of anticoagulant therapy.
Maxillofacial metastasis from breast cancer
Authors: Tariq Namad, Zineb Benbrahim, Rajae Najib, Afif Mohammed, Soufiane Baggar, Nezar Bouyahia, Samia Arifi, Nawfel Mellas
Journal: Pan Afr Med J (2014)
Keywords: breast cancer, maxillofacial, metastasis
MeSH terms: Breast Neoplasms / pathology, Maxillary Neoplasms / secondary, Paranasal Sinus Neoplasms / secondary, Case Reports, Aged, Breast Neoplasms / surgery, Fatal Outcome, Female, Humans, Maxillary Neoplasms / diagnosis, Maxillary Neoplasms / pathology, Paranasal Sinus Neoplasms / diagnosis, Paranasal Sinus Neoplasms / pathology, Time Factors

Metastatic tumors to paranasal sinuses are exclusively rare. In this paper, we report a case of breast carcinoma metastasizing to the right maxilla. The metastasis occurred 5 years after radical mastectomy and presented as a primary sinonasal mass. The diagnosis was confirmed with histopathologic and immunohistochemical examination however the patient died before starting any specific treatment because of tumor bleeding.
Hepatotoxicity Associated with Use of the Weight Loss Supplement Garcinia cambogia: A Case Report and Review of the Literature
Authors: Jiten P Kothadia, Monica Kaminski, Hrishikesh Samant, Marco Olivera-Martinez
Journal: Case Reports Hepatol (2018)
MeSH terms: Case Reports

The use of herbal and dietary supplements for weight loss is becoming increasingly common as obesity is becoming major health problem in the United States. Despite the popularity of these natural supplements, there are no guidelines for their therapeutic doses and their safety is always a concern. Garcinia cambogia extract with its active ingredient "hydroxycitric acid" is a component of many weight loss regimens. It suppresses fatty acid biosynthesis and decreases appetite. However, its prolonged use in weight maintenance is unknown. Here we describe a case of acute hepatitis after the use of Garcinia cambogia for weight loss.
c.3623G > A mutation encodes a CFTR protein with impaired channel function
Authors: Xiaoying Zhang, Jaspal S Hothi, Yanhui H Zhang, Saumini Srinivasan, Dennis C Stokes, Weiqiang Zhang
Journal: Respir Res (2016)
MeSH terms: Black or African American / genetics, Cystic Fibrosis / genetics, Cystic Fibrosis Transmembrane Conductance Regulator / genetics, Ion Channel Gating / genetics, Mutation / genetics, Case Reports, Research Support, N.I.H., Extramural, Base Sequence, Humans, Infant, Molecular Sequence Data, CFTR protein, human, Cystic Fibrosis Transmembrane Conductance Regulator

Background:
The aims of this study were to characterize clinical features of a pediatric African-American cystic fibrosis (CF) patient heterozygous for F508del and a novel c.3623G > A mutation, and to identify the molecular defect(s) associated with c.3623G > A mutation.
Methods:
The medical record of this patient was analyzed retrospectively. Western blotting and iodide efflux assay were used to study mutant CFTR protein expression level, maturation status, channel function, and the effects of CFTR modulation on these characteristics.
Results:
The encoding protein of c.3623G > A mutation, G1208D-CFTR, has a moderate processing defect and exhibits impaired channel function, which were partially rescued by using VX-809 or exposed to low temperature (28 °C). The patient has mild CF disease manifestations.
Conclusions:
Our biochemical findings correlate with the clinical phenotype and suggest that c.3623G > A is a CF-causing mutation. The study helps expand our knowledge of rare CFTR mutations in a minority population and may have important clinical implications for personalized therapeutic intervention.
Salivary Gland Heterotopia in the Gastroesophageal Junction: A Case Series and Review of the Literature
Authors: Lina Abdul Karim, Dong Hyang Kwon, Metin Ozdemirli
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Heterotopia is defined as the presence of mature, histologically normal, tissue in unusual anatomic sites. When this heterotopic tissue forms a mass, it is called a choristoma. This case series describes 3 cases of gastroesophageal junction (GEJ) salivary heterotopias. While heterotopias are usually incidental findings, choristomas can clinically and endoscopically mimic carcinomas and might lead to unnecessary procedures for the patients. Clinicians should therefore be aware of this entity. Literature search, however, failed to show any reports of salivary gland heterotopias in the GEJ. In fact, literature review revealed only 6 reported cases of salivary gland choristoma in the gastrointestinal tract, none at the GEJ. In this case series, we report 2 cases of salivary gland heterotopia and one case of salivary gland choristoma arising at the GE junction. To our knowledge, this is the first series of its kind in the literature.
The management of "coats' response" in a patient with x-linked retinitis pigmentosa-a case report
Authors: Shveta Bansal, Niladri Saha, W H Woon
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

The management of exudative retinal detachment in Coats disease can be very difficult with variable results. A case is presented of a 12 year old boy who was diagnosed with X-linked retinitis pigmentosa with an associated "Coat's Response". The patient had a marked reduction in his left visual acuity due to intragel and subhyaloid haemorrhage as well as exudative retinal detachment. This was managed successfully with vitrectomy and endolaser, resulting in clearance of the haemorrhage and flattening of the retina. In our experience endolaser should be considered as viable therapeutic option in the management of this condition.
Low grade endometrial stromal sarcoma: a case report
Authors: Reena Jain, Swaraj Batra, Ayesha Ahmad, Arifa Anwar Elahi, Monika Gupta, Poonam Saith
Journal: Iran J Med Sci (2015)
Keywords: endometrial stromal sarcoma, immunohistochemistry, uterine leiomyoma
MeSH terms: Case Reports

Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years. We report a case of low-grade ESS in a 39-year-old woman, presenting as rapid enlargement of a uterine fibroid polyp associated with irregular and excessive vaginal bleeding. Polypectomy followed by pan hysterectomy was performed. Histopathological examination and immunohistochemistry confirmed LGESS. As the tumor is rarely encountered, management protocols are still questionable. In our case, we tried a different post-surgical protocol and the patient is being closely followed up. Although rare, ESS should be considered in the differential diagnosis of all women who present with a rapid enlargement of a uterine leiomyoma.
The mckittrick-wheelock syndrome: a rare cause of severe hydroelectrolyte disorders and acute renal failure
Authors: Andrea Bruno, Domenico Chimienti, Alda Montanaro, Fernando Prete, Pasquale Libutti, Piero Lisi, Carlo Basile
Journal: Case Rep Nephrol (2011)
MeSH terms: Case Reports

The McKittrick-Wheelock syndrome is a rare cause of severe hydroelectrolyte disorders and fluid depletion as a result of rectal tumor hypersecretion, which can lead to acute renal failure. We report the case of a 70-year-old female who presented with hyponatremia, hypokalemia, hypochloremia, and acute renal failure, due to a watery, mucinous diarrhea. A large rectal villous adenoma was discovered on ileocolonoscopy, and definitive management was achieved by removal of the tumor. In conclusion, reversal of the biochemical derangement is the cornerstone of successful management of the McKittrick-Wheelock syndrome. Then, immediate surgical resection of the tumor is the treatment of choice.
Case report: A rare appearance of preretinal deposits in a patient with uveitis: multimodal imaging observation
Authors: Yizhe Cheng, Chunli Chen, Yuanyuan Xiao, Shuang Wang, Sihui Wang, Xiaoyan Peng
Journal: Front Med (Lausanne) (2023)
Keywords: dexamethasone intravitreal implant, multimodal imaging, preretinal deposits, tubercular infection, uveitis
MeSH terms: Case Reports

Background:
Uveitis is a disease presenting with varied clinical symptoms and potentially devastates visual function. Here, we report a patient with uveitis exhibiting a rare appearance of preretinal deposits (PDs).
Case presentation:
A 49-year-old female showed vitreous opacity and perivascular white PDs involving veins and arteries. The interferon-gamma release assay was strongly positive and chest computed tomography showed signs of calcified nodules; other tests were unremarkable. The patient was diagnosed with uveitis and tubercular infection. The patient was given systemic anti-tubercular therapy and steroids, which were subsequently combined with immunosuppressants. The shrinkage of HRD was more sensitively observed with OCT than on photographs during follow-up visits. The right eye was relieved subsequently, but the left eye showed vitreous opacity and responded poorly to the treatment. Three months after the dexamethasone intravitreal implant, the perivascular deposits in the left eye disappeared and the vitreous opacity was relieved.
Conclusion:
PDs can appear as spotted deposits in the posterior pole and segmental deposits in the periphery in patients with uveitis, which mainly involves the vitreous cavity and is easily confused with retinal vasculitis. OCT can more sensitively observe the response than other examinations.
Late Renal Allograft Rupture Associated with Cessation of Immunosuppression following Graft Failure
Authors: Sumayah Askandarani, Noura Aloudah, Hanan Al Enazi, Khaled O Alsaad, Abdulrahman Altamimi
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

A 29-year-old man developed chronic allograft nephropathy 63 months after renal transplantation. He became symptomatic with advanced chronic graft failure; his immunosuppressive medications were reduced and he was commenced on haemodialysis. Two months following the withdrawal of immunosuppression, he presented with abdominal pain, haematuria, and a marked drop in haemoglobin. The patient was taken to the operating room, where the renal allograft was found to be ruptured, and graft nephrectomy was subsequently performed. Histological examination of the graft specimen showed severe haemorrhagic acute vascular cellular rejection in a background of marked chronic allograft vasculopathy. Immunostaining for C4d showed diffuse, strong, linear circumferential staining of the peritubular capillaries, indicating a concurrent antibody-mediated rejection. We report herein an unusual case of spontaneous renal allograft rupture that occurred long time after transplantation due to severe acute rejection following cessation of immunosuppressive medications for advanced chronic allograft failure. To the best of our knowledge, the time interval between transplantation and the rupture of this allograft is the longest of those reported in the literature.
Intractable epilepsy due to angiocentric glioma: A case report and minireview
Authors: Guoqiang Chen, Lin Wang, Jinting Wu, Yongjian Jin, Xiaosong Wang, Yulan Jin
Journal: Exp Ther Med (2014)
Keywords: angiocentric glioma, cortical, electrocorticogram, intractable epilepsy

The aim of this case report and minireview was to investigate the diagnosis of and therapeutic approaches for angiocentric glioma (AG) and to summarize the clinical manifestations and the pathological and imaging characteristics of the disease. Intraoperative cortical electroencephalogram (ECoG) monitoring was performed to locate the epileptic foci in a child with AG who presented with intractable epilepsy, prior to the total resection of the tumor being performed under the microscope. The clinical features, imaging characteristics, intraoperative conditions, surgical methods and pathological results were analyzed and compared with the literature. The review revealed that to date, the clinical features of the 52 reported cases of AG (including this case) have been mainly characterized by epilepsy. High T2-weighted image (WI) and fluid-attenuated inversion recovery (FLAIR) signals may be detected with magnetic resonance imaging (MRI) scanning of the cranium; however, no enhancement signals are detected by enhanced scanning. The prognosis following surgical resection is favorable. The lesions in the present case demonstrated clear boundaries with a central cystic affection accompanied by an arachnoid cyst on the left temporal pole. Pathological examination revealed that the lesion was positive for glial fibrillary acidic protein (GFAP), S-100 protein, vimentin, epithelial membrane antigen (EMA), cluster of differentiation 99 (CD99) and D2-40. The Ki-67/MIBk-1 labeling index was ~1%. In conclusion, AG exhibits characteristic features in imaging; however, its diagnosis depends on histopathological examination. The prognosis of total surgical resection is good and intraoperative ECoG may be used to assist positioning.