OpenMed/multicare-articles huggingface dataset:
Case report: Successful combination of CLL1 CAR-T therapy and hematopoietic stem cell transplantation in a 73-year-old patient diagnosed with refractory acute myeloid leukemia
Authors: Yifan Zhao, Hao Wang, Yu Zhang, Yi Zhang, Xiaomei Zhang, Mohan Zhao, Jile Liu, Shujing Guo, Mingfeng Zhao
Journal: Front Immunol (2024)
Keywords: cll1, acute myeloid leukemia, chimeric antigen receptor t cell, hematopoietic stem cell transplantation, older
MeSH terms: Hematopoietic Stem Cell Transplantation / adverse effects, Immunotherapy, Adoptive / methods, Leukemia, Myeloid, Acute / therapy, Case Reports, Aged, Combined Modality Therapy, Humans, Male, Remission Induction, Treatment Outcome

The incidence of Acute myeloid leukemia (AML) increases with advancing age, and the prognosis for elderly patients is significantly poorer compared to younger patients. Although the combination therapy of venetoclax and hypomethylating agents has demonstrated improved prognosis in patients unable to tolerate intensive chemotherapy, there remains a therapeutic blank for those who fail to achieve remission with current treatment regimens. Here, we report the successful clinical utilization of autogenous CLL1 CAR-T therapy combined with hematopoietic stem cell transplantation in a 73-year-old patient diagnosed with refractory AML. The patient achieved morphological complete remission (CR) with incomplete marrow recovery and a slight presence of minimal residual disease (MRD) after receiving CLL1 CAR-T therapy. To further enhance the treatment and promote the recovery of hemopoiesis, we performed bridged allogenic hematopoietic stem cell transplantation (allo-HSCT) 20 days after the infusion of CLL1 CAR-T cells. The patient achieved MRD-negative CR following HSCT treatment. His primary disease maintained a complete remission status during the 11-month follow-up period. The patient encountered grade 2 cytokine release syndrome and grade 4 granulocytopenia subsequent to the infusion of CAR-T cells, while several rounds of infection and graft-versus-host disease were observed following allo-HSCT. Nevertheless, all these concerns were successfully addressed through comprehensive provision of supportive treatments. We have successfully demonstrated a highly effective and safe combination strategy involving CLL1 CAR-T therapy and allo-HSCT, which has exhibited remarkable tolerability and holds great promise even for elderly patients with AML.
Case Report: Primary malignant mesothelioma of the left atrium easily misdiagnosed as myxoma
Authors: Shuai Luo, Yao Li, Jin Li, Jiafei Zeng, Jinjing Wang
Journal: Front Cardiovasc Med (2024)
Keywords: diagnosis, differential diagnosis, left atrium, malignant mesothelioma, myxoma
MeSH terms: Case Reports

Background:
Malignant mesothelioma (MM) is a rare and aggressive tumor that is found in the pleura and peritoneum. A few cases of MM in the pericardium and tunica vaginalis testis have been reported. Moreover, primary occurrence in the atrium is extremely rare. The visual appearance of this tumor is similar to that of a common atrial myxoma, which makes it challenging for clinicians and radiologists to diagnose and treat this disease.
Case demonstration:
An 18-year-old woman presented with symptoms of chest pain, shortness of breath, cough, and expectoration for 7 days. Echocardiography was performed on the patient, which revealed an atrial mass. Myxoma was one of the differential diagnoses. The tumor was an elliptical mass with tips, and the cut surface was jelly-like, similar to myxoma. After surgery, a pathologic examination of the biopsied tumor confirmed epithelial-type MM. During postoperative follow-up, no recurrence of the tumor was observed.
Conclusions:
MM originating in the atrium is considered to be extremely rare. Consequently, clinicians can easily misdiagnose atrial MM as a myxoma. Moreover, to confirm the diagnosis, histopathologic biopsy, histomorphological characterization, immunohistochemistry, and molecular genetic testing are required. Therefore, clinical diagnosis and treatment of MM are challenging.
Syndromic epidermolysis bullosa simplex subtype due to mutations in the KLHL24 gene: series of case reports in Russian families
Authors: Yulia Y Kotalevskaya, Vadim A Stepanov
Journal: Front Med (Lausanne) (2024)
Keywords: klhl24 gene, epidermolysis bullosa simplex, genodermatosis, genotype–phenotype correlations, rare phenotype, syndromic epidermolysis bullosa
MeSH terms: Case Reports

Objective:
Epidermolysis bullosa simplex (EBS) is a common, well-characterized type of epidermolysis bullosa. However, some rare syndromic EBS phenotypes are not well described. The accumulation of clinical descriptions of patients with syndromic subtypes of EBS is important for understanding the natural history of the disease and assessing genotype-phenotype correlations.
Case summary:
We present a series of case reports of the syndromic subtype of EBS associated with mutations in the KLHL24 gene in seven patients from four unrelated families. The clinical features of this rare phenotype in children and adult patients are described in detail. In two families, we revealed pathogenic variant c.1A > G (p.Met1?) in the KLHL24 gene. The third family had c.3G > A (p.Met1?) mutation, and the fourth family had a novel de novo variant c.23del (p.Arg8AsnfsTer2).
Conclusion:
The description of the clinical manifestations of the disease in two generations of EBS families with different genetic variants allows the assessment and prediction of the natural course and severity of the disease in these families, the risk of complications, and the planning of the amount of medical care necessary.
Case report: two cases of rhabdomyolysis following esketamine treatment
Authors: René Zeiss, Melissa Schweizer, Bernhard Connemann, Kathrin Malejko
Journal: Front Psychiatry (2024)
Keywords: adr, adverse drug reaction, case report, esketamine, rhabdomyolysis, treatment-resistant depression
MeSH terms: Case Reports

Major depressive disorder is a mental disorder affecting millions of people worldwide. A considerable proportion of patients demonstrate a lack of response to conventional treatment. With the recent introduction of esketamine, a new treatment option has been approved for treatment-resistant depression. Although the medication is efficacious in a substantial portion of cases, rare, but possibly serious, adverse effects may occur. This case series shows two cases of rhabdomyolysis, a destruction of muscle tissue with elevated creatine kinase levels, after administration of esketamine. The first case presented is about a 33 year old male patient who suffered from a severe episode of a depressive disorder. He got nasal esketamine as an emergency treatment. While there was an initial improvement regarding the depressive symptoms, the patient developed muscle pain and fatigue after the administration of the fourth dose, with creatine kinase (CK) levels above 22,000 U/L, indicating rhabdomyolysis. Following the discontinuation of esketamine and the implementation of supportive care, the CK levels returned to normal and the depressive symptoms abated. The second case is about a 22-year-old male patient who also suffered from a severe depressive episode and got eketamine as an emergency treatment. Following the tenth dose, the patient exhibited muscle weakness and elevated CK levels (8,032 U/L), which persisted even after dose reduction. Esketamine administration was stopped, and the following monitoring demonstrated a slow return to normal levels of CK and liver enzymes. In both cases, there was no known medical history and both patients developed rhabdomyolysis after administration of esketamine. The temporal connection suggests a possible causal relationship. We found no literature on esketamine-induced rhabdomyolysis following the administration of nasal esketamine. However, these two cases emphasize the need of monitoring for laboratory changes like elevated CK-levels in patients receiving esketamine, especially considering its growing use in treatment-resistant depression.
Navigating Neurological and Cardiac Complexities: A Case Study on Viral Meningoencephalitis in a Patient With Ischemic Heart Disease
Authors: Han Grezenko, Faryal Zafar, Eemaz Nathaniel, Guillermo Aguirre, Shariq K Baluch, Muhammad Abubakar
Journal: Cureus (2024)
Keywords: cardiology, case report, ischemic heart disease, neurology, personalized medicine, viral meningoencephalitis
MeSH terms: Case Reports

We present a case of viral meningoencephalitis in a 40-year-old male with ischemic heart disease, a combination that is rare and presents unique diagnostic and therapeutic challenges. The patient's symptoms included high-grade fever, severe headache, projectile vomiting, and altered consciousness. The diagnosis was supported by MRI and CSF analysis. Management, complicated by the patient's cardiac condition, required a personalized approach, including antiviral therapy, corticosteroids, and vigilant monitoring of cardiac and neurological status. Treatment adjustments were made in response to the patient's evolving condition, leading to improvement within a week. This case underscores the need for a multidisciplinary approach in such complex scenarios, highlighting the significance of tailored care for patients with neurological symptoms and concurrent cardiac comorbidities. The report contributes to the literature on managing meningoencephalitis in patients with significant cardiac histories, underscoring personalized medicine's role in successful outcomes.
Multifocal Osteomyelitis in an Adolescent Patient With Cat Scratch Disease
Authors: Burcu Topçu, Hale Usluer Gönüllü, Osman Yeşilbaş, Pınar Polat Suma, Ahmet Soysal
Journal: Case Rep Infect Dis (2024)
Keywords: bartonella henselae, cat scratch disease, magnetic resonance imaging, osteomyelitis
MeSH terms: Case Reports

Cat scratch disease (CSD) typically presents as a self-limiting lymphadenopathy associated with a cat bite or scratch and commonly affects children and young adults. Atypical manifestations, involving the eyes, nervous system, heart, liver, spleen, skin, and musculoskeletal system, could be severe and difficult to diagnose, and they could occur in 5%-20% of the cases. Herein, we report an unusual case of CSD with multifocal osteomyelitis. A 15-year-old girl presented with right axillary lymphadenopathy. Since she had a history of cat scratch, azithromycin was started for CSD. Two days later, she was readmitted to our hospital with severe back pain which required differential diagnosis. Lumbar spinal magnetic resonance imaging (MRI) revealed multifocal vertebral osteomyelitis. The patient was hospitalized, and then teicoplanin and cefotaxime were added to the azithromycin therapy. After excluding the possible other causes, the definitive diagnosis of osteomyelitis secondary to CSD was made upon the combination of the MRI scan findings of the vertebrae, histopathological investigation of excisional right axillary biopsy, positron-emission tomography/computed tomography (PET/CT), and Bartonella henselae serologies. Atypical manifestations of CSD are widely variable; therefore, it should be kept in mind in the differential diagnosis of severe musculoskeletal pain and osteomyelitis.
Multiple Lower Limb Fractures in a Child With Spinal Muscular Atrophy Type 2: A Preventable Complication
Authors: Mounika Reddy, Vishnupriya Ambadas, Madhusudan Samprathi, Deepak Kumar Maley, Abhishek J Arora
Journal: Cureus (2024)
Keywords: bone mineral density, developmental delay disorders, early risk assessment, fragility fractures, neuromuscular diseases, pediatric genetics, physiotherapy education
MeSH terms: Case Reports

Patients with spinal muscular atrophy (SMA) are at risk of poor bone health and fractures. We report a child with SMA type 2, presenting with acute pain and swelling of both lower limbs following physiotherapy, and found to have multiple fractures in both lower limbs. Literature on fractures in children with SMA is limited. Awareness of risk assessment and appropriate preventive measures among healthcare providers caring for children with SMA is essential.
Outbreak of dermatophilosis in horses possibly transmitted by sharing riding equipment
Authors: Alfredo García Sánchez, Sofia Gabriela Zurita, Maria Gil Molino, Francisco Eugenio Martin Cano, Carmen Barraso Gil, Javier Hermoso de Mendoza Salcedo
Journal: Braz J Vet Med (2024)
Keywords: dermatophilosis, equine center, fomites, indirect transmission, individual stable
MeSH terms: Case Reports

The aim of this study is to describe an outbreak of dermatophilosis at an equestrian center in Castilla la Mancha (central Spain), which affected 16.6% (5/30) of the animals. Research was carried out to establish the mode of transmission and spread to other horses in the herd. Clinical features, diagnostic methods and treatment are also described.
Primary pulmonary nuclear protein of the testis midline carcinoma: case report and systematic review with pooled analysis
Authors: Dong Zhao, Wei Cao, Shiqian Zha, Yixuan Wang, Zhou Pan, Jingyi Zhang, Ke Hu
Journal: Front Oncol (2024)
Keywords: nut midline carcinoma (nmc), nuclear protein of the testis, pleural effusion, pulmonary, survival
MeSH terms: Systematic Review

Nuclear protein of the testis (NUT) midline carcinoma (NMC) is a rare tumor, with particularly low incidence in the lungs, and a correspondingly poor prognosis. To determine the clinicopathological characteristics, outcomes, and prognostic factors of primary pulmonary NMC, a case was reported and a systematic review was performed. Twenty-nine records, including ours, involving 62 cases, were finally included. The median age at diagnosis was 29.5 years. At presentation, the most common symptoms at presentation were cough (47.50%) and chest/back pain (37.50%). In terms of diagnosis, 32.14% of NMC cases were identified through immunohistochemistry (IHC); However, a greater number of cases may be misdiagnosed initially, and ultimately, the diagnosis of NMC was confirmed through a combination of IHC and fluorescence in situ hybridization (FISH). Despite the clinical application of various chemotherapy-based treatments, the actual effectiveness remains unsatisfactory. Furthermore, Cox regression analysis of multiple factors identified male gender and concurrent presence of pleural effusion as indicators of shorter survival time in patients. These results emphasize the importance of increased diagnostic awareness among clinical and pathology practitioners concerning NMC. While there is currently no established standard for treating NMC, a treatment approach combining multiple methods shows promise for future research. Concurrently, clinical and foundational investigations addressing variables such as gender and the presence of pleural effusion may yield valuable insights into the diagnosis and treatment of NMC.
Analysis of a case report of meningitis caused by Listeria monocytogenes
Authors: Lihui Chen, Manman Pei, Xingxing Wang, Yongfeng Zhang, Yuquan Ma, Yifei Chen, Ishtiaq Ahmad
Journal: Front Med (Lausanne) (2024)
Keywords: listeria monocytogenes, antibiotic therapy, case report, foodborne, meningitis
MeSH terms: Case Reports

Background:

Listeria monocytogenes is a Gram-positive bacterium transmitted to humans through contaminated food, water, and animal faeces, posing a public health risk. Listeria monocytogenes is difficult to isolate and is not sensitive to first-line treatment with broad-spectrum cephalosporins for bacterial meningitis. Listeria meningitis is rare but can progress rapidly and may be accompanied by serious complications (hydrocephalus, ventricular inflammation, cerebral palsy, and brain abscess) and a high mortality rate.
Case presentation:
It is a retrospective analysis of the clinical characteristics and treatment of a rare case of Listeria monocytogenes infection. Using laboratory indicators such as white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT), three detection methods (cerebrospinal fluid/blood culture), Targeted gene sequencing technology (tNGS), and Metagenomic next-generation sequencing technology (mNGS) combined with clinical manifestations of patients, analyze the use plan and prognosis of antibiotics in patients. The patient in this case initially had neurological symptoms such as fever, headache, unclear consciousness, and vomiting; laboratory indicators include elevated WBC, CRP, and PCT. Listeria monocytogenes was cultured in both the patient's cerebrospinal fluid and blood samples. After treatment with penicillin and meropenem, the patient recovered and was discharged without any sequelae.
Conclusion:
Due to the rarity of Listeria monocytogenes, there may be deficiencies and difficulties in clinical differential diagnosis, making it difficult to achieve targeted antibiotic treatment. Therefore, accurate identification of Listeria monocytogenes and relevant laboratory inflammation indicator testing, combined with traditional culture methods and NGS testing, through empirical coverage of Listeria monocytogenes, targeted antibiotic treatment ultimately impacts clinical outcomes significantly.
Successful treatment of lung adenocarcinoma complicated with a rare compound EGFR mutation L833V/H835L using aumolertinib: a case report and literature review
Authors: Linlin Li, Siyuan Huang, Liying Qin, Ningning Yan, Shujing Shen, Xingya Li
Journal: Front Pharmacol (2023)
Keywords: l833v/h835l, nsclc, aumolertinib, case report, epidermal growth factor receptor
MeSH terms: Case Reports

Background: The deletion of exon 19 and the Leu858Arg mutation of exon 21 are the most frequently observed mutations in the epidermal growth factor receptor (EGFR) gene, and patients with these mutations have shown significant benefits from EGFR-tyrosine kinase inhibitors (TKIs). However, there exists a small subgroup of patients with uncommon/rare mutations of EGFR, including compound mutations, which display a high degree of heterogeneity in terms of clinical features and variable sensitivities to EGFR-TKIs. The understanding of these uncommon mutations and their response to targeted therapy is still unclear and requires further investigation. Case presentation: We presented a case of a never-smoking patient with lung adenocarcinoma and brain metastasis. Initially, she received chemotherapy plus immune checkpoint inhibitor as first-line therapy as no EGFR mutations were detected by amplification-refractory mutation system-polymerase chain reaction. However, disease progressed rapidly. Subsequently, next-generation sequencing was carried out and revealed a rare compound mutation, L833V/H835L, in exon 21 of EGFR. As a result, she was switched to second-line therapy with the third-generation TKI aumolertinib, which demonstrated good efficacy. The patient was evaluated for a remarkable progression-free survival of 18 months and an overall survival of 29 months. Conclusion: The present study supports that aumolertinib might be a good treatment option for advanced NSCLC patients with EGFR L833V/H835L mutation, particularly in patients with brain metastasis. Furthermore, conducting a comprehensive screening for gene mutations is crucial in effectively identifying potential oncogenic driver mutations and guiding mutation-targeted therapy decisions in clinical practice.
Oral diet management for carcinoma at the base of tongue with radiotherapy and chemotherapy associated dysphagia: a case report
Authors: Zhen Ding, Lingmei Zhou, Kemei Jin, Runjinxing Wu, Yihua Gui
Journal: Front Nutr (2023)
Keywords: case report, dysphagia, nutritional management, thickener, tongue cancer
MeSH terms: Case Reports

Introduction:
Tongue cancer is one of the common malignancy of the head and neck, and directly impacts chewing, swallowing, and other eating activities. Based on the evidence-based guidelines and clinical management, this paper presents nutrition management experience of a patient with tongue cancer who had a dysphagia and feeding reflux while undergoing radiotherapy and chemotherapy.
Methods:
Nutritional risk screening and comprehensive nutritional assessment were performed based on the patient's medical history, and personalized nutritional programs were developed under the guidance of the clinical pharmaceutical consensus of parenteral nutrition and nutritional treatment guidelines for patients with tumors during radiotherapy. For the management of oral feeding, the patient's swallowing function was evaluated to manage oral feeding. Thickening powders were used to improve the consistency of the patient's food, which successfully achieved oral feeding of the patient.
Results:
The patient finally ate five meals a day by mouth, and energy requirements were met using industrialized nutritional supplements, and homogenized food was added in between the meals. The energy provided by enteral nutrition can reached approximately 60-75%. The patient's weight and albumin levels had increased significantly at the time of discharge.
Discussion:
The nutritional management of patients with dysphagia should be jointly managed by clinicians, nurses, nutritionists, and family members to effectively improve the quality of life (QOL) and nutritional status of patients. To ensure adequate nutritional supply, appropriate swallowing training may delay the deterioration of the chewing function and improve the eating experience of such patients.
Case report: PCA-2-associated encephalitis with different clinical phenotypes: a two-case series and literature review
Authors: Xiaona Li, Yue Lang, Di Ma, Jing Bai, Pingping Shen, Xinyu Wang, Li Cui
Journal: Front Immunol (2024)
Keywords: map1b, pca-2, pet-ct, autoimmune cerebellitis, limbic encephalitis, paraneoplastic neurologic syndrome
MeSH terms: Phenotype, Case Reports, Review, Aged, Antigens, Neoplasm / immunology, Autoantibodies / blood, Autoantibodies / immunology, Encephalitis / diagnosis, Encephalitis / immunology, Female, Humans, Limbic Encephalitis / diagnosis, Limbic Encephalitis / immunology, Magnetic Resonance Imaging, Male, Middle Aged, Positron Emission Tomography Computed Tomography, Autoantibodies, Antigens, Neoplasm

Purkinje cell cytoplasmic antibody type 2 (PCA-2), identified in 2000, targets the widely distributed microtubule-associated protein 1B in the central and peripheral nervous systems, leading to diverse clinical phenotypes of neurological disorders. We report two cases of PCA-2-associated encephalitis, each presenting with distinct onset forms and clinical manifestations, thereby illustrating the phenotypic variability of PCA-2-related diseases. The first patient was diagnosed with PCA-2-associated autoimmune cerebellitis and undifferentiated small cell carcinoma with metastasis in mediastinal lymph nodes of unknown primary origin. The second patient was diagnosed with PCA-2-associated limbic encephalitis. Our findings underscore the superior sensitivity of positron emission tomography-computed tomography over brain magnetic resonance imaging in the early detection of PCA-2-associated encephalitis. Given the high risk of relapse and suboptimal response to traditional immunotherapy in PCA-2-related neurological disorders, this study highlights the need for a deeper understanding of their pathogenesis to develop more effective treatments to control symptoms and improve patient prognosis.