OpenMed/multicare-articles huggingface dataset:
Case Report: Three cases of clinically suspected viral myocarditis with recovery of left ventricular dysfunction
Authors: Jonathan Brown, Hytham Rashid, Siva T Sarva, Suhas Tatapudi, Jeby Kalathoor, Aswin Srinivasan, Michael Daniel, Syed Raza
Journal: Front Cardiovasc Med (2024)
Keywords: cardiogenic shock, coxsackievirus, heart failure, myocarditis, non-ischemic cardiomyopathy
MeSH terms: Case Reports

Viral myocarditis is an important cause of non-ischemic cardiomyopathy. Multiple clinical manifestations have been reported, including acute heart failure, cardiogenic shock, and ventricular arrhythmias. We present three patients with clinically suspected viral myocarditis causing acute heart failure. Serum coxsackievirus B antibodies were positive in all three patients. Each case resulted in significant clinical improvement with hemodynamic support and acute recovery of left ventricular ejection fraction. Despite an initial critical presentation concerning for cardiogenic shock, we highlight three cases of clinically suspected coxsackie myocarditis with an excellent short-term prognosis.
Pleural empyema by Parvimonas micra in an immunocompetent patient: a case report
Authors: Stalin Vilcarromero, Max Small, Alexis Lizarzaburu, Abel Rivadeneyra-Rodriguez
Journal: Rev Peru Med Exp Salud Publica (2023)
MeSH terms: Empyema, Pleural / diagnosis, Case Reports, Base Composition, Humans, Phylogeny, RNA, Ribosomal, 16S, Sequence Analysis, DNA, RNA, Ribosomal, 16S, Parvimonas micra

We present the case of a young immunocompetent patient, with a history of pulmonary tuberculosis, who attended the hospital with a subacute clinical picture of persistent fever, weight loss, dyspnea and abolition of vesicular murmur. Chest CT scan showed an extensive empyema in the left hemithorax. Samples were taken for detection of common germs. Then, a chest drainage tube was placed and antibiotic therapy started. The MALDI-TOF MS test identified Parvimonas micra, an anaerobic bacterium, commensal to the oral flora, associated with severe periodontitis, but rarely reported in cases of pleural empyema, especially in immunocompetent patients. Gingivitis and pericoronaritis of the third molar were diagnosed during oral evaluation. The patient progressed favorably. Parvimonas micra should be considered as a possible etiological agent in cases of subacute or chronic pleural empyema, in addition to mycobacteria. Tests such as MALDI-TOF MS or 16S rRNA sequencing, chest tube placement, empirical antibiotic coverage and an adequate oral evaluation should be considered in these cases.
Retinoid Therapy in a Case of Harlequin Ichthyosis with a Short Literature Review
Authors: Emad Bahashwan, Jaber Alfaifi, Sahar Elmaghawri Mohamed Moursi, Youssef Elbayoumi Soliman
Journal: Case Rep Dermatol Med (2024)
MeSH terms: Case Reports

Harlequin ichthyosis (HI) is a genetically inherited epidermal disorder due to the mutation of the ABCA12 gene, which is responsible for lipid transportation, and presents with large keratinised scales characterised by deep erythematous fissures, with ectropion and eclabium. A moderate number of cases and a high mortality rate have been recorded. In this case report, a pregnant lady gave birth to a 33-week-old premature foetus with characteristic symptoms of HI. After admitting him to the NICU, a multidisciplinary treatment approach was conducted with paediatric dermatologists, ophthalmologists, urologists, and dieticians. The prognosis is positive, with desquamation of the hyperkeratotic plate revealing an erythematous and shiny skin. A short literature review on HI characteristics, diagnostic aids, and management has also been added.
Case report: Dendritic cell-cytokine induced killer cell therapy in subjects with chronic lymphocytic leukemia and peritoneal cancer
Authors: Brian Mehling, DongCheng Wu, Ellen O'Gorman, Daniel Sheridan, Doreen Santora, Renata Mihályová
Journal: Front Med (Lausanne) (2023)
Keywords: cancer, cytokine-induced killer cells, dendritic cells, immunotherapy, leukemia, peritoneal cancer
MeSH terms: Case Reports

This study aimed to characterize the safety and efficacy of DC-CIK therapy in two patients with previously treated chronic lymphocytic leukemia or peritoneal cancer, respectively. Participants had received conventional chemotherapy treatment for their specific cancers, and in addition, 1-2 treatments of DC-CIK therapy were administered to subjects over the course of 1 year. Subject A received an initial dosage of 3 intravenous infusions of DC-CIK therapy on three successive days and a repeat dosage 6 months later. Subject B received an initial dosage of 3 intravenous infusions of DC-CIK therapy on three successive days and received further chemotherapy after approximately 1 year. No treatment-related adverse events were reported, and both patients experienced favorable outcomes from the treatment, including enhanced treatment response, increased chemotherapy tolerance, and prolonged survival in comparison to typical 5-year survival rates.
Popliteal artery pseudoaneurysm of spontaneous occurrence: a case report
Authors: Wallace Klein Schwengber, Claudia Carolina Schnorr, Guilherme Camargo Winckler, Ricardo Bocchese Paganella, Marco Aurélio Grudtner
Journal: J Vasc Bras (2024)
Keywords: idiopathic, popliteal artery, pseudoaneurysm
MeSH terms: Case Reports

Idiopathic popliteal artery pseudoaneurysms are exceedingly rare, posing significant diagnostic challenges due to their elusive etiology. This report presents the case of a 78-year-old female with no history of trauma or orthopedic procedures who was diagnosed with a large pulsatile mass in the right popliteal fossa. Arteriography confirmed a popliteal artery pseudoaneurysm. Despite extensive clinical evaluation, no causative factors were identified, suggesting an idiopathic diagnosis. The patient underwent open surgical repair using a posterior approach, during which the popliteal artery defect was closed using a bovine pericardium patch. Postoperative follow-up revealed proximal patch stenosis, necessitating angioplasty. This case underscores the need for comprehensive diagnostic evaluation of atypical pseudoaneurysm presentations and highlights the complexities involved in managing idiopathic cases, emphasizing the importance of postoperative follow-up to address potential complications.
Bilateral Glaucoma as Possible Additional Feature for PGAP3-Associated Hyperphosphatasia
Authors: Osama Obaid, Reem Batawi, Heba Alqurashi, Thana Ewis, Ahmad A Obaid
Journal: Case Rep Genet (2024)
MeSH terms: Case Reports

Hyperphosphatasia with mental disorder (HPMRS) is a rare autosomal recessive disease caused by gene mutations in enzymes involved in the synthesis and remodeling of lipids. Seven-month-old boy diagnosed with bilateral glaucoma had a cleft palate, facial dysmorphism, hypertelorism, a broad nasal bridge, and large fleshy earlobes. A brain MRI scan also revealed brain abnormalities. The observed phenotype in a seven-month-old boy is in agreement with the phenotypic features of HPRMS type-4. Whole exome sequencing revealed a possible pathogenic variant of PGAP3 in a homozygous state (c.320C > T, p.Ser107Leu) which supported the diagnosis of HPRMS type-4. We report an unusual presentation for HPMRS and suggest adding this syndrome to the list of differential diagnoses of syndromic congenital glaucoma.
Fertility-Preserving Surgery in a Young Nulligravid Woman with Bilateral Coexistence of a Granulosa Cell Tumor with a Teratoma
Authors: Pham Ba Nha, Pham Van Tuyen, Nguyen Viet Ha, Nguyen Thi Thu Phuong
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Background:
The coexistence of a granulosa cell tumor with a teratoma is extremely rare and impossible to diagnose preoperatively. For most patients with advanced age and stage, the standard treatment is hysterectomy and bilateral salpingo-oophorectomy; however, fertility-preserving surgery should be considered for young nulligravid women.
Case:
We present a case of a 24-year-old nulligravid female with bilateral adnexal masses, imaging findings of ovarian teratomas, and normal levels of tumor markers. A laparotomy revealed bilateral dermoid cysts, and solid tissue invaded most of the remaining ovarian parenchyma with no signs of malignancy in the uterus and peritoneum space. Consequently, a bilateral oophorectomy was performed to preserve her fertility. Histopathology examination showed mature cystic teratomas coexisting with granulosa cell tumors on both ovaries. Within six months, there were no signs of recurrence on ultrasonography and tumor makers. Combined oral contraceptive pills were prescribed as hormone replacement therapy.
Conclusion:
Fertility-preserving surgery can be performed in young women with an ovarian granulosa cell tumor coexisting with a teratoma. Long-term examination, hormone replacement therapy, and in vitro fertilization are required.
Artri King-induced Hypothalamic-pituitary-adrenal Axis Disruption: A Report of 3 Cases
Authors: Elyssa Ann Berg, Lisa Dao, Run Yu, Carolina Hurtado
Journal: JCEM Case Rep (2023)
Keywords: artri king, cushing syndrome, iatrogenic adrenal insufficiency, supplement use
MeSH terms: Case Reports

We present a case series of 3 patients who developed iatrogenic hypothalamic-pituitary-adrenal axis disruption while taking Artri King, an over-the-counter supplement marketed for joint pain that is reported to contain dexamethasone not listed on the supplement's label. Patient 1, a 58-year-old woman, presented with persistent hyponatremia, weight gain, proximal muscle weakness, dorsocervical fat pad, and new, red striae on her breast and abdomen in the setting of Artri King use. Her dexamethasone level was elevated (Table 1), confirming the suspicion of dexamethasone content in this supplement. Patient 2, a 55-year old woman, had presented with cushingoid features and a low morning cortisol level (Table 1) in the setting of Artri King use. Patient 3, a 59-year-old man, presented with poorly controlled diabetes in the setting of Artri King use and an elevated serum dexamethasone level. Supplements containing hidden glucocorticoids can cause not only iatrogenic Cushing syndrome, but also adrenal suppression, providing a diagnostic challenge for providers.
Case report: The first description of a thyroglossal duct cyst in a hen (Gallus gallus domesticus)
Authors: Romelia Pop, Stephanie Oren, Andrada Negoescu, Cornel Cătoi, Alexandru-Flaviu Tăbăran
Journal: Front Vet Sci (2024)
Keywords: embryological defect, first description, hen, histopathology, thyroglossal duct cyst
MeSH terms: Case Reports

Thyroglossal duct cyst represents a congenital anomaly of the cervical region, rarely documented in animals. Although previously reported in dogs, cats, horses, goats, pigs, and calves, never in birds. This report describes a rare case of thyroglossal duct cyst in a hen. A necropsy of a Transylvanian Naked Neck hen carried following diphtheroid mucocutaneous lesions. The necropsy revealed a large, cyst-like structure measuring 0.5 cm at the level of the caudal edge of the left thyroid gland. Histologically, the cystic mass, bordered by 1-2 lines of well-differentiated ciliated cuboidal cells, presented nuclear immunoreactivity for Thyroid transcription factor 1. To the best of the authors' knowledge, there are no previous records of thyroglossal duct cysts in avians. Moreover, this is the first case describing a thyroglossal duct cyst in a hen.
Pemphigus vulgaris as an immune-related adverse event in recurrent metastatic esophageal squamous cell carcinoma treated with ipilimumab plus nivolumab: a case report and literature review
Authors: Hajime Nakamura, Aika Shionoya, Yohei Arihara, Naotaka Hayasaka, Tomohiro Kubo, Makoto Usami, Shintaro Sugita, Hisashi Uhara, Kohichi Takada
Journal: Front Immunol (2023)
Keywords: esophageal squamous cell carcinoma, immune-related adverse events, ipilimumab, nivolumab, pemphigus vulgaris
MeSH terms: Esophageal Neoplasms / drug therapy, Esophageal Squamous Cell Carcinoma / diagnosis, Esophageal Squamous Cell Carcinoma / drug therapy, Pemphigus / diagnosis, Pemphigus / drug therapy, Review, Case Reports, Humans, Ipilimumab / adverse effects, Nivolumab / adverse effects, Ipilimumab, Nivolumab

Ipilimumab plus nivolumab therapy is approved for patients with unresectable advanced esophageal squamous cell carcinoma (ESCC). Although a combination of immune checkpoint inhibitors (ICIs), compared to conventional chemotherapy, can improve overall survival in patients with advanced ESCC, this increases the incidence of immune-related adverse events (irAEs). Here, we describe an ESCC case that developed pemphigus vulgaris (PV), an extremely rare cutaneous irAE, during ipilimumab plus nivolumab treatment. The patient achieved a partial response to treatment. The PV was successfully managed after the cessation of ipilimumab and the use of a topical steroid. We should thus re-treat ESCC with nivolumab monotherapy. In the era of ICIs as standard cancer therapeutics, diagnostic criteria for blistering diseases need to be established to properly manage patients with cutaneous irAEs.
Thrombocytopenia and hyperprogression after radiotherapy and camrelizumab treatment in an esophageal cancer patient with increased JAK2 gene copies: a case report
Authors: Hang Wang, Yun Li, Min Qiu, Jianmin Wang
Journal: Front Oncol (2024)
Keywords: jak2/stat3 pathway, esophageal cancer, immune checkpoint inhibitor, radiotherapy, thrombocytopenia
MeSH terms: Case Reports

Radiotherapy (RT) and immune checkpoint inhibitor (ICI) are important treatments for esophageal cancer. Some studies have confirmed the safety and effectiveness of using RT in combination with ICI, while serious side effects have been exhibited by some patients. We report a patient with metastatic esophageal cancer who received RT combined with ICI. The patient experienced severe thrombocytopenia, and treatment with thrombopoietin and corticosteroids were ineffective. Finally, the patient developed abscopal hyperprogression outside the radiation field. Interestingly, next-generation sequencing revealed increased JAK2 gene copies in the surgical slices. The JAK2/STAT3 pathway is involved in the regulation of megakaryocyte development. Recurrent thrombocytopenia may activate the JAK2/STAT3 pathway, leading to megakaryocyte differentiation and platelet biogenesis. However, persistent activation of the JAK2/STAT3 pathway has been associated with immune ICI resistance and tumor progression. This case indicates that thrombocytopenia and increased JAK2 gene copies may be risk factors for poor prognosis after ICI and RT treatment.
Case report: Potential role of immunotherapy in thymic malignancies: a unique case of a durable and complete response upon an immune checkpoint inhibitor
Authors: Angelo Luciano, Erica Pietroluongo, Margaret Ottaviano, Angela Grieco, Annarita Peddio, Pietro De Placido, Alberto Servetto, Massimo Mascolo, Silvia Varricchio, Roberto Bianco, Giovannella Palmieri, Mario Giuliano
Journal: Front Immunol (2024)
Keywords: good’s syndrome, autoimmunity, immune-related adverse events, immunotherapy, thymomas
MeSH terms: Immune Checkpoint Inhibitors / adverse effects, Immune Checkpoint Inhibitors / therapeutic use, Thymus Neoplasms / drug therapy, Thymus Neoplasms / immunology, Thymus Neoplasms / therapy, Case Reports, Humans, Immunotherapy / adverse effects, Immunotherapy / methods, Male, Middle Aged, Myocarditis / drug therapy, Myocarditis / etiology, Myocarditis / immunology, Myocarditis / therapy, Neoplasms, Glandular and Epithelial, Nivolumab / adverse effects, Nivolumab / therapeutic use, Thymoma / immunology, Thymoma / therapy, Treatment Outcome, Immune Checkpoint Inhibitors, Nivolumab, Thymic epithelial tumor

Thymic epithelial tumors are rare malignancies with an incidence of 1.7 cases per million people per year. They pose significant management challenges due to their association with autoimmune disorders. In this case report, we present the 21-year history of a patient diagnosed with advanced B2/B3 thymoma and Good's syndrome. The patient achieved a complete and durable response after receiving only two cycles of the immune checkpoint inhibitor Nivolumab. However, this positive outcome was accompanied by the development of severe immune-related myocarditis complicated by reactivation of cytomegalovirus. Moreover, the patient developed a highly uncommon subdiaphragmatic pararectal dissemination of the thymic tumor, which is a condition rarely described in the literature. Despite the success in achieving complete and durable response with immune checkpoint inhibitors, the emergence of immune-related adverse events highlights the potential challenges associated with these treatments, emphasizing the need for careful monitoring and a comprehensive understanding of the intricate interplay between cancer, immune system dysregulations and immunotherapy.
Rehabilitation to Complement Unique Single-Stage Core Decompression and Total Hip Arthroplasty in Bilateral Avascular Necrosis: A Case Report
Authors: Arjavi A Pakhan, Pratik Phansopkar, Manali A Boob
Journal: Cureus (2024)
Keywords: avascular necrosis of the hip, biomechanics, core decompression, physical therapy, total hip arthroplasty
MeSH terms: Case Reports

Avascular necrosis (AVN), a debilitating condition characterized by bone tissue death due to inadequate blood supply, can severely impact the hip joint, leading to pain, limited mobility, and joint dysfunction. The complex blood supply and mechanical stress on the hip make it particularly vulnerable to AVN. Early detection is challenging as AVN may remain asymptomatic initially, but as it progresses, it results in severe joint degeneration. This case report outlines the management of a 38-year-old male patient with a dermatomyositis history who presented with bilateral hip pain attributed to AVN. Radiological investigations diagnosed grade 2 AVN in the left hip and grade 3 AVN in the right hip. The patient underwent core decompression for the left hip to halt disease progression and total hip arthroplasty (THA) for the right hip to alleviate pain and restore function. A structured three-week rehabilitation program was tailored to each surgical procedure, with pre-and post-treatment assessments revealing notable improvements in pain relief, range of motion (ROM), and muscle strength. This case underscores the importance of early diagnosis, personalized surgical interventions, and comprehensive rehabilitation in managing AVN in dermatomyositis patients. Physiotherapy is vital pre- and post-operatively to enhance physical function, strength, and mobility. Rehabilitation also plays a crucial role in postoperative recovery, early mobilization, and functional restoration. The multifaceted approach employed in this case highlights the need for a comprehensive strategy when managing AVN in dermatomyositis patients, providing valuable insights for similar cases.
A riboflavin transporter deficiency presenting as pure red cell aplasia: a pediatric case report
Authors: Jingying Cheng, Jiafeng Yao, Shasha Zhao, Lingling Fu, Liqiang Zhang, Jin Jiang
Journal: Front Pediatr (2024)
Keywords: slc52a2, children, genetic testing, pure red cell aplasia, riboflavin
MeSH terms: Case Reports

Introduction:
Riboflavin transporter deficiency (RTD) is a rare genetic disorder that affects riboflavin transport, leading to impaired red blood cell production and resulting in pure red cell aplasia. Recognizing and understanding its clinical manifestations, diagnosis, and management is important.
Case presentation:
A 2-year-old patient presented with pure red cell aplasia as the primary symptom of RTD. After confirming the diagnosis, rapid reversal of anemia was achieved after high-dose riboflavin treatment.
Conclusion:
RTD often has an insidious onset, and neurological symptoms appear gradually as the disease progresses, making it prone to misdiagnosis. Genetic testing and bone marrow biopsy can confirm the diagnosis.
Real-time polymerase chain reaction detection and surgical treatment of thoracic and lumbar spondylitis due to Brucella infection: two typical case reports
Authors: Bo Liu, Yun-Xiao Ji, Chang-Song Zhao, Qiang Zhang
Journal: Front Public Health (2024)
Keywords: brucellosis, gram staining, brucellosis spondylitis, case report, foraminal endoscopy, real-time pcr, surgery treatment
MeSH terms: Brucellosis / diagnosis, Brucellosis / drug therapy, Brucellosis / surgery, Lumbar Vertebrae / surgery, Real-Time Polymerase Chain Reaction, Spondylitis / diagnostic imaging, Spondylitis / drug therapy, Spondylitis / surgery, Thoracic Vertebrae / surgery, Case Reports, Anti-Bacterial Agents / therapeutic use, Brucella / isolation & purification, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Anti-Bacterial Agents

Background:
Spondylitis caused by Brucella infection is a rare but challenging condition, and its successful management depends on timely diagnosis and appropriate treatment. This study reports two typical cases of thoracic and lumbar brucellosis spondylitis, highlighting the pivotal roles of real-time polymerase chain reaction (real-time PCR) detection and surgical intervention.
Case presentation:
Case 1 involved a 49-year-old male shepherd who presented with a 6-month history of fever (40°C), severe chest and back pain, and 2-week limited lower limb movement with night-time exacerbation. Physical examination revealed tenderness and percussion pain over the T9 and T10 spinous processes, with grade 2 muscle strength in the lower limbs. CT showed bone destruction of the T9 and T10 vertebrae with narrowing of the intervertebral space, whereas MRI demonstrated abnormal signals in the T9-T10 vertebrae, a spinal canal abscess, and spinal cord compression. The Rose Bengal plate agglutination test was positive. Case 2 was a 59-year-old man who complained of severe thoracolumbar back pain with fever (39.0°C) and limited walking for 2 months. He had a 2.5 kg weight loss and a history of close contact with sheep. The Rose Bengal test was positive, and the MRI showed inflammatory changes in the L1 and L2 vertebrae. Diagnosis and treatment: real-time PCR confirmed Brucella infection in both cases. Preoperative antimicrobial therapy with doxycycline, rifampicin, and ceftazidime-sulbactam was administered for at least 2 weeks. Surgical management involved intervertebral foraminotomy-assisted debridement, decompression, internal fixation, and bone grafting under general anesthesia. Postoperative histopathological examination with HE and Gram staining further substantiated the diagnosis. Outcomes: both patients experienced significant pain relief and restored normal lower limb movement at the last follow-up (4-12 weeks) after the intervention.
Conclusion:
Real-time PCR detection offers valuable diagnostic insights for suspected cases of brucellosis spondylitis. Surgical treatment helps in infection control, decompression of the spinal cord, and restoration of stability, constituting a necessary and effective therapeutic approach. Prompt diagnosis and comprehensive management are crucial for favorable outcomes in such cases.