OpenMed/multicare-articles huggingface dataset:
Recurrent urosepsis and cardiogenic shock in an elderly patient with pheochromocytoma
Authors: Joan Joo-Ching Khoo, Vanessa Shu-Chuan Au, Richard Yuan-Tud Chen
Journal: Case Rep Endocrinol (2011)
MeSH terms: Case Reports

Pheochromocytomas are thought to be uncommon in the elderly. However, the prevalence is likely to be higher than reported, as older patients are less likely to be diagnosed due to absence of classical symptoms of sympathetic overactivity and confounding effects of aging, comorbidities, and medications. We describe a hypertensive elderly patient with incidentally diagnosed pheochromocytoma complicated by recurrent urosepsis, cardiomyopathy, and fatal myocardial infarction. Our case demonstrates that, in older hypertensive patients without classical symptoms, orthostatic hypotension and urinary retention, which are common in the elderly, may indicate catecholamine excess and that the deleterious cardiovascular consequences of catecholamine excess in the elderly are not prevented by pharmacological α- and β-blockade.
A Case of Phlegmonous Gastritis in a Patient with Psoriatic Arthritis on Infliximab
Authors: Laurence De Davide, Annie Beaudoin
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Phlegmonous gastritis is a pyogenic infection affecting the submucosa of the gastric wall. Although rarely diagnosed, it remains a disease with high mortality. We thereby describe the case of a 42-year-old male patient known for psoriatic arthritis on Infliximab who was diagnosed with phlegmonous gastritis secondary to immunosuppressive therapy. The patient had a favourable outcome with a conservative treatment consisting of a 14-day course of broad antibiotherapy.
Use of plasmapheresis in managing the diagnostic dilemma of symptomatic hypertriglyceridemia
Authors: Nigel Gordon Maher, Hariharan Ramaswamykanive
Journal: Case Rep Gastrointest Med (2012)

We present a case study of a 29-year-old male who presented with abdominal pain typical for pancreatitis. Detailed history and investigations revealed that the cause of abdominal pain was secondary to the raised triglyceride levels. It was difficult to distinguish whether he had hypertriglyceridemia-induced abdominal pain or acute pancreatitis, given that he had only a mildly raised lipase and a normal contrast computed tomography scan of the pancreas. The abdominal pain resolved with the fall in the triglyceride levels following plasmapheresis. Plasmapheresis is an underevaluated modality of the treatment of hypertriglyceridemia due to its cost and availability.
Intrauterine Growth Retardation Complicated by Biermer's Disease: An Observation in Togo
Authors: Essohana Padaro, Baguilane Douaguibe, Kossi Agbétiafa, Irénée Kueviakoe, Ahoefa Vovor
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Objective:
To report the first case in Togo of Biermer's disease associated with intrauterine growth retardation (IUGR) in a 39-year-old pregnant woman.
Observation:
The patient with phenotype AA, born on 20/02/1978, G2P0 (a spontaneous abortion at 3 months), was referred to hematology on 17th March 2017 for anemia at 26 weeks of amenorrhea (WA). She had received martial treatment with ferrous fumarate 66 milligrams daily. At 26 weeks, the uterine height was 16 centimeters, and there was good fetal vitality. During ultrasound, there was a harmonious development of the fetus, but it was lower than that for the gestational age at 10th percentile based on fetal biometry, and anemia was at 65 g/l. She was then referred to hematology where she was found to have pancytopenia with macrocytic aregenerative anemia at 47 g/l (MCV at 109 fl), neutropenia at 1.02 g/l, and thrombocytopenia at 58 g/l. The myelogram found megaloblastosis at 53%, collapsed serum B12 vitamin at 61.7 pg/ml, normal serum folate at 9.9 ng/ml, increased serum homocysteine to 51.44 μmol/l, and elevated LDH. The search for intrinsic anti-factor antibodies was positive. Digestive endoscopy noted fundal atrophy. The patient was given vitamin B12 injection; at the 7th day, hemoglobin was observed at 94 g/l, then a normalization of the blood count after 3 weeks, and a good evolution of the pregnancy with delivery at 38 WA of a newborn, female, weighing 1960 g with 500 grams of placenta, with a size of 40 cm, and a cranial perimeter of 29 cm. The child had stunted weight growth (at 16 months; weight = 7 kg; height = 69 cm).
Conclusion:
Biermer's disease as a maternal cause of IUGR and infantile hypotonia is a reality in Togo. It requires management in patients and especially during pregnancy to avoid neurological complications in children born from mothers with this disease.
Resection of the Gastric Tube Reconstructed through the Retrosternal Route without Sternotomy
Authors: Masahiro Kimura, Yasuyuki Shibata, Kotaro Mizuno, Hironori Tanaka, Motoki Hato, Satoshi Taniwaki, Yoichiro Mori, Nobuo Ochi, Takaya Nagasaki, Shuhei Ueno, Yuki Eguchi
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

With advances of combined modality therapy, prognoses in esophageal cancer have been improving. After resection of esophageal cancer, the development of gastric tube cancer is a risk. While such cancer in an early stage can be cured endoscopically, total gastric tube resection is indicated in advanced stages. A 68-year-old man underwent subtotal esophagectomy reconstructed with a gastric tube through the retrosternal route. Gastric cancer was found one and a half years postoperatively. The gastric tube was resected without sternotomy. This is the first report of a patient undergoing resection of the gastric tube reconstructed through the retrosternal route without sternotomy.
A Rare Occurrence of Endometriosis Externa Individually Within the Rectus Abdominis Muscle
Authors: Ipek M Evruke, Andelib Babaturk, Gamze Akbas
Journal: Cureus (2023)
Keywords: abdominal wall, endometriosis externa, rectus abdominis muscle, scar endometriosis, ultrasonography
MeSH terms: Case Reports

Endometriosis is defined as the presence of ectopic functional endometrial tissue outside the uterine cavity. It most commonly occurs in the pelvic organs, including the ovaries, ligaments of the uterus, and the pouch of Douglas. Extrapelvic implantation of endometrial tissue has also been reported in the literature. Extrapelvic endometriosis can be explained by lymphatic/vascular migration or mechanical transplantation of the tissue during surgery. Rectus abdominis muscle endometriosis is a rare phenomenon that usually presents with a palpable abdominal mass and cyclic pain. Ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) can be effective to define the location and size of the mass. Our patient was a 32-year-old woman presenting with cyclic abdominal pain and the development of an abdominal mass she had noticed for a year. USG and MRI scans revealed an endometrial focus in the right rectus abdominis muscle. Surgical excision with negative margins was performed, since surgical treatment of the lesion is offered as the definitive treatment.
Successful management of congenital bronchial web in an adolescent using bronchoscopic ablation: A case report and review of literature
Authors: Sara G Hamad, Ahmed Abushahin, Hisham Abdulsattar, Kashif Waqas, Mutasim Abu-Hasan
Journal: Respir Med Case Rep (2022)
Keywords: bronchial web, central airway obstruction, congenital bronchial web, endoscopic argon plasma ablation, interventional bronchoscopy
MeSH terms: Case Reports

Airway webs are abnormal fibrous membranes in the airway lumen that rarely occur but can lead to serious or even life-threatening symptoms because of critical airway obstruction. Airway webs can be acquired or congenital. Acquired webs are likely to be secondary to trauma, infections, or neoplasm. Congenital laryngeal, subglottic and tracheal webs present early in infancy or childhood and are more common than congenital bronchial webs. To our knowledge, there are a few reports on the bronchial web in the literature, and the true incidence of these lesions is unknown as many probably go undetected across the lifespan. We here report a case of a congenital bronchial web and provide a review of the literature of all reported bronchial webs. Our patient is a teenage boy who was diagnosed with a congenital bronchial web obstructing the right main-stem bronchus (RMB) and causing right lung hypoplasia and persistent right middle and right lower lobe collapse. The web was treated successfully using endoscopic ablation by argon plasma coagulation and balloon dilatation. Treatment resulted in remarkable relief of right main stem obstruction and significant improvement in right lung collapse as well as clinical, spirometric, and radiological findings. Due to the rarity of bronchial web, the clinical knowledge and the bronchoscopic interventional strategies demonstrated of this report make it relevant. Furthermore, it emphasizes that early diagnosis and management lead to favorable clinical outcomes.
Intrasinusoidal Hodgkin Lymphoma; A Mimic of Anaplastic Large Cell Lymphoma
Authors: John R Krause, James Fowler, Javed I Gill
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

The distinction between classical Hodgkin lymphoma (HL) and anaplastic large cell lymphoma (ALCL) is not problematic in most instances. In rare situations, HL may present with a sinusoidal infiltrative pattern that may mimic ALCL. It is important to use a battery of immunohistochemical stains to differentiate between these two entities as therapy and clinical behavior are different. We present a case of a young woman who presents with the very unusual intrasinusoidal infiltrative pattern.
Fat embolism syndrome: clinical and imaging considerations: case report and review of literature
Authors: Nissar Shaikh, Ashok Parchani, Venkatraman Bhat, Marie Anne Kattren
Journal: Indian J Crit Care Med (2008)
Keywords: fat embolism syndrome, imaging, magnetic resonance imaging
MeSH terms: Case Reports

Fat embolism syndrome (FES) is a serious clinical disorder occurring after trauma, orthopedic procedures and rarely in non-traumatic patients. Fat emboli develop in nearly all patients with bone fractures, but they are usually asymptomatic. Small number of patients develop signs and symptoms of various organ system dysfunction due to either mechanical obstruction of capillaries by fat emboli or due to hydrolysis of fat to fatty acids. A triad of lung, brain and skin involvement develop after an asymptomatic period of 24 to 72 hours. This symptom complex is called FES. The incidence reported is up to 30%, but many mild cases may recover unnoticed. Diagnosis of fat embolism is clinical with nonspecific, insensitive diagnostic test results. Treatment of fat embolism syndrome remains supportive and in most cases can be prevented by early fixation of large bone factures. Here we report two cases of traumatic fat embolism, which were diagnosed initially by Gurd's criteria and subsequently confirmed by typical appearance on magnetic resonance imaging (MRI) of the brain in these patients. These patients were successfully treated with supportive management. In conclusion, diagnosis of FES needs high index of suspicion, exclusion of other conditions and use of clinical criteria in combination with imaging. Magnetic resonance imaging of the brain is of great importance in diagnosis and management of these patients.
A near fatal complication following stenting of thoracic aortic aneurysm
Authors: Waseem M Hajjar, Sami A Al Nassar, Ahmed Iftikhar, Ahmed N Alaqeed
Journal: Ann Thorac Med (2011)
Keywords: bronchial obstruction, pulmonary vessel compression, thoracic aortic aneurysm
MeSH terms: Case Reports

Tracheobronchial obstruction along with compression of pulmonary vessels is a rare complication after stenting of aortic aneurysm. We present this rare situation in a young patient who underwent stenting of traumatic thoracic aortic aneurysm and developed this near fatal complication and also the conservative management plan which we adopted to manage this case.
Dramatic response to dabrafenib and trametinib combination in a BRAF V600E-mutated cholangiocarcinoma: implementation of a molecular tumour board and next-generation sequencing for personalized medicine
Authors: Arturo Loaiza-Bonilla, Erica Clayton, Emma Furth, Mark O'Hara, Jennifer Morrissette
Journal: Ecancermedicalscience (2014)
Keywords: braf, mek, cholangiocarcinoma, dabrafenib, exceptional responder, genomic medicine, molecular tumour board, next-generation sequencing, personalized medicine, trametinib
MeSH terms: Case Reports

This is the case of a 47-year-old woman diagnosed with chemotherapy and radiation-refractory BRAF V600E mutant, poorly differentiated intrahepatic cholangiocarcinoma (ICC), with multiple metastatic lesions within the liver, lungs, pleura, and bone, stage IV. Discussion of her malignancy's next-generation sequencing genomic information at a multidisciplinary molecular tumour board took place. The patient was considered a suitable candidate for dual BRAF and MEK inhibition, with the intent to prolong her survival and optimize the quality of life. We report her excellent tolerance and exceptional response to dual therapy with dabrafenib and trametinib, including symptomatic and sustained near-complete radiological improvement. We also briefly review the current knowledge of the genomics of cholangiocarcinoma with a focus on BRAF mutations, and make a point of the importance of the establishment of a molecular tumour board for personalized genomic medicine approaches. To our knowledge, this is the first reported case of the use of personalized genomic information for the successful management of a patient with ICC, and it is also the first description of dual BRAF and MEK targeted therapy in this malignancy, leading to what is considered an exceptional response.
Cognitive Impact of Cerebellar Non-invasive Stimulation in a Patient With Schizophrenia
Authors: Charles Laidi, Carole Levenes, Alex Suarez-Perez, Caroline Février, Florence Durand, Noomane Bouaziz, Dominique Januel
Journal: Front Psychiatry (2020)
Keywords: cerebellum, cognition, eyeblink conditioning, schizophrenia, tdcs—transcranial direct current stimulation
MeSH terms: Case Reports

Cerebellum plays a role in the regulation of cognitive processes. Cerebellar alterations could explain cognitive impairments in schizophrenia. We describe the case of a 50 years old patient with schizophrenia whom underwent cerebellar transcranial direct current stimulation (tDCS). In order to study the effect of cerebellar stimulation on cognitive functions, the patient underwent a neuropsychological assessment and an eyeblink conditioning (EBC) protocol. Although the effect of brain stimulation cannot be only assessed in a single-case study, our results suggest that cerebellar stimulation may have an effect on a broad range of cognitive functions typically impaired in patients with schizophrenia, including verbal episodic, short term, and working memory. In addition to neuropsychological tests, we evaluated the cerebellar function by performing EBC before and after tDCS. Our data suggest that tDCS can improve EBC. Further clinical trials are required for better understanding of how cerebellar stimulation can modulate cognitive processes in patients with schizophrenia and healthy controls.
Retrospective Case Reports of Anemic Pregnant Women Receiving Intravenous Ferric Carboxymaltose: Experience from a Tertiary Hospital in Spain
Authors: Rafael Aporta Rodriguez, Mariola García Montero, Jose Pablo Lorente Aporta, Carolina Gallego Luque, Alfonso Chacón Mayor, Jose Aragón Ruiz, Virginia Torres Degayón, Claudia García Jimenez, Guadalupe Sanchez Sanchez
Journal: Obstet Gynecol Int (2016)

Iron deficiency and iron deficiency anemia during pregnancy call for safe treatment options that raise maternal hemoglobin levels and counterbalance iron demand and blood volume expansion while minimizing risks for the growing fetus. This retrospective study describes experience with intravenous ferric carboxymaltose given to pregnant women in a tertiary hospital in Spain. In a 5-year period, 95 pregnant women who had pretreatment hemoglobin <10 g/dL and at least one time of ferric carboxymaltose administration during pregnancy were included. Main outcome measures were week of pregnancy at iron administration, Hb levels before and after treatment, neonatal 5-minute Apgar scores, and birth weight. The majority received one dose of ferric carboxymaltose (1000 mg iron) during advanced pregnancy (median 31 weeks; interquartile range [IQR]: 27; 37 weeks) with minor to no adverse outcomes. Overall, median Hb increased from 8.5 g/dL (8.1; 8.9 g/dL) before treatment to 11.0 g/dL (9.9; 11.7 g/dL) after treatment. Normal Apgar scores were observed in all 97 infants (median birth weights 3560 g, 3270, and 3798 g). Four women received ferric carboxymaltose in the first trimester and twenty-eight during the second trimester without adverse outcomes for mother or child. These cases add to the evidence that ferric carboxymaltose administration during pregnancy is effective and safe.
Adult Presentation of Ectopic Vas Deferens with Dysplastic Kidney
Authors: Yusuf Saifee, Pranjal Modi
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

A 24-year-old male presented with voiding lower urinary tract symptoms. On evaluation, the patient was found to have midbulbar urethral stricture and right dysplastic pelvic kidney with right vesicoureteral reflux. A micturating cystourethrogram (MCUG) shows opacification of the right vas deferens along the entire course till the testis. The patient underwent end-to-end urethroplasty. But soon the patient presented with urinary tract infection (UTI) and epididymorchitis in the follow-up period. The patient was explored laparoscopically to remove dysplastic kidney and ectopic vas deferens. Laparoscopically, the testicular end of the left vas deferens entering the deep inguinal ring was clipped and cut. Also the dysplastic kidney and ureter were removed till the vesicoureteral junction. At 1 year of follow-up, the patient is voiding well with no episodes of UTI.
Computed tomography findings in bilateral perinephric lymphangiomatosis
Authors: Aijaz Hakeem, Tariq A Gojwari, Sheikh Reyaz, Shubana Rasool, Hakim Shafi, Shahida Mufti
Journal: Urol Ann (2010)
Keywords: ct, perinephric collection, renal lymphangiomatosis
MeSH terms: Case Reports

Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis.
Colon perforation caused by swallowing a shrimp leg: A case report
Authors: En-Nung Kao, Kuo-Hsiu Liao, Teng-Wei Chen, De-Chuan Chan, Jyh-Cherng Yu
Journal: Int J Surg Case Rep (2018)
Keywords: colon, foreign body, perforation

Introduction:
Ingestion of a foreign body rarely results in perforation of the gastrointestinal tract. Foreign bodies such as dentures, fish bones, chicken bones, toothpicks and cocktail sticks have been known to cause bowel perforation; however, bowel perforation caused by shrimp leg has not been reported so far.
Presentation of case:
We report a case of a 69-years-old man who presented with a 4-months epigastric pain. Laboratory data revealed inflammation at the first hospital visit. Computed tomography revealed a hypodense lesion containing a hyperdense foreign body in the abdomen. Intra-abdominal abscess caused by foreign body perforation was diagnosed.
Discussion:
An increased incidence of perforation has been reported in association with Meckel's diverticulum, the appendix, and diverticular disease. The abdominal abscess in this case was located beside the diverticulum of transverse colon, so the perforation most likely occurred in the diverticulum of transverse colon.
Conclusion:
Perforation of colon by shrimp leg is very rare and not reported currently. Although some cases have been successfully treated chronic foreign-body perforation with abscess by using antibiotics alone, typical treatments remains surgical drainage of the abscess and removal of foreign body.
Plasmapheresis for Fulminant Wilson's Disease Improves Mental Status and Coagulopathy
Authors: Quarshie Glover, William Nicholas Rose
Journal: Case Reports Hepatol (2023)
MeSH terms: Case Reports

Wilson's disease is a rare genetic condition that affects copper metabolism, resulting in tissue copper accumulation and resultant organ damage. We report a case of a young woman who presents with Wilson's disease complicated by hemolysis, impaired hepatic function, coagulopathy, and acute kidney injury. She was treated with plasmapheresis as a bridge to a liver transplant. Her mental state, renal function, and bilirubin level improved after starting plasmapheresis. She successfully underwent a liver transplant and remained stable post-liver transplant. We share our experience on the use of plasmapheresis in treating Wilson's disease.
Angiofibroma Localized in the Sphenoid Sinus
Authors: Alper Yenigun, Fadlullah Aksoy, Omer Vural, Orhan Ozturan
Journal: Case Rep Otolaryngol (2017)
MeSH terms: Case Reports

Juvenile nasopharyngeal angiofibroma is the most common benign tumor of the nasopharynx with complaints of unilateral nasal obstruction and recurrent nosebleeds in the young male population. Despite being a benign tumor, it can be aggressively destructive in surrounding tissues and bones by acting locally. The gold standard treatment method is the surgical excision of the tumor. This case report is a case of angiofibroma, a 32-year-old asymptomatic male patient with no evidence of clinical signs and endoscopic examination, which is recognized as a localized vascular mass lesion in the right sphenoid sinus on the cranial MR imaging. We prepared this case report that may represent an angiofibroma localized only within the sphenoid sinus which is very rare in the literature.
Giant Cell Arteritis Presenting with Mania, Psychosis, and Cognitive Dysfunction: A Case Report
Authors: Heidi Madeleine Latvala, Solveig Klæbo Reitan, Arne Einar Vaaler
Journal: Case Rep Psychiatry (2023)
MeSH terms: Case Reports

Background:
Giant cell arteritis (GCA) is an autoimmune vasculitis affecting medium- and large-sized arteries. Vascular inflammation may lead to narrowing of the arterial lumen, and acute occlusion may result in vision loss and stroke. The classical symptoms include headache, fever, and jaw claudication. However, there is an increasing recognition of atypical presentations. Case Presentation. We report a case of a 70-year-old woman presenting with fluctuating manic symptoms and confusion, in addition to headache and musculoskeletal pain. After diagnosis of GCA, treatment with corticosteroids gradually improved the somatic symptoms.
Conclusion:
Corticosteroids led to a temporary exacerbation of manic symptoms, which improved after 3 to 4 weeks of continuous treatment, indicating that the symptoms were most likely associated with GCA. The patient manifested with clinical features and a clinical course that has, to our knowledge, not been described or published before. Therefore, GCA may be an underdiagnosed disease in psychiatric populations and should be considered in case of atypical, new-onset psychiatric disorders in the elderly.