OpenMed/multicare-articles huggingface dataset:
Severe Hypothyroidism and Large Goiter due to Iodine Deficiency in an Adolescent Male in the United States: A Case Report and Review of the Literature
Authors: Claire E Moore, Sabitha Sasidharan Pillai, Juliana Austin, Meghan E Fredette, Monica Serrano-Gonzalez
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

Acquired hypothyroidism due to iodine deficiency is extremely rare in the United States due to the introduction of table salt iodization in the 1920s (Leung et al., 2012). We present the case of an adolescent male with a history of mild autism spectrum disorder and an extremely restrictive diet who was found to have iodine deficiency as the etiology for his rapidly enlarging goiter and antibody-negative hypothyroidism. Thyroid-stimulating hormone (TSH) was 416 μIU/mL (0.350-5.500 μIU/mL), free thyroxine (T4) was <0.1 ng/dL (0.80-1.80 ng/dL), and triiodothyronine (T3) was 41 ng/dL (82-213 mg/dL) at diagnosis. The patient's 24-hour urinary iodine was undetectable. He was started on iodine supplementation with rapid visible improvement of goiter within two weeks and normalization of thyroid function tests within four weeks. Thorough dietary history and nutritional screening are important in cases of acquired hypothyroidism and/or goiter. Alternatively, diets that are low in iodized salt, dairy, bread, and seafood should raise concern for iodine deficiency, and patients with suspected or proven iodine deficiency should be screened for hypothyroidism.
An Increased Presence of Male Personalities in Dissociative Identity Disorder after Initiating Testosterone Therapy
Authors: Monique Mun, Mohan Gautam, Renee Maan, Bassem Krayem
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

Patients with gender dysphoria (GD) report significant dissociative symptoms and are found to have a high prevalence of a dissociative disorder of any kind. When GD patients elect to undergo cross-sex hormone therapy, there is a significant reduction in dissociative symptoms. However, to the best of our knowledge, there are no known case reports that describe an alteration of personalities in dissociative identity disorder after initiating cross-sex hormone therapy. Thus, we present a case of a 20-year-old transgender male with GD, whom after initiating cross-sex hormone therapy with testosterone experienced an increased presence of his existing male personalities.
Rectal adenocarcinoma metastatic to the tonsil; PET-CT observations with pathological confirmation: A case report
Authors: Jian-Ping He, Shuang Zhang, Zong-Guo Pang, Qiu Li
Journal: Oncol Lett (2014)
Keywords: metastasis, rectal adenocarcinoma, tonsil

Metastasis of rectal adenocarcinoma develops by lymphatic or hematogenous spread. The usual sites of metastasis from rectal adenocarcinoma include local and distant lymph nodes, the liver and the lungs. The current case report presents a unique case of a mass that was identified in the tonsil by positron emission tomography-computed tomography (PET-CT), indicating a metastasis from rectal adenocarcinoma. Metastatic tumor to the tonsil is extremely rare and to the best of our knowledge, no previous studies have reported a case of tonsil metastasis from rectal adenocarcinoma. PET-CT scanners represent an important evolution in technology that is helping to bring anatomical imaging togeother with functional imaging in cancer diagnosis and therapy. Written informed consent was obtained from the patient.
Parapharyngeal metastasis from papillary thyroid microcarcinoma
Authors: Khaled Harrathi, Malika El Omri, Rim Fradi, Amel El Korbi, Naourez Kolsi, Rachida Bouatay, Jamel Koubaa
Journal: Pan Afr Med J (2020)
Keywords: metastasis, neck dissection, papillary carcinoma, parapharyngeal metastasis, unknown primary
MeSH terms: Carcinoma, Papillary / diagnosis, Pharyngeal Neoplasms / diagnosis, Thyroid Neoplasms / diagnosis, Case Reports, Carcinoma, Papillary / pathology, Humans, Lymphatic Metastasis, Male, Middle Aged, Pharyngeal Neoplasms / pathology, Pharyngeal Neoplasms / secondary, Thyroid Neoplasms / pathology, Papillary Thyroid Microcarcinoma

Carcinoma of the thyroid gland is one of the most commonly encountered endocrine malignancies. Papillary carcinoma is the most common histological type and its pattern of metastasis are usually lymphatic. Lymphatic metastasis to parapharyngeal space is rare and have been reported, so we report the case of a 50-year-old male patient who had an occult papillary carcinoma of the thyroid presented as right lateral node of the neck and a nodal involvement of the right parapharyngeal space.
Giant intrathoracic ganglioneuroma with scoliosis treated by one-stage posterior resection and scoliosis correction: a case report
Authors: Belal Elnady, Ahmed Shawky Abdelgawaad, Hussein Elkhayat
Journal: SICOT J (2020)
Keywords: ganglioneuroma with scoliosis, giant ganglioneuroma, posterior approach, spinal ganglioneuroma
MeSH terms: Case Reports

Spinal ganglioneuroma occurs mostly in the thoracic spine causing various manifestations including scoliosis that can be misdiagnosed as idiopathic scoliosis. Few reports exist in the literature on the diagnosis and management of scoliosis secondary to huge ganglioneuroma and usually staged treatment is preferred. In this report, we present a 17-year-old female patient presented with back pain, lower limbs numbness, spinal deformity, and shortness of breath. Plain X-rays showed a 50° right thoracic scoliotic curve. MRI and chest CT revealed a huge extra pulmonary mass shifting the mediastinum with intra spinal extension through the left neural foramina compressing the spinal cord. Percutaneous US guided needle biopsy confirmed the diagnosis of ganglioneuroma. One-stage posterior instrumented correction of scoliosis, spinal cord decompression, and excision of the whole mass from the mediastinum and the spine through posterior approach was done for the patient with smooth postoperative recovery. Chest CT scan was done 2 years after surgery and excluded any local recurrence.
Clostridium perfringens necrotizing pancreatitis: an unusual pathogen in pancreatic necrosis infection
Authors: Ana Sánchez-Gollarte, Laura Jiménez-Álvarez, Marina Pérez-González, Cristina Vera-Mansilla, Alma Blázquez-Martín, Manuel Díez-Alonso
Journal: Access Microbiol (2021)
Keywords: clostridium perfringens, acute pancreatitis, clostridial pancreatic necrosis infection, pancreatic gas gangrene
MeSH terms: Case Reports

Pancreatic necrosis infection (PNI) accounts for about 20-40 % of severe acute pancreatitis. PNI caused by anaerobic bacteria is unusual but when they present, Clostridium perfringens is the microorganism most commonly involved. We present a 60-year-old patient with a previous history of SARS-CoV-2, diagnosed with acute pancreatitis. During the hospitalisation he developed Clostridium perfringens bacteraemia. A CT-scan showed pancreatic gas gangrene and a surgical necrosectomy was performed. Clostridium perfringens was isolated in cultures of the pancreatic tissue and collections. The patient's clinical status improved after surgery and the appropriate medical therapy. He was discharged 76 days after admission. Nowadays, the 'step-up approach' is an accepted therapeutic tool in treatment of pancreatic necrosis and peripancreatic fluid collections. However, most authors suggest that Clostridum perfringens infection requires a more aggressive approach due to the high mortality associated to clostridial infection.
Myocarditis leading to severe dilated cardiomyopathy in a patient with dengue Fever
Authors: Hassan Tahir, Vistasp Daruwalla, Saleem Hayat
Journal: Case Rep Cardiol (2015)

Background. Majority of dengue fever cases follow a benign self-limiting course but recently rare presentations and complications are increasingly seen due to rising burden of disease. Cardiac involvement in dengue fever with fatal outcome is a very rare complication. We report a case of 44-year-old patient who presented with symptoms of severe acute congestive heart secondary to myocarditis induced cardiomyopathy caused by dengue virus infection. Case Presentation. A 44-year-old man presented to ER with the complaints of high fever, fatigue, and shortness of breath. Patient was lethargic and blood pressure was low when he was brought to the ER. CXR showed cardiomegaly with pulmonary congestion and echocardiography revealed dilated left ventricle and ejection fraction of 10%. Patient condition worsened and he got admitted to the ICU because of acute hypoxic respiratory failure. Despite aggressive measures, patient died on day 5. Conclusion. Dilated cardiomyopathy is a rare complication of dengue myocarditis. Early recognition of acute DCM caused by dengue myocarditis is imperative in the management of dengue fever as early detection and management of cardiac failure can improve the survival of patient.
Nonneoplastic Tongue Swellings of Lymphatic and Lymphocytic Origin: Three Case Reports
Authors: Manar A Abdul Aziz, Nermin M Yussif
Journal: Case Rep Dent (2016)

Tongue is formed of a mass of muscles and salivary gland embedded in anterior highly vascular and posterior lymphoid stroma and covered by specialized surface epithelium. Growths from all of these heterogonous components may occur resulting in a wide variation in clinical features and behavior, ranging from self-limiting to aggressive lesions. Therefore, surgical excision is the treatment of choice. The aim of the current study is to report three different lesions that came to the Oral Surgery Department in the Faculty of Oral and Dental Medicine, Cairo University. Following clinical and histopathological examination, the diagnosis of reactive lymphoproliferative lesion, cystic lymphoepithelial lesion, and developmental lymphatic vessel malformation was reached.
An Unusual Presentation of Pyelonephritis: Is It COVID-19 Related?
Authors: L J van 't Hof, L Pellikaan, D Soonawala, H Roshani
Journal: SN Compr Clin Med (2021)
Keywords: covid-19, coagulopathy, hemorrhagic infection, pyelonephritis, sars-cov-2, ureteral obstruction

In severe cases of COVID-19, late complications such as coagulopathy and organ injury are increasingly described. In milder cases of the disease, the exact time frame and causal path of late-onset complications have not yet been determined. Although direct and indirect renal injury by SARS-CoV-2 has been confirmed, hemorrhagic renal infection or coagulative problems in the urinary tract have not yet been described. This case report describes a 35-year-old female without relevant medical history who, five days after having recovered from infection with SARS-CoV-2, had an unusual course of acute pyelonephritis of the right kidney and persistent fever under targeted antibiotic treatment. A hemorrhagic ureteral obstruction and severe swollen renal parenchyma preceded the onset of fever and was related to the developing pyelonephritis. Sudden thrombotic venous occlusion in the right eye appeared during admission. Symmetrical paresthesia in the limbs in combination with severe lower back pain and gastro-intestinal complaints also occurred and remained unexplained despite thorough investigation. We present the unusual combination of culture-confirmed bacterial hemorrhagic pyelonephritis with a blood clot in the proximal right ureter, complicated by retinal vein thrombosis, in a patient who had recovered from SARS-CoV-2-infection five days before presentation. The case is suspect of a COVID-19-related etiology.
Acute Disseminated Encephalomyelitis Following COVID-19 Infection
Authors: Farah Assi, Rim Abdallah, Ali Mecheik, Hassan H Rahhal, Jaafar Wazne
Journal: Cureus (2023)
Keywords: acute disseminated encephalomyelitis, covid-19, covid-19-induced ards, intravenous immunoglobulins, pulsed-dose steroids, sars-cov-2
MeSH terms: Case Reports

Acute disseminated encephalomyelitis (ADEM) is a relatively rare, post-inflammatory, immune-mediated demyelinating central nervous system disease that is predominantly reported in pediatric populations. Following the emergence of severe acute respiratory syndrome coronavirus 2, cases of ADEM are being reported following infection with this virus. Our case report describes a male patient in his early 40s who developed severe coronavirus disease 2019 (COVID-19) that rapidly progressed to a critical disease requiring invasive mechanical ventilation and high positive end-expiratory pressure, which was complicated by extensive neurological involvement and quadriplegia. MRI of the brain showed characteristic demyelinating lesions, suggestive of ADEM. As other entities were ruled out, our patient was treated using pulse steroids and intravenous immunoglobulins. The patient showed a good response to treatment and had an overall good prognosis, despite the severity of his condition. ADEM following COVID-19 is a rare entity worldwide.
Triphallia (triple penis), the first reported case in human
Authors: Shakir Saleem Jabali, Ayad Ahmad Mohammed
Journal: Int J Surg Case Rep (2020)
Keywords: diphallia, multiple penises, supernumerary penises, triphallia, urogenital anomalies
MeSH terms: Case Reports

Introduction:
Supernumerary penises is an extremely rare congenital anomaly which affects one in every 5-6 million live births. Affected patients may have only a rudimentary penis, supernumerary penile glances or complete duplication or triplication of penises. Some patients may have some other associated congenital anomalies.
Presentation of case:
A 3-month-old child presented because of left side hydrocele. There were evidence of two supernumerary penises in the perineum, the first one was about 2 cm in length with a glans and was attached to the root of the penis, and the third one was about 1 cm and was below the scrotum. Hydrocelectomy was performed. The two supernumerary penises were extending to perineal region and were attached to original penis, both had corpora cavernosum and spongiosum with no urethra inside. Both supernumerary penises were excised and both corpora were sutured with a fine slowly absorbable suture material. The patient was discharged with no postoperative events and follow up was done for one years with no reported adverse events.
Conclusion:
Triphallia (three penises) is unreported condition in human until now. Patients with supernumerary penises have unique presentation and no cases are identical. The position of the penis may be ectopic or orthotopic. Treatment is difficult because it poses medical, ethical, and cosmetic aspects. A combined multidisciplinary team is required for the management and long term follow up is required. Excision or reconstruction of the duplicate penis is required depending on the corporal development and anatomy of the urethra.
Water-cooled radiofrequency: a neuroablative or a neuromodulatory modality with broader applications?
Authors: Khalid Malik, Honorio T Benzon, David Walega
Journal: Case Rep Anesthesiol (2011)
MeSH terms: Case Reports

We report the successful use of water-cooled radiofrequency where more traditional forms of neuroablation-conventional and pulsed radiofrequency-had failed to achieve adequate pain relief. We also discuss the mechanism of neural damage with water cooled radiofrequency and discuss why this technique may have a broader role in the management of a wide array of pain syndromes.
Self-Inflicted Trauma Secondary to Local Anaesthesia in Children
Authors: Srikrishna Vempaty, James Robbins
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Long acting local anaesthetics and inferior alveolar nerve block in children can cause loss of sensation and proprioception in a large area supplied by that particular nerve. Similar to the maxilla in mandible also, adequate level of anaesthesia can be achieved in the desired site of treatment by using a short acting local anaesthetic. Early return of normal sensory feedback after using short acting anaesthetics can be helpful in preventing self-harm.
Delusional Disorder, Erotomanic Type, Exacerbated by Social Media Use
Authors: Justin Faden, Jonathan Levin, Ronak Mistry, Jessica Wang
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

Erotomania is an uncommon form of delusional disorder in which an individual has an unfounded belief that another is in love with him. Previous case reports have shown that social media networks may play a role in worsening delusional beliefs. We report the case of a 24-year-old male college student that utilized social media to stalk a female college student, resulting in his suspension from school and hospitalization. The student was diagnosed with delusional disorder, erotomanic type, and started on risperidone. He showed little improvement and was transferred to another facility. This is the first identified case of social media triggering or exacerbating delusional disorder. We recommend increasing education on the ramifications of sharing personal information on social media.
Immune-Mediated Necrotizing Myopathy Manifesting after Five Years of Statin Therapy
Authors: Nathan G DeRon Jr, Francis Fischer, Dylan Lopez, Elizabeth C Brewer
Journal: Case Rep Rheumatol (2023)
MeSH terms: Case Reports

Immune-mediated necrotizing myopathy (IMNM) is an increasingly common and serious condition in which autoantibodies attack muscle fibers causing clinically significant muscle weakness, fatigue, and myalgias. Recognizing the clinical presentation of IMNM is difficult but necessary, as rapid intervention decreases morbidity. We present a case of a 53-year-old female with IMNM induced by statin therapy with confirmed anti-3-hydroxy-3-methylglutaryl coenzyme A reductase antibodies present on serologic testing. The patient's statin therapy was halted, and the patient was provided with one dose of methylprednisolone and ongoing therapy with mycophenolate. She showed subsequent slow improvements in her muscle weakness and myalgias. It is important for clinicians to be aware of the possible consequences of statin therapy, as these drugs are generally regarded as benign in the medical community. Clinicians should also be aware that statin-induced myopathy can occur at any time during statin therapy. The condition does not necessarily correlate with beginning a new statin medication, as demonstrated in this case in which the patient was on chronic statin therapy before developing symptoms. Continued clinician education and building the fund of medical knowledge regarding this disease are vital to enable clinicians to recognize this disease and act promptly to reduce patient morbidity and improve outcomes.
Hyponatremia and stroke mimic: a case report
Authors: Pharan Djimafo Tiwet, Isabelle Tchounkeu Kuigwa, Reine Sandrine Mendeuka, Marie-Dominique Gazagnes
Journal: Pan Afr Med J (2022)
Keywords: hyponatremia, schwartz-bartter syndrome, acute stroke, case report, stroke mimic
MeSH terms: Emergency Medical Services, Hyponatremia / diagnosis, Hyponatremia / etiology, Inappropriate ADH Syndrome, Stroke / diagnosis, Stroke / etiology, Water-Electrolyte Imbalance, Case Reports, Female, Humans, Middle Aged

The differential diagnosis of acute stroke is often a challenge for the emergency care staff. In medical literature, about 30% of patients presenting in an emergency department with suspected stroke at initial assessment are actually stroke mimic. We report here a case of a 61-year-old woman who got admitted at the emergency service for an acute stroke that was actually a symptomatic hyponatremia due to a Schwartz-Bartter syndrome associated with an undiagnosed breast cancer. It is very important to quickly identify and manage patients presenting with a high probability of acute stroke even though many other pathological conditions can present with the same clinical onset. Electrolyte disturbances are one of those stroke mimic conditions that are usually reversible if properly identified and treated on time.
Case report: A case of acute disseminated encephalomyelitis after SARS-CoV-2 infection in pediatric patients
Authors: Francesca Cautilli, Mariavittoria Feleppa, Massimiliano Valeriani, Laura Papetti, Gabriele Monte, Fabio Midulla, Alberto Spalice
Journal: Front Neurol (2023)
Keywords: covid-19, acute disseminated encephalopathy, children, complications, neurological complications
MeSH terms: Case Reports

Introduction:
Since the beginning, there has been enough evidence about the multi-systematic involvement of the coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent observations have revealed that, together with others, typical neurological manifestations are also associated with COVID-19 infection. In the first 2 years, children accounted for a few percent of cases, but with the emergence of the Omicron variant, the number of cases in the pediatric population has increased. It has been described that ~5% of the affected population suffered from severe neurological complications, such as seizure, coma, encephalitis, demyelinating disorders, and aseptic meningitis. Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system. Typically, it presents in childhood and occurs 1 or 2 weeks after infection or vaccination.
Case presentation:
We present the case of a 12-year-old boy who developed ADEM, 10 days after an asymptomatic SARS-CoV-2 infection. Neurological symptoms began with headache, fever, irritability, paraplegia, and loss of sensitivity from the T1 level. The diagnosis of ADEM was confirmed by the typical signs found on brain MRI, whereas spinal cord MRI showed signs of transverse myelitis. The cerebrospinal fluid (CSF) testing excluded infections and did not reveal oligoclonal antibody bands (anti-MOG-negative and anti-AQP-negative). High-dose steroids (30 mg/kg/day) and IVIG (2 g/kg) were administered to the patient without any clinical improvement. The patient received a cycle of plasma exchange therapy, followed by rituximab infusion, with partial improvement. After 3 months, the magnetic resonance imaging (MRI) results demonstrated radiological improvement in accordance with the ADEM diagnosis.
Conclusion:
This clinical case confirms that SARS-CoV-2 infections are increasingly implicated in severe neurological consequences in both adult and pediatric patients. While the most frequent complications that were reported in children included headache, altered mental status, and encephalopathy, ~5% of the individuals suffered from severe neurological complications, leading to lifelong sequelae. All physicians must be aware of these data and detect neurological signs of severe (or not) complications that require a specific follow-up and treatment.
Case report: Unusual persistent hypotension and acute occlusion after peripheral paclitaxel balloon angioplasty
Authors: Lin Yang, Jianlin Liu, Chao Liu
Journal: Front Cardiovasc Med (2022)
Keywords: complication, femoropopliteal artery occlusion, no-reflow phenomenon, paclitaxel-coated balloon, persistent hypotension
MeSH terms: Case Reports

Background:
Paclitaxel-coated balloon (PCB) angioplasty is a mainstream treatment for peripheral artery disease; however, the safety of PCB remains controversial.
Case presentation:
We confirmed acute occlusion during PCB angioplasty in a patient with femoropopliteal artery occlusion. The occluded vessels were revascularized completely after endovascular medical therapy and bailout stenting angioplasty. Then, the patient experienced persistent post-procedure orthostatic hypotension (30 days) and received hydration and vasoactive agents with a target mean arterial blood pressure of 75-85 mmHg. The patient's blood pressure gradually recovered over the 30 days after the procedure, and there was no recurrence of symptomatic hypotension during the follow-up.
Conclusions:
This rare complication is helpful to evaluate the safety of the PCB device.