OpenMed/multicare-articles huggingface dataset:
Bilateral Vestibular Dysfunction Associated With Chronic Exposure to Military Jet Propellant Type-Eight Jet Fuel
Authors: Terry D Fife, Michael J A Robb, Kristen K Steenerson, Kamala C Saha
Journal: Front Neurol (2018)
Keywords: jp-8, jp-8 jet fuel, bilateral vestibular dysfunction, hydrocarbons, jet propulsion fuel-8, ototoxicity, rotational chair, vestibulotoxicity
MeSH terms: Case Reports

We describe three patients diagnosed with bilateral vestibular dysfunction associated with the jet propellant type-eight (JP-8) fuel exposure. Chronic exposure to aromatic and aliphatic hydrocarbons, which are the main constituents of JP-8 military aircraft jet fuel, occurred over 3-5 years' duration while working on or near the flight line. Exposure to toxic hydrocarbons was substantiated by the presence of JP-8 metabolite n-hexane in the blood of one of the cases. The presenting symptoms were dizziness, headache, fatigue, and imbalance. Rotational chair testing confirmed bilateral vestibular dysfunction in all the three patients. Vestibular function improved over time once the exposure was removed. Bilateral vestibular dysfunction has been associated with hydrocarbon exposure in humans, but only recently has emphasis been placed specifically on the detrimental effects of JP-8 jet fuel and its numerous hydrocarbon constituents. Data are limited on the mechanism of JP-8-induced vestibular dysfunction or ototoxicity. Early recognition of JP-8 toxicity risk, cessation of exposure, and customized vestibular therapy offer the best chance for improved balance. Bilateral vestibular impairment is under-recognized in those chronically exposed to all forms of jet fuel.
Unicentric Castleman's disease located between the aorta and inferior vena cava: A case report
Authors: Masaki Murata, Oki Nagano, Go Hasegawa, Yohei Ikeda, Yuki Nakagawa, Yoshinobu Seki, Tsutomu Nishiyama, Yoshihiko Tomita
Journal: SAGE Open Med Case Rep (2019)
Keywords: castleman’s disease, retroperitoneal tumor, unicentric
MeSH terms: Case Reports

We report a 70-year-old woman diagnosed with unicentric Castleman's disease with a contrast well-enhanced retroperitoneal tumor of 25 mm in diameter that located between the aorta and inferior vena cava. The imaging finding did not suggest any specific features, and no other lesion was detected. Laboratory examinations indicating malignant lymphoma such as soluble interleukin-2 were all negative. We resected the retroperitoneal tumor laparoscopically, and histopathological examination revealed hyaline vascular type Castleman's disease. Although complete resection of hyaline vascular type unicentric Castleman's disease results in a good prognosis, a late relapse has been reported and long-term follow-up is warranted.
Angle Closure Glaucoma in Retinitis Pigmentosa
Authors: Chandni Pradhan, Simanta Khadka, Purushottam Joshi
Journal: Case Rep Ophthalmol Med (2020)
MeSH terms: Case Reports

Background:
Angle closure glaucoma (ACG) whether primary or secondary lens induced has rare occurrence in cases with retinitis pigmentosa (RP).
Method:
Five patients with history of diminished vision, ocular pain, and nyctalopia were clinically evaluated. Four patients had unilateral presentations of circumciliary congestion, corneal edema, and high intraocular pressure (IOP), while one had bilateral presentation, respectively. Anterior chambers were shallow; fundoscopy revealed the features of RP and gonioscopy affirmed closed angles in all the cases. The management strategies were individualized based on the specific ocular condition.
Result:
The raised IOP were not well controlled with conventional medical treatment. Neodymium yttrium aluminium garnet laser peripheral iridotomy (LPI) was performed in two patients and in the fellow eye in other two patients as a prophylactic measure. Phacoemulsification surgery with implantation of intraocular lens (IOL) was performed in three patients, whereas phacoemulsification only without IOL and trabeculectomy performed in one patient. Among them, two patients had subluxated lens, where one was managed with capsular tension ring and the other was left aphakic, respectively. However, the vision was not improved significantly in these patients.
Conclusion:
RP may be associated with ACG in rare instances. In these patients, angle closure-related high IOP can have a detrimental effect on the pre-existing visual impairment. However, this can be prevented by thorough clinical examination and timely intervention in those susceptible eyes.
Cutaneous Basal Cell Carcinoma with Bone Metastases: An Orthopaedic Case Report
Authors: Brianna R Fram, John Strony, Geetha Jagannathan, Scot A Brown
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Basal cell carcinoma (BCC) is the most common skin cancer, and its incidence is increasing. Though metastatic BCC (mBCC) is uncommon, the literature demonstrates a 0.0028%-0.55% rate of metastasis. We report on a patient treated at our institution who was found to have mBCC with osseous metastases. To our knowledge, this is the first report of mBCC in the orthopaedic literature. Orthopaedic oncologists should consider mBCC in patients diagnosed with carcinoma of unknown origin, with a known history of BCC, or individuals with light skin pigmentation and age 50 or greater. This can help clinicians make the correct diagnosis and provide the appropriate treatment.
Diabetic Ketoacidosis Revealing a Severe Hypertriglyceridemia and Acute Pancreatitis in Type 1 Diabetes Mellitus
Authors: Fatima Zahra Zaher, Imane Boubagura, Sana Rafi, Ghizlane Elmghari, Nawal Elansari
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic complication occurring in patients with diabetes, especially in patients with type 1 diabetes (T1D), due to an insulin deficiency. Moderate hypertriglyceridemia is commonly observed in DKA but severe hypertriglyceridemia with a triglyceride level exceeding 10g/L is very rarely reported. We report a case of a 14-year-old boy who had type 1 diabetes for 4 years treated with insulin therapy, also having adrenal insufficiency treated with hydrocortisone who presented with ketoacidosis and excruciating abdominal pain. Investigations revealed hypertriglyceridemia at 64g/L, lipasemia at 1000 U/L, and stage E pancreatitis on abdominal CT. The patient was treated with intravenous insulin, rehydration, and fenofibrate with good clinical and biological evolution. Severe hypertriglyceridemia causing pancreatitis in type 1 diabetes mellitus is a rare but very serious complication of DKA in children.
Asymptomatic autoamputation of ovary and fallopian tube in a 2 days newborn: a case report
Authors: Dimitrios Godosis, Vassilis Lambropoulos, Vasileios Mouravas, Eleftheria Massa, Kleanthis Anastasiadis, Chrysostomos Kepertis, Ioannis Spyridakis
Journal: Pan Afr Med J (2021)
Keywords: floating ovary, autoamputation, case report, neonate, torsion
MeSH terms: Fallopian Tubes / pathology, Ovarian Cysts / diagnosis, Torsion Abnormality / diagnosis, Case Reports, Adnexal Diseases / diagnosis, Adnexal Diseases / pathology, Fallopian Tubes / surgery, Female, Humans, Infant, Newborn, Laparoscopy, Ovarian Cysts / pathology, Ovarian Cysts / surgery, Pregnancy, Torsion Abnormality / pathology, Torsion Abnormality / surgery, Ultrasonography, Prenatal

Automatic amputation of the ovary represents a rather uncommon condition. Especially asymptomatic autoamputation is an even more unusual laparoscopic finding. We hereby present a case of a 2-days´-old infant with a prenatal ultrasound (US) diagnosis of a cystic mass, laparoscopically proved as an amputated right adnexa. The female infant was asymptomatic and had normal laboratory exams, including hormone levels, according to her age. The infant was managed surgically, as the size of the cystic lesion, both prenatally and postnatally was indicative of surgical intervention. Careful monitoring is critical for the management of cystic lesions diagnosed prenatally. Although rare, the suspicion of an auto-amputated ovary has to be risen during diagnostic approach of infants with adnexal cysts, especially when these lesions are supposed to "wander" during imaging examinations, and also taking into account the size of the lesion in order for a final approach and management to be established.
Pancreatic tail schwannoma in a 44-year-old male: a case report and literature review
Authors: Ahmed Abu-Zaid, Ayman Azzam, Hussam Abou Al-Shaar, Abdullah M Alshammari, Tarek Amin, Shamayel Mohammed
Journal: Case Rep Oncol Med (2013)

Pancreatic schwannomas are exceedingly uncommon neoplasms. According to a recent study in 2012, less than 50 cases of pancreatic schwannoma have been described in the English literature over the past thirty years. The vast majority of pancreatic schwannomas take place in the head and body of pancreas, respectively. Herein, we report the case of pancreatic tail ancient schwannoma in a 44-year-old man who presented with a 4-month history of epigastric pain. On physical examination, epigastric region was moderately tender to palpation without evidence of a palpable mass. All laboratory tests were normal. Contrast-enhanced computed tomography (CT) scan showed a 9.2 × 9.5 × 11.5 cm, huge, and well-defined left suprarenal mass arising either from adrenal gland, pancreas, or retroperitoneum. The mass demonstrated mild heterogeneous enhancement with central cystic/necrotic area. No evidence of distant metastasis was identified. At laparoscopy, the mass was noticed to originate from pancreatic tail. Patient underwent surgical resection of pancreatic tail. Microscopic and immunohistochemical examination of the pancreatic tail specimen showed ancient schwannoma. Patient received no adjuvant therapy. At a postoperative 6-month followup, patient was completely asymptomatic and CT scan imaging showed no evidence of tumor recurrence. Moreover, a literature review on pancreatic schwannomas is presented.
Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome and IgA nephropathy
Authors: Keisuke Sugimoto, Shinsuke Fujita, Tomoki Miyazawa, Mitsuru Okada, Tsukasa Takemura
Journal: Pediatr Nephrol (2013)
MeSH terms: Glomerulonephritis, IGA / complications, Lymphadenitis / complications, Pharyngitis / complications, Stomatitis, Aphthous / complications, Case Reports, Child, Fever / complications, Fever / immunology, Fever / surgery, Glomerulonephritis, IGA / immunology, Glomerulonephritis, IGA / surgery, Humans, Lymphadenitis / immunology, Lymphadenitis / surgery, Male, Pharyngitis / immunology, Pharyngitis / surgery, Stomatitis, Aphthous / immunology, Stomatitis, Aphthous / surgery, Syndrome, Tonsillectomy

Background:
A syndrome of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA), as well as immunoglobulin A nephropathy (IgAN), may be caused by autoimmune reactivity nephropathy.
Case-diagnosis/treatment:
A 10-year-old boy presented with periodic fever, exudative tonsillitis, oral aphthous ulcer, and cervical lymph node inflammation. These conditions had occurred at intervals of about 2-6 weeks since the age of 3 years. Microscopic hematuria, first detected at age 8 years, worsened during episodes of PFAPA-related fever; since 10 years of age, the hematuria was accompanied by sustained proteinuria. Examination of a kidney biopsy specimen led to a diagnosis of IgAN. In the kidney specimen, fractalkine immunoreactivity and heavy macrophage infiltration were prominent. Multi-drug cocktail therapy improved the urinalysis findings, and subsequent tonsillectomy succeeded in controlling recurrences of PFAPA and IgAN. In a post-treatment renal biopsy specimen, mesangial proliferation was decreased, and fractalkine immunoreactivity was absent.
Conclusion:
Immunologic reactions against certain antigens in local mucosa, including tonsils, may be impaired in PFAPA and IgAN, as evidenced by the suppression of both diseases in our patient by tonsillectomy. Accordingly, the concurrence of PFAPA and IgAN in our patient appeared to be a consequence of shared autoimmune mechanisms and systemic and local increases in cytokine concentrations, rather than coincidence.
QT Prolongation due to Graves' Disease
Authors: Zain Kulairi, Nisha Deol, Renee Tolly, Rohan Manocha, Maliha Naseer
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Hyperthyroidism is a highly prevalent disease affecting over 4 million people in the US. The disease is associated with many cardiac complications including atrial fibrillation and also less commonly with ventricular tachycardia and fibrillation. Many cardiac pathologies have been extensively studied; however, the relationship between hyperthyroidism and rate of ventricular repolarization manifesting as a prolonged QTc interval is not well known. Prolonged QTc interval regardless of thyroid status is a risk factor for cardiovascular mortality and life-threatening ventricular arrhythmia. The mechanism regarding the prolongation of the QT interval in a hyperthyroid patient has not been extensively investigated although its clinical implications are relevant. Herein, we describe a case of prolonged QTc in a patient who presented with signs of hyperthyroidism that was corrected with return to euthyroid status.
A Novel IL3-ETV6 Fusion in Chronic Eosinophilic Leukemia Not Otherwise Specified With t(5; 12) (q31; p13): A Case Report and Literature Review
Authors: Cenzhu Zhao, Man Wang, Yuchen Zhan, Yang Xu, Suning Chen, Qinrong Wang, Jingnan An, Tianhui Liu
Journal: Front Oncol (2022)
Keywords: cel-nos, il3-etv6, case report, eosinophilia, fusion gene, t(5, 12)(q31, p13)
MeSH terms: Case Reports

Chronic eosinophilic leukemia not otherwise specified (CEL-NOS) is classified as Myeloproliterative Neoplasms (MPN) and refers to chronic eosinophilic leukemia with some atypical recurrent genetic evidence(1). A rare fusion of ACSL6-ETV6 was previously identified in patients with the t(5;12) (q31; p13) karyotype(2). Here, we report a case of CEL-NOS with a translocation of t(5;12) (q31; p13) and identify IL3-ETV6 transcription, which has not been identified in hematologic diseases. In this patient, eosinophilia was observed. And compared with CEL-NOS patients without ETV6 fusion, a higher mRNA expression level of IL3 was found. After failing treatment with dasatinib, the patient was given hydroxyurea (HU). Subsequently his white blood cell (WBC) and eosinophils decreased significantly and remained in the normal range until publication. Due to the side effects, treatment with HU was replaced by PEG-interferon (PEG-IFN). What's more, we summarized the case in our study and 21 patients with the karyotype of t(5; 12) (q31; p13) reported by other groups. It was found that most of them had similar clinical manifestations of eosinophilia and tyrosine kinase inhibitor (TKI) insensitivity. The ectopic mRNA expression of IL3 may be the main cause of eosinophilia, and HU and prednisone acetate (PAT), as well as IFN, were considered treatments for this group.
Diffuse large B-cell lymphoma with calf muscle localization
Authors: Laura Bourdeanu, Rashmi Menon, George Somlo
Journal: Case Rep Hematol (2011)
MeSH terms: Case Reports

Although diffuse large B-cell lymphoma (DLBCL) usually occurs in the lymph nodes, approximately 30-40% of the time it can have an extranodal site of involvement and it can arise in nearly every body site such as intestine, bone, breast, liver, skin, lung, and central nervous system. Muscle involvement of DLBCL is especially uncommon, comprising 0.5% of extranodal NHL. We report a case of a 72-year-old man with extranodal DLBCL of a unique manifestation in the calf muscle, involving predominantly the gastrocnemius muscle. The patient achieved complete response and remained free of local recurrence or metastasis following diagnosis.
Behavioral and Cortical Effects during Attention Driven Brain-Computer Interface Operations in Spatial Neglect: A Feasibility Case Study
Authors: Luca Tonin, Marco Pitteri, Robert Leeb, Huaijian Zhang, Emanuele Menegatti, Francesco Piccione, José Del R Millán
Journal: Front Hum Neurosci (2017)
Keywords: alpha oscillations, brain-computer interface, covert visuospatial attention, electroencephalogram, functional connectivity, spatial neglect

During the last years, several studies have suggested that Brain-Computer Interface (BCI) can play a critical role in the field of motor rehabilitation. In this case report, we aim to investigate the feasibility of a covert visuospatial attention (CVSA) driven BCI in three patients with left spatial neglect (SN). We hypothesize that such a BCI is able to detect attention task-specific brain patterns in SN patients and can induce significant changes in their abnormal cortical activity (α-power modulation, feature recruitment, and connectivity). The three patients were asked to control online a CVSA BCI by focusing their attention at different spatial locations, including their neglected (left) space. As primary outcome, results show a significant improvement of the reaction time in the neglected space between calibration and online modalities (p < 0.01) for the two out of three patients that had the slowest initial behavioral response. Such an evolution of reaction time negatively correlates (p < 0.05) with an increment of the Individual α-Power computed in the pre-cue interval. Furthermore, all patients exhibited a significant reduction of the inter-hemispheric imbalance (p < 0.05) over time in the parieto-occipital regions. Finally, analysis on the inter-hemispheric functional connectivity suggests an increment across modalities for regions in the affected (right) hemisphere and decrement for those in the healthy. Although preliminary, this feasibility study suggests a possible role of BCI in the therapeutic treatment of lateralized, attention-based visuospatial deficits.
Successful Treatment of Early Relapsed High-Risk AML After Allogeneic Hematopoietic Stem Cell Transplantation With Biomodulatory Therapy
Authors: Anna-Sophia Kattner, Ernst Holler, Wolfgang Herr, Albrecht Reichle, Daniel Wolff, Daniel Heudobler
Journal: Front Oncol (2020)
Keywords: acute myeloid leukemia, allogeneic stem cell transplantation, anakoinosis, biomodulatory treatment, relapse
MeSH terms: Case Reports

Early relapse of acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an often unsuccessful therapeutic challenge. Since treatment options are few and efficacy is low, new approaches such as de novo allo-HSCT, targeted therapies and biomodulatory drugs have been developed, albeit prognosis is very poor. In this manuscript we present an unusual case of a patient with high-risk AML with an unbalanced jumping translocation and FLT3-TKD (low) mutation who presented with early relapse (FLT3 negative) after allo-HSCT, refractory to one cycle of azacytidine and discontinuation of immunosuppression (IS). As salvage therapy, the patient received a biomodulatory therapy consisting of low-dose azacytidine 75 mg/day (given s.c. d1-7 of 28), pioglitazone 45 mg/day orally, and all-trans-retinoic acid (ATRA) 45 mg/m2/day orally achieving a complete remission after two cycles of therapy. Even after cessation of treatment after 5 cycles, the patient remained in complete remission with full chimerism in peripheral blood and bone marrow for another 7 months. In conclusion, we report about an unusual case of long-lasting complete remission of early relapsed high-risk AML after allo-HSCT treated with azacytidine, pioglitazone and ATRA after standard of care treatment with HMA and discontinuation of IS failed.
Emergence of BCR- ABL1 Fusion in AML Post-FLT3 Inhibitor-Based Therapy: A Potentially Targetable Mechanism of Resistance - A Case Series
Authors: Ahmad S Alotaibi, Musa Yilmaz, Sanam Loghavi, Courtney DiNardo, Gautam Borthakur, Tapan M Kadia, Beenu Thakral, Naveen Pemmaraju, Ghayas C Issa, Marina Konopleva, Nicholas J Short, Keyur Patel, Guilin Tang, Farhad Ravandi, Naval Daver
Journal: Front Oncol (2020)
Keywords: aml, bcr-abl, flt3, flt3 inhibitors, secondary mutations
MeSH terms: Case Reports

Despite the promising result with FLT3 inhibitors in AML, the emergence of resistance poses a significant challenge, leading to a shorter response duration and inferior survival. This is frequently driven by on-target or parallel prosurvival mutations. The emergence of BCR-ABL1 as a mechanism of possible clonal evolution in relapsed AML has rarely been reported. Here we report our experience with three patients who had emergent BCR-ABL1 fusion at relapse after FLT3 inhibitors-based therapies. The first patient was refractory to multiple lines of therapies, including FLT3 inhibitors-based therapy. Patients 2 and 3 showed some response to combined FLT3-inhibitor and BCR-ABL targeted therapy (gilteritinib and ponatinib). The availability of effective targeted therapies for BCR-ABL1 makes this an important aberration to proactively identify and possibly target at relapse post-FLT3-inhibitor therapies.
Primary pulmonary T-cell lymphoma after operation for small intestinal stromal tumor: A case report
Authors: Zhiwei Peng, Li Yi, Yahong Tao, Zhiyong Chen, Ze Lin, Anjing He, Mengni Jin, Fanrong Liu, Minjing Zuo
Journal: Front Oncol (2022)
Keywords: case report, gastrointestinal stromal tumors, imatinib, primary pulmonary t-cell lymphoma, primary pulmonary lymphoma
MeSH terms: Case Reports

Background:
The risk of gastrointestinal stromal tumor (GIST) in combination with other primary malignancies is high, which occurs before and after the diagnosis of GIST. Primary pulmonary T-cell lymphoma is a rare type of non-Hodgkin lymphoma.
Case presentation:
We report a 53-year-old male patient who was admitted to our hospital with fever, cough, and expectoration for 2 weeks. Chest computed tomography (CT) showed a cavitary mass in the left lower lobe with multiple nodules in the upper lobes of both lungs. The patient had a history of surgery for small intestinal stromal tumors and was treated with oral imatinib after surgery. Lung biopsy was diagnosed as lymphomatoid granulomatosis, tending to grade 3. The pathological diagnosis was corrected by surgery and genetic testing for lung non-Hodgkin CD8-positive cytotoxic T-cell lymphoma with Epstein-Barr virus (EBV) infection in some cells. After multiple chemotherapies, the CT scan showed a better improvement than before. The patient is still under follow-up, and no tumor recurrence has been found.
Conclusion:
Patients with a history of GIST should be monitored for other malignancies. The clinical symptoms and imaging examinations of primary pulmonary T-cell lymphoma are not characteristic, and the definite diagnosis still depends on pathological examination. The patient was treated with the CHOP chemotherapy regimen after the operation, the curative effect was good.