OpenMed/multicare-articles huggingface dataset:
An Unusually Short Latent Period of Therapy-Related Myeloid Neoplasm Harboring a Rare MLL-EP300 Rearrangement: Case Report and Literature Review
Authors: Reina Takeda, Kazuaki Yokoyama, Seiichiro Kobayashi, Toyotaka Kawamata, Sousuke Nakamura, Tomofusa Fukuyama, Mika Ito, Nozomi Yusa, Eigo Shimizu, Nobuhiro Ohno, Rui Yamaguchi, Seiya Imoto, Satoru Miyano, Kaoru Uchimaru, Arinobu Tojo
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Therapy-related myeloid neoplasm (t-MN) is a late and lethal complication induced by chemotherapy and/or radiation therapy. Hematological malignancy is one of the most common primary diseases in patients with t-MN. However, the occurrence of t-MN in adult T-cell leukemia/lymphoma (ATL) patients is rarely reported, possibly due to the dismal prognosis of ATL per se. Here, we report a 62-year-old female who developed t-MN only three months after the completion of conventional chemotherapy and anti-CCR4 antibody for ATL acute type. The patient presented with persistent fever and monocytosis without any evidence of infectious diseases. Bone marrow examinations revealed chronic myelomonocytic leukemia-like disease with a chromosomal translocation of t(11;22)(q23;q13) as a solo cytogenetic abnormality, resulting in the diagnosis of t-MN. Next-generation sequencing analysis identified a rare chimeric transcript, MLL-EP300, without any additional somatic mutations. Although the patient underwent allogenic hematopoietic stem cell transplantation, she died of viral encephalomyelitis at 7 months after diagnosis of t-MN. Since recent therapeutic advances have extended the survival of patients with ATL, further evaluation of the long-term risks of developing t-MN in these patients is warranted.
Acute Hepatitis due to Garcinia Cambogia Extract, an Herbal Weight Loss Supplement
Authors: Akshay Sharma, Elisa Akagi, Aji Njie, Sachin Goyal, Camelia Arsene, Geetha Krishnamoorthy, Murray Ehrinpreis
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

The Drug Induced Liver Injury Network reports dietary supplements as one of the most important causes of drug induced hepatotoxicity, yet millions of people use these supplements without being aware of their potential life-threatening side effects. Garcinia cambogia (GC) extract is an herbal weight loss supplement, reported to cause fulminant hepatic failure. We present a case of a 57-year-old female with no previous history of liver disease, who presented with acute hepatitis due to GC extract taken for weight loss, which resolved after stopping it and got reaggravated on retaking it. Obtaining a history of herbal supplement use is critical in the evaluation of acute hepatitis.
Syndrome of inappropriate secretion of antidiuretic hormone cholestasis and pericardial effusion due to brucellosis infection: a case report
Authors: Ahmet Cumhur Dülger, Ozgür Kemik, Aziz Sümer, Hüseyin Akdeniz, Mehmet Emin Küçükoğlu, Esra Turan Canbaz, Veyis Itik, Enver Aytemiz
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is an extremely rare complication of infectious diseases. A rare case of brucellosis complicated by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) cholestasis and pericardial involvement is reported. A 27-year-old woman was admitted for fever, abdominal pain, and scleral icterus. Her medical history revealed no recent use of diuretic agents. In addition to cholestasis and elevated liver enzymes, euvolemic hyponatremia, hypouricemia, low plasma osmolality, and high urinary osmolality were also detected. Surrenal and thyroid tests were also within normal range. Echocardiography revealed minimal pericardial effusion with normal cardiac functions. The final diagnosis was SIADH due to Brucellosis. Hyponatremia, cholestasis, and pericardial disease were resolved with effective antibrucellar treatment with streptomycine and doxycycline. After completing treatment of brucellosis, there was not any more evidence of cholestasis and pericardial fluid.
Small Bowel Volvulus Complicated by Bowel Infarction
Authors: Birgitt Janssens, Adelard De Backer, Filip Vanhoenacker
Journal: J Belg Soc Radiol (2022)
Keywords: abdominal computed tomography, small bowel infarction, small bowel volvulus
MeSH terms: Case Reports

Teaching Point: Torsion of a segment of the small bowel and its mesentery, together with closed loop obstruction and absent enhancement of paper-thin small bowel walls, is an alarm sign for small bowel volvulus complicated by acute bowel infarction.
Accessory and cavitated uterine masses: a case series and review of the literature
Authors: S Dekkiche, E Dubruc, M Kanbar, A Feki, M Mueller, J-Y Meuwly, P Mathevet
Journal: Front Reprod Health (2023)
Keywords: acum, müllerian anomalies, chronic pelvic pain, dysmenorrhea, uterine malformations

Objectives:
The purpose of this study is to report nine patients of young women who underwent a surgical treatment of an accessory and cavitated uterine mass (ACUM) in our hospital between 2014 and 2022 and review all cases described in the literature.
Material and methods:
The principal outcomes measured are the imaging techniques used to determine the diagnosis, the type of surgery used and the post-operative evolution of symptoms. We also report and analyse the 79 patients found in the literature since 1996 in addition to our 9 patients.
Results:
Surgical excision is the only long-lasting treatment. Small invasive surgery with laparoscopic access is the gold standard and most widely used (83.0%). Some new therapeutic procedures have been recently described of which ethanol sclerotherapy seems very promising. Post-operatively, 54.5% of patients have a complete relief of symptoms. MRI is the best imaging technique to identify ACUM. Finally, we refine the description of this pathology and give a more precise definition of it.
Conclusion:
Through our literature review and the analysis of our cases, we want to underline an important diagnostic criterion of this pathology: the fallopian tube on the homolateral side of the ACUM never communicates with the latter. It is a capital element for differential diagnosis.
Case Report: Desmoid fibromatosis in the mediastinum of a 6-month-old toddler, what to do?
Authors: Santiago A Endara, Gerardo A Dávalos, Gabriel A Molina, Christian A Armijos, D Sebastian Narvaez, Nelson Montalvo
Journal: Front Surg (2023)
Keywords: desmoid disease, desmoid fibromatosis, desmoid tumor, mediastinal mass, pediatric
MeSH terms: Case Reports

Desmoid fibromatosis is a rare, aggressive borderline lesion arising from soft tissues. Treatment will depend on the structures that the tumor has involved. Surgery with negative margins is the recommended strategy as it can usually achieve disease control; however, the tumor's location sometimes does not allow it. Therefore, a combination of medical therapies along with strict surveillance is crucial. We present the case of a 6-month-old boy with a chest mass. After further evaluation, a rapidly growing mediastinal mass involving the sternum and costal cartilage was detected. Desmoid fibromatosis was the final diagnosis.
Acute Myeloid Leukemia Presenting as Myeloid Sarcoma with a Predisposition to the Gynecologic Tract
Authors: Ryan M Kahn, Sushmita Gordhandas, Eloise Chapman-Davis, Elizabeth Margolskee, Cathleen Matrai, Amy Chadburn, Ellen Ritchie
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Myeloid sarcoma (MS) is a rare, extramedullary tumor consisting of immature white blood cells of myeloid lineage. MS is usually associated with the concurrent diagnosis of acute myeloid leukemia (AML) but can also present in the absence of bone marrow disease or at relapse of AML. MS of the gynecologic tract is exceedingly rare; however, it is hypothesized that it is likely more prevalent than previously understood given postmortem findings and persistence in preserved ovarian tissue. There is minimal literature surrounding MS and extramedullary relapse with no clear guidelines. This is a case report of a 48-year-old woman with MS involving the uterine corpus, fallopian tubes, and left ovary followed by a literature review. The overall aim is to review data regarding leukemic immune evasion and sanctuary sites in order to raise awareness as this represents an important and underrecognized hematologic malignancy in an often misdiagnosed, underrecognized site.
A case report of primary para-testicular spindle cell rhabdomyosarcoma
Authors: Peng Su, Ying Yang, Xiaomin Wang, Shulian Chen, Neng Zhang, Hua Yang
Journal: Front Oncol (2023)
Keywords: case report, para-testicular, pathological features, radical inguinal orchiectomy, spindle cell rhabdomyosarcoma
MeSH terms: Case Reports

Para-testicular rhabdomyosarcoma (PTRMS) is a rare tumor, and it accounts for 7% of all rhabdomyosarcoma tumors. Among all the rhabdomyosarcoma (RMS) types, the spindle cell RMS is extremely rare. The present study describes a case of a para-testicular spindle cell RMS that was treated with a radical inguinal orchiectomy (RIO) and right scrotal resection. A 17-year-old male patient presented with a half-year history of a rapidly growing, painless, right scrotal mass. His CT of the pelvic cavity showed a mixed-density mass in the right scrotum, and the maximum cross-sectional area was approximately 76.5 mm × 64.5 mm. An X-ray of the chest demonstrated no evidence of metastasis, and a local surgical excision was performed subsequently. The histopathological and immunohistochemical examination confirmed the final diagnosis of spindle cell RMS. As a newly diagnosed case, strict and regular follow-up is needed. This article focuses on the importance of prompt recognition, diagnosis, pathological features, and appropriate management of para-testicular spindle cell RMS.
Case Report: A Rehabilitation Practice Report During ICU Management for a Patient With Multiple Disabilities Due to COVID-19 Pneumonia and COPD
Authors: Tokio Kinoshita, Ken Kouda, Yasunori Umemoto, Yoshinori Yasuoka, Yuta Minoshima, Yukio Mikami, Yukihide Nishimura, Kyohei Miyamoto, Seiya Kato, Fumihiro Tajima
Journal: Front Med (Lausanne) (2021)
Keywords: sars-cov-2, case report, early ambulation, rehabilitation, supplemental oxygen therapy
MeSH terms: Case Reports

Patients with severe coronavirus disease (COVID-19) and admitted to the intensive care unit (ICU) are at high risk of developing ICU-acquired weakness and disuse syndrome. Although their medical management may include prolonged deep sedation for pulmonary protection and ventilator management, we aim for early mobilization of these patients with COVID-19. We present the case of a 71-year-old man with chronic obstructive pulmonary disease (COPD) and COVID-19 pneumonia. Passive range of motion training and sitting on the edge of the bed were started in the ICU while the patient was under deep sedation. His activities of daily living eventually improved to where he could independently walk to the toilet without respiratory distress. Patients with severe COVID-19 who require mechanical ventilation are at risk of muscle weakness and exercise intolerance. These patients require rehabilitation therapy, beginning in the acute phase of illness, to recover their physical function. Although validation with a larger cohort is necessary, our results suggest that patients with COPD and COVID-19 pneumonia should undergo rehabilitation concurrently with status-driven changes in respiratory management.
Recurrent haemorrhagic ovarian cyst and anticoagulant therapy: a case report with review of treatment modalities
Authors: Kavitha Nagandla, Mohamed Faiz Bin Mohamed Jamli, Faridah Hanim, Joanne Lim Xu Mei, Siti Fathima Syazliana Din
Journal: Pan Afr Med J (2021)
Keywords: haemorrhagic, anticoagulants, management, ovarian cyst, surgery
MeSH terms: Anticoagulants / adverse effects, Heart Valve Prosthesis, Hemorrhage / etiology, Ovarian Cysts / diagnosis, Case Reports, Anticoagulants / administration & dosage, Female, Humans, Middle Aged, Ovarian Cysts / etiology, Ovarian Cysts / therapy, Pelvic Pain / etiology, Recurrence, Anticoagulants

The common gynaecological causes of acute pelvic pain include ruptured ectopic pregnancy, haemorrhagic corpus luteal cyst or torsion of an ovarian cyst. Ovarian vascular accidents are reported in women on oral anticoagulation presenting as an acute pelvic pain. Although such vascular accidents with anticoagulation therapy are an unusual entity, a meticulous history, clinical examination, and laboratory workup to confirm the diagnosis and timely intervention is needed to reduce attending morbidity and mortality. However, a standard algorithm for management is not described in the literature. We hereby report successful management of recurrent hemorrhagic ovarian cyst due to coagulopathy in a woman with mechanical heart valves with timely surgical intervention. This case report discusses operative versus non operative management approach and may provide value addition to readers encountering such cases in their clinical practice.
Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis
Authors: Gulsen Akkoc, Eda Kepenekli Kadayifci, Ayse Karaaslan, Serkan Atici, Nurhayat Yakut, Sevliya Ocal Demir, Ahmet Soysal, Mustafa Bakir
Journal: Case Rep Infect Dis (2016)

Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae.
Top-down computerized cognitive remediation in schizophrenia: a case study of an individual with impairment in verbal fluency
Authors: Marjolaine Masson, Til Wykes, Michel Maziade, Clare Reeder, Marie-Anne Gariépy, Marc-André Roy, Hans Ivers, Caroline Cellard
Journal: Case Rep Psychiatry (2015)

The objective of this case study was to assess the specific effect of cognitive remediation for schizophrenia on the pattern of cognitive impairments. Case A is a 33-year-old man with a schizophrenia diagnosis and impairments in visual memory, inhibition, problem solving, and verbal fluency. He was provided with a therapist delivered cognitive remediation program involving practice and strategy which was designed to train attention, memory, executive functioning, visual-perceptual processing, and metacognitive skills. Neuropsychological and clinical assessments were administered at baseline and after three months of treatment. At posttest assessment, Case A had improved significantly on targeted (visual memory and problem solving) and nontargeted (verbal fluency) cognitive processes. The results of the current case study suggest that (1) it is possible to improve specific cognitive processes with targeted exercises, as seen by the improvement in visual memory due to training exercises targeting this cognitive domain; (2) cognitive remediation can produce improvements in cognitive processes not targeted during remediation since verbal fluency was improved while there was no training exercise on this specific cognitive process; and (3) including learning strategies in cognitive remediation increases the value of the approach and enhances participant improvement, possibly because strategies using verbalization can lead to improvement in verbal fluency even if it was not practiced.
Ischemic Stroke and Ruptured Mycotic Aneurysm, Two Complications of Infective Endocarditis in One Patient
Authors: Alassane Mamadou Diop, Ahmadou Bamba Mbodj, Serigne Abdou Aziz Fall, Ibrahima Niang
Journal: Case Rep Neurol Med (2022)
MeSH terms: Case Reports

The incidence of infective endocarditis is estimated to be around 30 cases per million inhabitants/year. It can be responsible for various neurological complications such as cerebral infarction, meningitis, cerebral abscesses, and cerebral hemorrhage due to ruptured mycotic aneurysms. Several germs have been incriminated in this condition including Staphylococcus, Streptococcus, and Enterococcus. We report the case of a 64-year-old patient who presented with an acute motor deficit of the left upper limb associated with dysarthria. MRI showed infarcts in both cerebral hemispheres, and the TOF sequence showed an amputation of M2. On transesophageal ultrasound, there was evidence of vegetations at the mitral valve. Blood culture isolated Streptococcus oralis. With antibiotic treatment, the evolution was marked by a stable apyrexia with regression of the dysarthria. Before her surgery, she suddenly developed aphasia with worsening of the motor deficit. CT scan showed a right fronto-parietal hematoma which was related to a ruptured cerebral aneurysm. She underwent endovascular embolisation and subsequent cardiac surgery.
Case Report: Neoadjuvant immunotherapy with pembrolizumab alone for bilateral upper tract urothelial carcinoma is a feasible strategy for kidney sparing and avoidance of hemodialysis
Authors: Wai-Nga Chan, Yun-Ching Huang, Dong-Ru Ho, Chih-Shou Chen
Journal: Front Oncol (2022)
Keywords: case report, immune checkpoint inhibitors, kidney sparing, neoadjuvant immunotherapy, upper tract urothelial carcinoma
MeSH terms: Case Reports

In Taiwan, the incidence of upper-tract urothelial carcinomas (UTUCs) is higher than in western countries (20%-31% vs. 5%-10%), as is bilateral disease. The standard management for high-grade UTUC is radical nephroureterectomy with bladder cuff excision and regional lymphadenectomy. The challenges in managing bilateral UTUCs are how to retain renal function and avoid permanent hemodialysis. We present two cases of developed bilateral high-grade renal pelvis urothelial carcinoma, cT3N0M0 stage III, that revealed excellent results in tumor regression after three cycles of half-dose pembrolizumab. One case received unilateral retroperitoneal laparoscopic nephroureterectomy with bladder cuff excision; thereafter, renal function has been good until now, and the remaining right kidney has been free of tumor recurrence in the 3 years of follow-up. The other patient, however, expired from an immune-related adverse event (irAE) 22 days after the third cycle of pembrolizumab, although tumor remission was evident also. Neoadjuvant pembrolizumab alone could be a potential strategy in positive of selected biomarkers for high-grade bilateral UTUC with remaining neglectable nephrotoxicity and may avoid permanent hemodialysis.
Glycogenic Hepatopathy: A Rare Hepatic Complication of Poorly Controlled Type 1 DM
Authors: Leila A Alenazy, Muhammad Javed, Hussien Elsiesy, Emad Raddaoui, Waleed K Al-Hamoudi
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Glycogen hepatopathy (GH) is a rare complication of type 1 diabetes mellitus that leads to an abnormal accumulation of glycogen in the hepatocytes. The exact mechanism of GH remains unknown, but fluctuations in blood glucose and insulin levels play important roles in promoting glycogen accumulation. We report a case of a 16-year-old female diagnosed with poorly controlled type 1 diabetes mellitus with hepatomegaly and elevated liver enzymes. The patient experienced multiple admissions for diabetic ketoacidosis, and she also had celiac disease diagnosed 2 years previously based on serology and a duodenal biopsy. The laboratory analyses results were compatible with acute hepatitis, and the celiac serology was positive. Other investigations ruled out viral hepatitis and autoimmune and metabolic liver diseases. Ultrasound and computerized tomography (CT) scans of the abdomen revealed liver enlargement with diffuse fatty infiltration. A liver biopsy revealed the presence of abundant glycogen in the cytoplasm of the hepatocytes. PAS staining was strongly positive, which confirmed the diagnosis of GH. There were no features of autoimmune hepatitis or significant fibrosis. Duodenal biopsy results were consistent with celiac disease. Despite our efforts, which are supported by a multidisciplinary team approach that included a hepatologist, a diabetic educator, a dietitian, and an endocrinologist, we have encountered difficulties in controlling the patient's diabetes, and she persistently maintains symptomatic hepatomegaly and abnormal liver biochemistry. Given the patient's age, we assumed that these abnormalities were related to patient noncompliance. In conclusion, GH remains an under-recognized complication of type 1 DM that is potentially reversible with adequate glycemic control. The awareness of GH should prevent diagnostic delay and its implications for management and the outcome.
Deep Brain Stimulation of Medial Dorsal and Ventral Anterior Nucleus of the Thalamus in OCD: A Retrospective Case Series
Authors: Mohammad Maarouf, Clemens Neudorfer, Faycal El Majdoub, Doris Lenartz, Jens Kuhn, Volker Sturm
Journal: PLoS One (2016)
MeSH terms: Mediodorsal Thalamic Nucleus, Obsessive-Compulsive Disorder / therapy, Ventral Thalamic Nuclei, Case Reports, Adult, Anxiety / complications, Deep Brain Stimulation, Depression / complications, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder / complications, Obsessive-Compulsive Disorder / psychology, Quality of Health Care, Retrospective Studies

Background:
The current notion that cortico-striato-thalamo-cortical circuits are involved in the pathophysiology of obsessive-compulsive disorder (OCD) has instigated the search for the most suitable target for deep brain stimulation (DBS). However, despite extensive research, uncertainty about the ideal target remains with many structures being underexplored. The aim of this report is to address a new target for DBS, the medial dorsal (MD) and the ventral anterior (VA) nucleus of the thalamus, which has thus far received little attention in the treatment of OCD.
Methods:
In this retrospective trial, four patients (three female, one male) aged 31-48 years, suffering from therapy-refractory OCD underwent high-frequency DBS of the MD and VA. In two patients (de novo group) the thalamus was chosen as a primary target for DBS, whereas in two patients (rescue DBS group) lead implantation was performed in a rescue DBS attempt following unsuccessful primary stimulation.
Results:
Continuous thalamic stimulation yielded no significant improvement in OCD symptom severity. Over the course of thalamic DBS symptoms improved in only one patient who showed "partial response" on the Yale-Brown Obsessive Compulsive (Y-BOCS) Scale. Beck Depression Inventory scores dropped by around 46% in the de novo group; anxiety symptoms improved by up to 34%. In the de novo DBS group no effect of DBS on anxiety and mood was observable.
Conclusion:
MD/VA-DBS yielded no adequate alleviation of therapy-refractory OCD, the overall strategy in targeting MD/VA as described in this paper can thus not be recommended in DBS for OCD. The magnocellular portion of MD (MDMC), however, might prove a promising target in the treatment of mood related and anxiety disorders.