OpenMed/multicare-articles huggingface dataset:
Case Report: Omalizumab for Chronic Spontaneous Urticaria in Pregnancy
Authors: Shuang-Lu Liao, Miao Yu, Zuo-Tao Zhao, Marcus Maurer
Journal: Front Immunol (2021)
Keywords: angioedema, chronic spontaneous urticaria, omalizumab, pregnancy, wheals
MeSH terms: Anti-Allergic Agents / administration & dosage, Chronic Urticaria / drug therapy, Omalizumab / administration & dosage, Pregnancy Complications / drug therapy, Pruritus / drug therapy, Case Reports, Review, Adult, Chronic Urticaria / diagnosis, Chronic Urticaria / immunology, Chronic Urticaria / psychology, Female, Humans, Pregnancy, Pregnancy Complications / diagnosis, Pregnancy Complications / immunology, Pregnancy Complications / psychology, Pruritus / diagnosis, Pruritus / immunology, Pruritus / psychology, Quality of Life, Treatment Outcome, Anti-Allergic Agents, Omalizumab

Most chronic spontaneous urticaria (CSU) patients are female, and pregnancy can aggravate the disease activity of patients, but little is known about the efficacy and safety of omalizumab in pregnant CSU patients. We report two pregnant CSU patients treated with omalizumab and review the published information on omalizumab treatment during 11 pregnancies. The outcomes reported on patients with known pregnancies showed they had normal pregnancies and healthy babies as well as complete control of their CSU. The two new cases we reported support the view that omalizumab could be an effective and safe treatment option for pregnant and breastfeeding CSU patients. Further high-quality studies need to be carried out in order to obtain more information on the long-term efficacy and safety of the use of omalizumab during pregnancy in patients with chronic urticaria, including CSU.
Case report: Disseminated herpes simplex virus 1 infection and hemophagocytic lymphohistiocytosis after immunomodulatory therapy in a patient with coronavirus disease 2019
Authors: Elvio Mazzotta, Juan Fiorda Diaz, Marco Echeverria-Villalobos, Gregory Eisinger, Sarah Sprauer, Arindam Singha, Michael R Lyaker
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19, hemophagocytic lymphohistiocytosis, human herpes simplex virus 1, liver failure, tofacitinib
MeSH terms: Case Reports

Corticosteroids and immunomodulatory therapies are widely used to treat patients with severe coronavirus disease 2019 (COVID-19). Janus kinase (JAK) inhibitors such as tofacitinib have been recently studied as adjuvants in the treatment of COVID-19. Although immunomodulatory therapies may be linked to decreased mortality rates in the acute phase, subsequent severe infectious complications may result from them. We describe a case of a multiorgan system failure secondary to disseminated primary herpes simplex virus 1 (HSV-1) infection and hemophagocytic lymphohistiocytosis (HLH) following treatment with tofacitinib and high-dose dexamethasone therapy for severe COVID-19. Early diagnosis and treatment of these life-threatening conditions may have a significant impact on COVID-19 patients' outcomes.
Benign glandular schwannoma
Authors: Khaldoon Aljerian
Journal: Autops Case Rep (2022)
Keywords: glandular schwannoma, immunohistochemistry, neurilemmoma, sweat glands neplasms
MeSH terms: Case Reports

We report a case of a benign glandular schwannoma in a 63-year-old male who presented with a solitary subcutaneous mass on the left knee, with no previous history of neurofibromatosis type 1. This histological subtype is rare, with only 38 cases reported in the literature. Some of the glands found in this patient resembled sweat glands. These lining stromal spindle cells were positive for S-100 but negative for EMA. S100 was faintly staining the glandular elements. All the glands in the tumor were positive for EMA, particularly at the luminal borders. They were also positive for pancytokeratin. The cystic areas variably show intraluminal, foamy, and hemosiderin-laden macrophages. The different glands expressed two patterns. Some of these were reactive for CK7 and low molecular weight keratin. Immunohistochemical workup is mandatory to assess the neoplastic nature of this glandular component.
Clinical Response to Apatinib Combined With Brain Radiotherapy in EGFR Wild-Type and ALK-Negative Lung Adenocarcinoma With Multiple Brain Metastases
Authors: Xiaofang Ying, Huali Liu, Mingwei Wang, Min Peng, Peng Ruan, Vivek Verma, Guang Han
Journal: Front Oncol (2020)
Keywords: alk-negative, egfr wild-type, apatinib, brain metastases, lung adenocarcinoma
MeSH terms: Case Reports

Background: Brain radiotherapy is the standard treatment option for multiple brain metastases (BMs) from non-small cell lung cancer (NSCLC), especially in the absence of a driver mutation. However, the prognosis for such patients remains poor. Apatinib is a potent antiangiogenic compound directed at the vascular endothelial growth factor receptor-2 (VEGFR-2); however, to date, there are no investigations of apatinib concurrent with brain radiotherapy for NSCLC patients with BMs. We report a case of EGFR wild-type and ALK-negative lung adenocarcinoma patient with multiple symptomatic BMs, who received apatinib together with brain radiation therapy. A favorable oncologic outcome was achieved for both brain metastatic lesions and the primary pulmonary tumor. Case Presentation: A 61-year-old female (never smoker) who initially presented with headache and dizziness was diagnosed with lung adenocarcinoma with multiple brain metastasis (cT2aN3M1b stage IV), and was negative for EGFR and ALK. The patient refused to receive chemotherapy and was only amenable to brain radiotherapy and targeted therapy. After approval from the institutional ethics committee, she underwent concurrent oral apatinib (500 mg/day) with whole brain radiation therapy (WBRT) (37.5Gy) with simultaneous in-field boost (49.5Gy) in 15 fractions with image guided intensity-modulated radiotherapy. Three weeks later, neurologic symptoms entirely ceased and a partial response (PR) for the BMs with near-complete resolution of peritumoral brain edema was achieved. Chest CT performed at the same time and showed shrinkage of the lung primary with a PR. The patient suffered grade III oral mucositis one week after brain radiotherapy and refused further apatinib. At 12 months after brain radiotherapy, the brain tumors remained well controlled. Conclusions: This is the first known documentation of a rapid clinical response of apatinib concurrent with brain radiotherapy in a lung adenocarcinoma patient with symptomatic multiple BMs. Apatinib combined with brain radiotherapy could be an alternative treatment option for BMs from NSCLC, especially for those without a driver mutation. Further clinical trials are required to corroborate this discovery.
Acute variceal bleeding in a patient with idiopathic myelofibrosis successfully treated with endoscopic variceal band ligation and chemotherapy: a case report
Authors: Kumiko Tamaki, Michiro Otaka, Naoto Sakamoto, Kenshi Matsumoto, Shunhei Yamashina, Sumio Watanabe
Journal: J Med Case Rep (2010)

Introduction:
Idiopathic myelofibrosis is a chronic myeloproliferative disorder characterized by leukoerythroblastosis, massive splenomegaly, and increases in the reticular and collagen fibers in the bone marrow. Portal hypertension is observed in some patients with idiopathic myelofibrosis. Gastrointestinal hemorrhages, which are due mostly to the rupture of the esophageal varices, have been sporadically reported to be an infrequent complication of idiopathic myelofibrosis.
Case presentation:
We report a case of a Japanese 63-year-old woman with myelofibrosis and variceal hemorrhage, with a background of concomitant portal and pulmonary hypertension. She was successfully treated through a combination of endoscopic variceal ligation and chemotherapy.
Conclusion:
This is the first known report on the successful application of endoscopic variceal ligation and chemotherapy as the therapeutic procedure for an esophageal variceal hemorrhage in a patient with myelofibrosis.
30-yr course and favorable outcome of alveolar echinococcosis despite multiple metastatic organ involvement in a non-immune suppressed patient
Authors: Karine Bardonnet, Dominique A Vuitton, Frédéric Grenouillet, Georges A Mantion, Eric Delabrousse, Oleg Blagosklonov, Jean-Philippe Miguet, Solange Bresson-Hadni
Journal: Ann Clin Microbiol Antimicrob (2013)
MeSH terms: Albendazole / therapeutic use, Antinematodal Agents / therapeutic use, Echinococcosis, Hepatic / therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Echinococcosis, Echinococcosis, Hepatic / surgery, Follow-Up Studies, Humans, Immunosuppression Therapy, Liver Diseases / drug therapy, Liver Diseases / surgery, Lung / surgery, Lung Diseases / pathology, Lung Diseases / surgery, Lung Diseases / therapy, Male, Mebendazole / analogs & derivatives, Mebendazole / therapeutic use, Positron-Emission Tomography, Treatment Outcome, Antinematodal Agents, Mebendazole, Albendazole, flubendazole, Alveolar echinococcosis

We report the 30-yr history of a well-documented human case of alveolar echinococcosis, with a lung lesion at presentation followed by the discovery of a liver lesion, both removed by surgery. Subsequently, within the 13 years following diagnosis, metastases were disclosed in eye, brain and skull, as well as additional lung lesions. This patient had no immune suppression, and did not have the genetic background known to predispose to severe alveolar echinococcosis; it may thus be hypothesized that iterative multi-organ involvement was mostly due to the poor adherence to benzimidazole treatment for the first decade after diagnosis. Conversely, after a new alveolar echinococcosis recurrence was found in the right lung in 1994, the patient accepted to take albendazole continuously at the right dosage. After serology became negative and a fluoro-deoxy-glucose-Positron Emission Tomography performed in 2005 showed a total regression of the lesions in all organs, albendazole treatment could be definitively withdrawn. In 2011, the fluoro-deoxy-glucose-Positron Emission Tomography showed a total absence of parasitic metabolic activity and the patient had no clinical symptoms related to alveolar echinococcosis.The history of this patient suggests that multi-organ involvement and alveolar echinococcosis recurrence over time may occur in non-immune suppressed patients despite an apparently "radical" surgery. Metastatic dissemination might be favored by a poor adherence to chemotherapy. Combined surgery and continuous administration of albendazole at high dosage may allow alveolar echinococcosis patients to survive more than 30 years after diagnosis despite multi-organ involvement.
Surgical Treatment of a Giant Pleomorphic Adenoma of the Submandibular Gland: A Case Report
Authors: Zehui Wu, Defeng Liu, Shihao Peng, Yuejun Wang, Xiaolin Zhan, Laibin Li, Hong Wan, Yangyang Li, Tao Guo, Aman Xu
Journal: Front Surg (2022)
Keywords: diagnosis, pleomorphic adenoma, recurrence, salivary gland neoplasm, submandibular gland, treatment
MeSH terms: Case Reports

Pleomorphic adenomas (PAs) are the most common benign salivary neoplasms. PAs are generally slow-growing but may sometimes become aggressive and grow rapidly within a short period of time. Here, we report the case of an 83-year-old Chinese woman with an anterior neck mass that had been growing over the past 30 years. She felt uncomfortable because the mass had grown quite rapidly in the past year. The final diagnosis of a PA of the left submandibular gland was confirmed by histopathological and immunohistochemical examinations after surgical resection. Our patient recalled a history of an excision of a neck mass 40 years prior to presentation at another hospital. Based on our imaging findings and surgical findings, we speculate that the neck mass 40 years prior may also have been a PA. Our case reminds us the rare recurrence possibility of PAs, and early and thorough resection may have a good prognosis. In addition, to the best of our knowledge, this is the largest PA of the submandibular gland reported to date.
Iatrogenic Spinal Subdural Hematoma due to Apixaban: A Case Report and Review of the Literature
Authors: Alba Colell, Adrià Arboix, Francesco Caiazzo, Elisenda Grivé
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

In the last decade, the clinical relevance for developing safer oral anticoagulants prompted the development of new classes of drugs that have shown a lower risk of life-threatening bleeding events as compared to standard warfarin. Nontraumatic spinal subdural hematoma is an uncommon urgent complication that can be associated with the use of these agents. An unusual case of spinal subdural hematoma related to apixaban treatment for nonrheumatic atrial fibrillation is reported here.
Treatment for Brodie's abscess of the radius in an adolescent: A case report
Authors: Takahiro Ushijima, Ken Arai
Journal: Int J Surg Case Rep (2020)
Keywords: brodie’s abscess, chronic osteomyelitis, curettage
MeSH terms: Case Reports

Introduction:
Brodie's abscess is an uncommon type subacute osteomyelitis. It is typically localized in the metaphysis of tubular bones, particularly in the lower extremities. We herein report a rare case of the abscess appearing in the upper extremities. Furthermore, we successfully treated the large abscess without autogenous bone grafting.
Presentation of case:
14-year-old female presented with pain and swelling on the right forearm. Plain radiograph and CT scan indicated a 10 cm longitudinal cortical bone hypertrophy and a well-defined radiolucent lesion in the diaphysis of the right radius. MRI demonstrated that the lesion was hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging inside as well as outside the bone marrow of the radius. Laboratory data showed no inflammatory response, but Staphylococcus aureus was detected by biopsy. We diagnosed Brodie's abscess of the radius, and performed definitive surgery. Infected bone marrow was curetted and a bony sequestrum inside the cortical bone was harvested. We did not use autogenous bone grafting, since the upper extremities are areas of unloaded bone. Postoperative administration of antibiotics was subsequently performed. One year after surgery, the patient was asymptomatic and there were no complications or signs of infection recurrence.
Conclusion:
We diagnosed and surgically treated a rare case of Brodie's abscess of the radius in an adolescent. An abscess with large cavity is usually treated by curettage and autogenous cancellous bone grafting. However, since the upper extremities are areas of unloaded bone, we successfully treated the abscess by debridement without bone grafting.
Rare giant granular cell ameloblastoma: a case report and an immunohistochemical study
Authors: Santosh Hunasgi, Anila Koneru, Dinesh Singh Chauhan, Yadavalli Guruprasad
Journal: Case Rep Dent (2013)

Aims. The aim is to present a case of rare giant granular cell ameloblastoma and to review the pertinent literature highlighting the molecular aspects of its pathogenesis by analyzing the expression of CD-68, Bcl-2, and β -catenin. Methods. H and E stained sections showed large odontogenic islands showing peripheral ameloblast-like cells and central stellate reticulum-like cells with extensive granular cell transformation surrounded by fibrous stroma. Polyclonal rabbit anti-CD 68, anti-Bcl2, and anti- β -catenin were stained immunohistochemically. Results. CD-68 showed a moderate to strong staining intensity in granular cells. Moderate staining of Bcl-2 was expressed by the peripheral columnar cells of tumor islands and negative in the granular cells. Expression of β -catenin was generally weak, except for only the focal areas that showed a moderate staining intensity and weak in peripheral cells. Conclusion. The present case of giant granular cell ameloblastoma is a rare entity. Development of monstrous size is indicative of ameloblastomas persistent growth. Granular cell transformation in ameloblastomas probably occurs as a consequence of extensive molecular changes. Immunohistochemical studies help us to know the pathogenesis of this granular cell ameloblastoma. Therefore, an effort has been made here to study the expression of Bcl-2, CD-68, and β -catenin.
Suture pull-through insertion techniques for Descemet stripping automated endothelial keratoplasty in Chinese phakic eyes: outcomes and complications
Authors: Ying Hong, Rong-Mei Peng, Miao Wang, Hong-Qiang Qu, Jing Hong
Journal: PLoS One (2013)
MeSH terms: Corneal Dystrophies, Hereditary / surgery, Descemet Membrane / surgery, Descemet Stripping Endothelial Keratoplasty / methods, Postoperative Complications / pathology, Research Support, Non-U.S. Gov't, Adolescent, Adult, Child, Child, Preschool, Corneal Dystrophies, Hereditary / pathology, Corneal Transplantation, Descemet Membrane / pathology, Female, Humans, Intraocular Pressure, Lens, Crystalline / physiology, Male, Middle Aged, Ocular Hypertension / physiopathology, Retrospective Studies, Sutures, Tonometry, Ocular, Visual Acuity

Purpose:
To investigate the outcomes and complications of suture pull-through insertion techniques for Descemet stripping automated endothelial keratoplasty (DSAEK) in Chinese phakic eyes.
Patients and methods:
Retrospective case series. Included in the study were all Chinese patients with phakic eyes who underwent DSAEK at Peking University Third Hospital from August 2008 to August 2011. All ocular diseases of the patients were recorded. Distance visual acuity (DVA), near visual acuity (NVA), intraocular pressure (IOP), anterior chamber depth (ACD), central corneal thickness (CCT), and corneal endothelial cell density (ECD) were compared prior to and 12 months after DSAEK. The DSAEK success rate, endothelial cell loss (ECL), complications, and prognosis were analyzed. All patients had at least 12 months of follow up.
Results:
Twenty-one eyes of 16 patients were included (11 males and 5 females). Ages ranged from 2 to 47 years with an average age of 29.8 years. The average follow up was 15.4 months (ranging from 12 to 36 months). Diagnoses included 7 eyes (4 patients) with corneal endothelial dystrophy and 14 eyes (12 patients) with bullous keratopathy. Presurgical DVA and NVA (LogMAR) were 1.7 ± 0.7 and 1.2 ± 0.4; postsurgical DVA and NVA were 0.8 ± 0.6 and 0.7 ± 0.5; Z = -3.517, -2.764; P<0.001 and P = 0.006 respectively. Presurgical IOP was 15.8 ± 3.7 mm Hg; postsurgical IOP was 15.2 ± 2.6 mm Hg; Z = -0.505, P = 0.614. Presurgical ACD was 3.00 ± 0.74 mm; postsurgical ACD was 2.72 ± 0.59 mm; Z = -0.524, P = 0.600. Donor ECD was 2992 ± 163 cells/mm(2), ECD was 1836 ± 412 cells/mm(2) with a 12-month postsurgical ECL of 39%. Success rate was 86%. Surgery complications included pupillary block-induced hypertension in 5 eyes (24%), graft detachment in 3 eyes (14%), and graft dislocation in 1 eye (5%).
Conclusions:
DSAEK on Chinese phakic eyes can significantly improve DVA and NVA by preserving the patient's own crystalline lens. DSAEK is an optional surgery for patients who need to preserve accommodative function. More attention should be given to postsurgical pupillary block-induced hypertension.
An Unusual, Intermediate-Sized Lesion Affecting Motor Organization in a Patient With Schizencephaly: A Case Report
Authors: Sung-Woon Baik, Gi-Wook Kim, Myoung-Hwan Ko, Jeoung-Hwan Seo, Yu-Hui Won, Sung-Hee Park
Journal: Front Hum Neurosci (2020)
Keywords: congenital brain anomalies, diffusion tensor imaging, polymicrogyria, schizencephaly, transcranial magnetic stimulation

Schizencephalies are abnormal clefts of the cerebral hemispheres that result from abnormal late neuronal migration and cortical organization. In the present study, we report a different type of unusual motor organization in a patient with a schizencephalic cleft in the right hemisphere and polymicrogyria in the opposite hemisphere. Despite similar brain pathology affecting the sensorimotor cortex, motor organization differed from previously known bilateral congenital brain lesions. We conducted a transcranial magnetic stimulation (TMS) and diffusion tensor image (DTI) study to confirm the motor organization. In this case, ipsilateral corticospinal projections to the paretic hands were observed during TMS of the less affected hemisphere, along with polymicrogyria, similar to the previous study. However, a crossed corticospinal tract to the paretic hand from the more severely affected hemisphere was observed in this case-a pattern of motor organization that has yet to be reported in this patient population. Our findings indicate that motor organization after early brain injury may be affected by the interhemispheric competition of the corticospinal system and bilateral brain lesions, thereby resulting in unilateral hemiparesis.
Extensive Metastatic Sarcomatoid Renal Cell Carcinoma Evaluated by 18F-FDG PET/CT: a Case Report and Review of Literature
Authors: Dominique Fuser, Matthew L Hedberg, Louis P Dehner, Farrokh Dehdashti, Barry A Siegel
Journal: J Kidney Cancer VHL (2018)
Keywords: fdg pet/ct, pet/ct, metastasis, renal cell carcinoma, sarcomatoid
MeSH terms: Case Reports

Sarcomatoid renal cell carcinoma (sRCC) is a highly aggressive form of dedifferentiated renal cell carcinoma. We report a 62-year-old man who presented with respiratory symptoms and a lung mass on chest computed tomography (CT). The patient underwent positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) and was found to have extensive metastatic disease. Based on the history and imaging findings, there were possible primary malignancies, including bronchogenic carcinoma, melanoma, or an aggressive lymphoma. An excisional biopsy surprisingly revealed a high-grade sarcomatoid carcinoma with no evidence of differentiation, and immunohistochemical (IHC) studies showed that the tumor cells were positive for markers of genitourinary origin (PAX-8 and vimentin). The histologic and IHC results, along with multiple FDG-avid exophytic lesions in both kidneys, were considered diagnostic of sRCC. Here we have highlighted the potential role of 18F-FDG-PET-CT in patients with sRCC, discussed the diagnostic challenges, and presented a brief review.
May-Thurner Syndrome: A Suspicion That Led to an Incidental Discovery
Authors: Ahmed Kazi, Abeera Akram, Brooj Awan, Carolina Borz-Baba
Journal: Cureus (2023)
Keywords: deep vein thrombosis (dvt), endovascular stent graft, endovascular thrombectomy, iliac compression syndrome, pulmonary emboli
MeSH terms: Case Reports

May-Thurner syndrome (MTS)/Iliac vein compression syndrome is characterized by left iliac vein stenosis secondary to compression by the right common iliac artery against the fifth-lumbar vertebra. It increases the incidence of deep venous thrombosis (DVT). We had a 43-year-old female presenting with left leg swelling and was found to have extensive DVT provoked by a long history of travel. Because of the extension of her thrombus, a catheter-guided thrombectomy (CDT) was planned and findings of MTS were identified incidentally. She had an endovascular stent placed and was discharged on long-term anticoagulation.