OpenMed/multicare-articles huggingface dataset:
A case report of neuralgic amyotrophy
Authors: Jianfeng Sun, Ji Mao, Fengfei Zhang, Xi Gui, Junfeng Liao
Journal: Front Neurol (2024)
Keywords: diagnosis, differential diagnoses, high-frequency ultrasound, neuralgic amyotrophy, precision therapy
MeSH terms: Case Reports

Neuralgic muscular atrophy is not uncommon in clinical practice. Due to the different branches of brachial plexus involved in the lesion, the clinical symptoms are different, and there is a lack of clear imaging diagnostic criteria, so the diagnosis of this disease brings great challenges to clinicians. We have certain experience in the diagnosis and treatment of this disease, and hereby select a representative case of neuralgic muscular atrophy to share its diagnosis and treatment process, focusing on analyzing the characteristic symptoms of this disease, valuable imaging data and targeted treatment, so as to enable clinicians to better understand this disease.
Case report: Structural brain abnormalities in TUBA1A-tubulinopathies: a narrative review
Authors: Piero Pavone, Pasquale Striano, Giovanni Cacciaguerra, Simona Domenica Marino, Enrico Parano, Xena Giada Pappalardo, Raffaele Falsaperla, Martino Ruggieri
Journal: Front Pediatr (2023)
Keywords: dwm phenotype, dandy–walker malformation, tuba1a-tubulinopathy, cerebral anomalies, tubulinopathies
MeSH terms: Case Reports

Introduction:
Tubulin genes have been related to severe neurological complications and the term "tubulinopathy" now refers to a heterogeneous group of disorders involving an extensive family of tubulin genes with TUBA1A being the most common. A review was carried out on the complex and severe brain abnormalities associated with this genetic anomaly.
Methods:
A literature review of the cases of TUBA1A-tubulopathy was performed to investigate the molecular findings linked with cerebral anomalies and to describe the clinical and neuroradiological features related to this genetic disorder.
Results:
Clinical manifestations of TUBA1A-tubulinopathy patients are heterogeneous and severe ranging from craniofacial dysmorphism, notable developmental delay, and intellectual delay to early-onset seizures, neuroradiologically associated with complex abnormalities. TUBA1A-tubulinopathy may display various and complex cortical and subcortical malformations.
Discussion:
A range of clinical manifestations related to different cerebral structures involved may be observed in patients with TUBA1A-tubulinopathy. Genotype-phenotype correlations are discussed here. Individuals with cortical and subcortical anomalies should be screened also for pathogenic variants in TUBA1A.
Contarini's Syndrome: Bilateral Pleural Effusions Due to Different Etiologies
Authors: Tatsunori Shizuku, Miyu Osawa, Izumi Kitagawa, Yasuharu Tokuda
Journal: Cureus (2024)
Keywords: bilateral pleural effusions, contarini’s syndrome, emergency medicine, geriatric medicine, respiratory care
MeSH terms: Case Reports

Contarini's syndrome is a condition in which the occurrence of bilateral pleural effusions is attributed to different causes for each side. The decision to perform bilateral thoracentesis can be challenging for clinicians, particularly in elderly patients with multiple comorbidities. A 75-year-old Asian man with a past medical history of dementia and dysphagia presenting with dyspnea was brought to our emergency department. Imaging studies revealed bilateral pleural effusions and multiple costal fractures. The results of bilateral thoracentesis indicated an exudate pleural effusion in the right lung and a hemorrhagic pleural effusion in the left lung. Given the results, we determined the etiology of the right pleural effusion to be a parapneumonic effusion resulting from aspiration pneumonia, while the left hemorrhagic pleural effusion was due to costal fractures. After initiating treatment with antibiotics and placement of bilateral drainage tubes, the patient's condition improved remarkably. This case underscores the importance of considering bilateral thoracentesis, particularly in geriatric patients.
Case report: Simultaneous measurement of intracranial pressure and lumbar intrathecal pressure during epidural patch therapy for treating spontaneous intracranial hypotension syndrome. Spontaneous intracranial hypotension or spontaneous intraspinal hypovolume?
Authors: Nicolas Engrand, Quentin Salardaine, Jean-Philippe Desilles, Cécile Echard, Pierre Bourdillon, Marc Williams, Guillaume Baille
Journal: Front Neurol (2024)
Keywords: bithalamic ischemia, case report, epidural patch, spontaneous intracranial hypotension, subacute subdural hematoma
MeSH terms: Case Reports

Objectives:
Spontaneous intracranial hypotension (SIH) is frequently complicated by subacute subdural hematoma (SDH) and more rarely by bilateral thalamic ischemia. Here, we report a case of SIH-related SDH treated with three epidural patches (EPs), with follow-up of the intracranial pressure and lumbar intrathecal pressure.
Methods:
A 46-year-old man presented bilateral thalamic ischemia, then a growing SDH. After failure of urgent surgical evacuation, he underwent three saline EPs, two dynamic myelography examinations and one digital subtraction angiography-phlebography examination. However, because of no dural tear and no obstacle to the venous drainage of the vein of Galen, no therapeutic procedure was available, and the patient died.
Results:
The case exhibited a progressive increase in the transmission of lumbar intrathecal pressure to intracranial pressure during the three EPs. The EPs may have successfully treated the SIH, but the patient did not recover consciousness because of irreversible damage to both thalami.
Conclusion:
Clinicians should be aware of the bilateral thalamic ischemia picture that may be the presenting sign of SIH. Moreover, the key problem in the pathophysiology of SIH seems to be intraspinal and intracranial volumes rather than pressures. Therefore, intracranial hypotension syndrome might actually be an intraspinal hypovolume syndrome.
Network targeting combination therapy of synthetic lethal vulnerabilities in 9p21- deficient glioblastoma: A case report
Authors: Michael P Castro, Kristin Dittmar
Journal: Neurooncol Adv (2023)
Keywords: exceptional responders, glioblastoma, network targeting combination therapy (ntct), synthetic lethality

Background:
Patients with relapsed or progressive glioblastoma only rarely respond to salvage therapies. Nevertheless, comprehensive genomic profiling can provide insight that can identify promising approaches. Signaling pathway analyses have revealed synthetic lethal partnerships, which create the possibility of targeting vulnerabilities arising from the loss of tumor suppressor genes. For synthetic lethal vulnerabilities that are not present in normal tissues, lethal cytotoxicity against cancer cells can be achieved without the necessity of causing normal tissue toxicity. This case report describes a patient with progressive glioblastoma with homozygous deletion of chromosome 9p21.
Methods and results:
Vulnerabilities created by CDKN2A and MTAP loss were exploited with pemetrexed, bevacizumab, and candesartan to achieve a clinically meaningful remission by targeting multiple synthetic lethal nodes.
Conclusion:
Synthetic lethality can reveal the basis for exceptional responsiveness, thus extending the utility of molecular profiling and fulfilling the promise of precision medicine.
Perforation of the bile duct caused by endoscopic papillary large balloon dilation: A case report
Authors: Yoichiro Sato, Naoki Okano, Kensuke Hoshi, Shuntaro Iwata, Yusuke Kimura, Susumu Iwasaki, Kensuke Takuma, Yoshinori Igarashi, Takahisa Matsuda
Journal: DEN Open (2024)
Keywords: eplbd, bile duct perforation, bile duct stone
MeSH terms: Case Reports

The patient was a woman in her 70s with multiple large biliary stones. Lithotripsy was attempted after endoscopic papillary large balloon dilatation. During balloon dilation, inflator resistance, and body movement due to patient pain were observed, and maximum pressure was required for the disappearance of the balloon waist. A bile duct perforation was observed when the balloon was deflated. Computed tomography after endoscopic retrograde cholangiopancreatography showed free air from the duodenal peritoneum to the right retroperitoneum. The patient was conservatively treated with nasobiliary drainage. Endoscopic large balloon dilatation is useful for large bile duct stones that are difficult to remove using endoscopic sphincterotomy alone or endoscopic papillary balloon dilation. Perforation is a potentially fatal adverse event; therefore, imaging of the intrapancreatic bile ducts should be performed before endoscopic retrograde cholangiopancreatography and attention should be paid to the balloon dilation method.
Utility of Orthodontic Braces as Flexible Splint for Stabilizing an Avulsed Tooth: A Case Report
Authors: J Leidenz, Sarah C Soto Perez
Journal: Case Rep Dent (2024)
Keywords: orthodontic braces, splint, tooth avulsion
MeSH terms: Case Reports

Dental avulsion is a traumatic dental injury with complete displacement of the tooth outside the bony socket. Both primary and permanent teeth are predisposed to such traumatic incidents. The most effective treatment in such cases is tooth replantation. Additionally, a short-term flexible splint is needed to stabilize the avulsed/replanted tooth. This case report describes orthodontic braces as a standardized flexible splint option for the treatment of tooth avulsion. Herein, the case of a 9-year-old female patient who presented to a private dental clinic with an avulsed upper left central incisor, 1 h after the accident has occurred. Once the tooth was replanted with all the necessary precautions, orthodontic braces and wire were utilized to stabilize the tooth. Most dental splints are custom-made, requiring thorough professional knowledge and expertise for their fabrication and placement. The protocol described in this report is aimed at easing tooth stabilization using materials within the scope of a basic dental setup consultation room.
Comprehensive considerations for dermatologists: the application of FDG-PET in evaluating cutaneous lesions in pediatric Langerhans cell histiocytosis
Authors: Sahithi Talasila, Eric M Teichner, Robert C Subtirelu, Naga Chaitanya P Talasila, Sricharvi Mannam, Thomas Werner, Abass Alavi, Mona-Elisabeth Revheim
Journal: Front Med (Lausanne) (2024)
Keywords: langerhans cell histiocytosis (lch), [18f]fluorodeoxyglucose-positron emission tomography (fdg-pet), cutaneous langerhans cell histiocytosis, pediatric langerhans cell histiocytosis, skin-limited langerhans cell histiocytosis
MeSH terms: Review

Langerhans cell histiocytosis (LCH) is a complex disorder characterized by the clonal proliferation of Langerhans cells, primarily affecting children and adolescents. This condition exhibits a wide spectrum of clinical presentations, necessitating a multidisciplinary approach for diagnosis, treatment, and follow-up. Cutaneous manifestations of LCH are significant, mimicking common dermatoses and posing diagnostic challenges. [18F]Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) has emerged as an important tool in the evaluation of pediatric LCH, offering insights into disease activity, extent, and therapeutic response. Moreover, FDG-PET provides a non-invasive means to distinguish between active LCH skin lesions and other dermatological conditions with similar clinical appearances, enhancing diagnostic accuracy and aiding in disease monitoring. This educational review summarizes the utility of nuclear imaging techniques, with a focus on PET scans, in the diagnosis and management of cutaneous pediatric LCH. A comprehensive literature search identified seven relevant articles, including retrospective studies and case reports. These studies highlight the efficacy of FDG-PET in localizing active LCH skin lesions, monitoring disease activity, and guiding treatment decisions. FDG-PET represents a valuable imaging modality for dermatologists, oncologists, and pediatricians managing pediatric LCH patients with cutaneous involvement. This non-invasive technique contributes to improved diagnostic accuracy and facilitates early intervention, ultimately enhancing patient care and outcomes.
True uterus didelphys in she-camel: a case report and review of literature
Authors: Mohamed A A Mahdy, Mohammed S Nasr Eldeen
Journal: Front Vet Sci (2024)
Keywords: müllerian duct anomalies, case report, congenital abnormalities, she-camel, uterus didelphys
MeSH terms: Case Reports

Background:
Uterus didelphys is a rare congenital anomaly of the female reproductive tract characterized by a divided uterine cervix and body. It occurs due to abnormal development of the paramesonephric (Müllerian) duct. Different forms of uterus didelphys have been reported in several animal species, including bovine, equine, ewe, goat, swine, and bitch. However, there is no previous report that has documented a completely divided female genital tract in she-camel. Moreover, there is a lack of literature regarding this anomaly in animals. Therefore, the present study reports, for the first time, a rare case of a completely divided female genital tract in a she-camel. In addition, the existing relevant literature on uterus didelphys in different animal species is reviewed.
Case presentation:
A female reproductive tract of she-camel, approximately 10 years old, with a history of previous successful pregnancy, was brought to the anatomy department following the slaughtering of the animal. Initial examination revealed a normal reproductive tract consisting of two ovaries, two fallopian tubes, a uterus, and a vagina. A closer examination revealed a completely divided vagina, with an external os opened into each part of the vagina, as well as a divided uterine body and cervix. Intrauterine infusion of saline through one external os confirmed complete separation of uterine body and cervix.
Conclusion:
To the authors' knowledge, this is the first reported case of a completely divided female genital tract in a she-camel. This review summarizes the previous reports about uterus didelphys in farm animals.
Allergic bronchopulmonary mycosis caused by Scedosporium apiospermum: A case report
Authors: Ryota Okazaki, Shino Arita, Hinako Hoshio, Naoki Uetani, Genki Inui, Hiroki Ishikawa, Takafumi Nonaka, Hiroki Kohno, Yoshihiro Funaki, Tomoya Harada, Masato Morita, Akira Watanabe, Akira Yamasaki
Journal: Respir Med Case Rep (2024)
Keywords: allergic bronchopulmonary mycosis, antifungal drug, eosinophil, mucous plugs, scedosporium apiospermum
MeSH terms: Case Reports

A 61-year-old woman, hospitalized for a persistent cough and dyspnea, had no history of bronchial asthma, but was undergoing chemotherapy for methotrexate-related lymphoproliferative disorder due to rheumatoid arthritis. Her peripheral blood eosinophil count was significantly increased, and chest CT revealed left lower lobe atelectasis and high-attenuation mucus. Bronchoscopy revealed mucous plugs and pathological examination revealed numerous eosinophils and filamentous fungi. Allergic bronchopulmonary mycosis (ABPM) caused by Scedosporium apiospermum was diagnosed using culture and genetic analyses. Treatment with corticosteroids and antifungal drugs led to improvement. ABPM caused by S. apiospermum is extremely rare, emphasizing the importance of species identification.
Case Report: Effective management of adalimumab-induced acquired hemophilia A with the CyDRI protocol
Authors: Andrea Ceglédi, Árpád Bátai, János Dolgos, Mónika Fekete, László Gopcsa, Viktória Király, Gergely Lakatos, György Nagy, Zsuzsanna Szemlaky, Andrea Várkonyi, Beáta Vilimi, Gábor Mikala, Imre Bodó
Journal: Pathol Oncol Res (2024)
Keywords: acquired hemophilia a, adalimumab, bleeding disorder, immunosuppression, rheumatoid arthritis
MeSH terms: Adalimumab / adverse effects, Adalimumab / therapeutic use, Hemophilia A / chemically induced, Hemophilia A / drug therapy, Case Reports, Aged, Antirheumatic Agents / adverse effects, Antirheumatic Agents / therapeutic use, Arthritis, Rheumatoid / drug therapy, Factor VIIa / therapeutic use, Humans, Male, Recombinant Proteins / therapeutic use, Retrospective Studies, Rituximab / adverse effects, Rituximab / therapeutic use, Adalimumab, Factor VIIa, Antirheumatic Agents, Rituximab, recombinant FVIIa, Recombinant Proteins, Factor 8 deficiency, acquired

Introduction:
Acquired Hemophilia A (AHA) is a rare autoimmune disorder characterized by the emergence of inhibitors that specifically target coagulation Factor VIII, frequently resulting in severe bleeding episodes.
Methods:
We conducted a retrospective analysis of the medical records of a 68-year-old male patient who presented with adalimumab-induced AHA.
Results:
The patient received adalimumab, a tumor necrosis factor inhibitor antibody, as part of his treatment for rheumatoid arthritis. The patient's clinical journey, characterized by intense bleeding and coagulopathy, was effectively managed with the application of recombinant Factor VIIa (rFVIIa) and the CyDRi protocol.
Discussion:
The case emphasizes the importance of prompt coagulation assessment in patients with bleeding symptoms receiving disease-modifying therapy for rheumatoid arthritis that includes adalimumab therapy, considering the rare yet life-threatening nature of AHA. Additionally, this report provides an extensive review of the existing literature on drug-induced AHA, with a special emphasis on cases linked to immunomodulatory medications. Through this two-pronged approach, our report aims to enhance understanding and awareness of this severe complication among healthcare providers, promoting timely diagnosis and intervention.
Innovative ICG Application in Benign Gynaecological Surgery: Enhancing Safety and Precision
Authors: Summer Deah Menezes, Tanushree Rao
Journal: Case Rep Obstet Gynecol (2024)
Keywords: endometriosis, indocyanine green, laparoscopic surgery
MeSH terms: Case Reports

In the context of increased adoption of minimally invasive surgery for benign gynaecological conditions, this study underscores the paramount importance of patient safety. We explored the efficacy of indocyanine green (ICG), a fluorescent dye, in enhancing the visualisation of critical anatomical structures during complex laparoscopic procedures. Our methods involved the direct administration of ICG into the ureters for precise identification and dissection, as well as an innovative vaginal application to delineate the rectovaginal plane in cases with distorted pelvic anatomy. The study presented two cases: a laparoscopic hysterectomy for a multifibroid uterus and a case of advanced endometriosis with rectal involvement. Results indicated that ICG use significantly improved real-time visualisation of the ureters and the rectovaginal plane, which facilitated the surgeries and reduced the cognitive load on surgeons. There were no intraoperative complications, and the postoperative phase showed positive patient outcomes. In conclusion, the application of ICG in these laparoscopic surgeries proved to be a beneficial adjunct, suggesting its potential for broader application in benign gynaecological surgeries. Future research is warranted to explore additional uses of ICG, with a focus on enhancing patient safety and surgical efficacy.
Case report: Liver PEComa after kidney transplantation in recipient with tuberous sclerosis complex
Authors: Marcin Dymkowski, Paulina Kalman, Piotr Niecikowski, Łukasz Koperski, Maciej Kosieradzki
Journal: Front Oncol (2024)
Keywords: pecoma, epithelioid angiomyolipoma, kidney transplant, organ transplantation, tuberous sclerosis
MeSH terms: Case Reports

Introduction:
Perivascular epithelioid cell tumors (PEComa) are rare tumors of mesenchymal origin that exhibit perivascular epithelioid cell phenotype. One of its most common localizations is uterus, whereas only a few studies reported PEComa localization as liver. There is a correlation between the presence of PEComa and tuberous sclerosis complex (TSC). TSC is a rare disease which leads to the development of mostly non-cancerous tumors in various organs. We would like to present a case of a kidney transplant recipient with a PEComa detected post-transplant in the liver.
Case report:
A 27-year-old patient, 3 years after kidney transplantation (KTx) due to chronic renal failure in the course of autosomal dominant polycystic kidney disease and concomitant TSC, was admitted to the Clinic and Department of General and Transplant Surgery for abnormal findings in computed tomography (CT). A CT scan was conducted for oncological follow-up after a kidney transplant (KTx) because before the transplantation, a small cystic lesion measuring 7 mm in diameter was removed from the donor kidney and diagnosed as papillary renal cell carcinoma (PRCC). Two tumors in the liver were detected - one 27mm in diameter in segment VII/VIII and the other 8mm in diameter in segment II/III. Because of typical radiological signs hepatocellular carcinoma was suspected, but the serum level of alpha fetoprotein was within normal limits and liver function was preserved. The intraoperative biopsy and the radiofrequency ablation (RFA) of the larger tumor were performed three months later. In the histopathological examination benign PEComa (HMB45 +, Melan A +) was detected.
Conclusion:
The oncological surveillance made it possible to detect liver lesion in early stage and in 3,5-year follow-up no sign of recurrence of PEComa was found. This case is the second to show RFA as treatment method of liver PEComa and first in kidney transplant recipient.
Case report: A case of pseudo-acute kidney injury due to cyclin-dependent kinase inhibitor
Authors: Praveen Errabelli, Maulik Lathiya, Devender Singh
Journal: Front Nephrol (2024)
Keywords: cdk (cyclin-dependent kinase), egfr, abemaciclib, acute kidney injury, creatinine clearance, cystatin c (cys c), pseudo acute kidney injury
MeSH terms: Case Reports

Various classes of targeted therapies have emerged in the last few years, which have revolutionized cancer treatment, and improved the prognosis and survival of cancer patients. Unfortunately, these agents have serious toxic effects on the kidneys. Some of the toxic effects are hypertension, acute kidney injury (AKI), and proteinuria. One interesting phenomenon that has emerged recently is pseudo-acute kidney injury due to the interference with the tubular secretion of creatinine by some of the targeted therapeutic agents. Understanding this physiology is needed to avoid unnecessary investigation and withholding of lifesaving chemo regimen. Alternative methods to assess renal function such as cystatin C-based estimated glomerular filtration rate (eGFR) can differentiate true AKI from pseudo-AKI. Here, we describe one such case of pseudo-AKI from cyclin-dependent kinase (CDK) 4/6 inhibitor, abemaciclib, which inhibits tubular secretion of creatinine. Using cystatin-C-based eGFR revealed pseudo-AKI in this case.