OpenMed/multicare-articles huggingface dataset:
Leflunomide in the Treatment of a Pseudotumoral Genital Herpes Simplex Virus Infection in an HIV Patient
Authors: Marie R Roger, Gregory M Anstead
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

The patient is a 52-year-old African American man with a past medical history of HIV infection (on antiretroviral therapy, CD4 count 399 cells/µL, and undetectable HIV viral load) and recurrent genital herpes. While on valacyclovir, the patient presented with four tumorous lesions on the perineum and scrotum. A biopsy specimen stained positively with HSV-1 and HSV-2 immunostains and displayed a lymphoplasmacytic infiltrate. The patient received foscarnet and imiquimod for two weeks with minimal improvement. Based on the previous activity of leflunomide, which has both antiviral and immunomodulatory properties, in cytomegalovirus and herpes simplex infections, leflunomide 20 mg orally twice daily was started. The patient received 23 days of foscarnet, 14 days of topical imiquimod, and 11 days of leflunomide with approximately 80% reduction in the size of the perineal lesion. After nine months on leflunomide there was complete regression of the large perineal lesion and only two small ulcerations remained on the scrotum. Pseudotumoral herpes lesions in HIV patients represent an immune reconstitution event and are poorly responsive to the usual anti-herpes agents. This report demonstrates the successful use of leflunomide in the treatment of an HIV patient with pseudotumoral herpes. Thalidomide has also been used with some success.
Parathyroidectomy Resolves Tooth Discoloration: A New Presenting Sign of Hyperparathyroidism?
Authors: Estella Musacchio, Andrea Piotto, Pierluigi Binotto, Antonio Toniato, Leonardo Sartori
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Introduction:
We report the resolution of tooth discoloration following parathyroidectomy in an otherwise asymptomatic woman with primary hyperparathyroidism-associated hypercalcemia. Case Report. A 59-year-old Caucasian woman, diagnosed with primary hyperparathyroidism in 2011, nonsmoker with excellent overall oral health. She complained of tooth discoloration starting in 2013. Pigmentation was particularly evident in the necks of the lower central and lateral incisors (Vita Classical score C2). No bleaching was undertaken. Parathyroidectomy was performed five years after primary hyperparathyroidism diagnosis. Six months later, a reduction in pigmentation was strikingly evident, with incisors scoring A1 and A2. The improvement persisted over time. Tooth value also increased compared to baseline.
Conclusions:
This is, to our knowledge, the first report that parathyroidectomy might resolve dental discoloration. This outcome deserves investigation in a meaningful sample size and may eventually prompt the inclusion of dental issues among the consequences of primary hyperparathyroidism.
A Case of Acquired Haemophilia A in a Patient with Chronic Myelomonocytic Leukaemia
Authors: Takeshi Araki, Shinya Ohata, Kohei Okamoto, Kazuhide Morimoto, Mana Hiraishi, Shinichiro Yamada, Ishikazu Mizuno, Takeshi Sugimoto
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

A 67-year-old male, with a known diagnosis of myelodysplastic syndromes with multilineage dysplasia (MDS-MLD) was admitted to our hospital with a primary complaint of subcutaneous bleeding in his left thigh. Laboratory data showed anaemia and prolongation of activated partial thromboplastin time (85.8 s, normal range 24-39 s) without thrombocytopenia. Coagulation factor VIII (FVIII) activity was less than 1% (normal range 60-150%), and a FVIII inhibitor was identified and quantified at 166 BU/mL to indicate a diagnosis of acquired haemophilia A (AHA). A recent, but sustained circulating monocytosis (>1 × 109/L) was observed, which combined with elevated numbers of neutrophil and monocytic cells in the marrow, suggested evolution of MDS-MLD to chronic myelomonocytic leukaemia (CMML), coinciding with AHA. Further analysis revealed a karyotype of 46, XY, i(14) (q10), which was the same abnormality previously identified in the patient. To treat bleeding caused by AHA, steroid and activated prothrombin complex concentrate were administered. Azacitidine (AZA) was used to treat CMML. During the clinical course, bleeding partially improved; however, subsequent acute myocardial infarction occurred on day 87. Worsening bone marrow failure was observed 4 months after the original admission, despite administration of AZA therapy, and the patient died due to bleeding from AHA. This case suggests that the evolution of MDS to CMML status can be associated with AHA conferring a bleeding tendency.
Dislocation of a McMinn-Like Prosthesis with Distinctive Metallosis and Fracture of the Os Ilium
Authors: Peter Caspar Bünemann, Stefan Luck, Malte Ohlmeier, Thorsten Gehrke, Tobias Malte Ballhause
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Osteoarthritis of the hip joint (coxarthrosis) is the most common hip disease in adults. Since the 1960s, total hip arthroplasty (THA) has made great progress and is nowadays one of the most frequently used procedures in orthopedic surgery. Different bearing concepts exist in various implant designs. A metal-on-metal bearing can create metal debris and lead to metallosis. We present a unique case of a 78-year old woman, who received hip resurfacing with a McMinn-like prosthesis 15 years ago. Over the cause of time, metallosis developed and created a bone cyst in the Os ilium, and osteolysis led to a dislocation of the femoral implant. A minor stumble fall led to a fracture of the Os ilium. We present our treatment method with implantation of a cemented THA and refill of the bone cyst with bone from allogene femoral heads. The surgery led to a reconstruction of the physiological center of rotation in the hip. Consequently, to the inpatient stay, the patient took part in a follow-up treatment with intensive physiotherapy. Taken together, the results after total hip arthroplasty are more superior to other hip surface replacements in terms of longevity and patient satisfaction. Especially, metal-on-metal bearing couples carry a great risk of metallosis, which goes a long with pseudotumors, osteolysis, and the elevated metal ions in the blood. Since this case is unique in the literature, no guidelines are noted for surgical treatment. In our opinion, a periprosthetic fracture of this type should be performed in a hospital using extensive endoprosthetic expertise.
Case Report: A case of recurrent thrombosis in pediatric antiphospholipid syndrome associated with pediatric onset systemic lupus
Authors: Lingjuan Liu, Liqun Liu, Lu Zhang, Peng Huang, Xiqiang Dang, Lanjun Shuai, Xingfang Li, Yongzhen Li, Dingan Mao, Xiaochuan Wu, Yan Cao
Journal: Front Pediatr (2023)
Keywords: antiphospholipid antibody, antiphospholipid syndrome, gross hematuria, nephrotic syndrome, systemic lupus erythematosus
MeSH terms: Case Reports

Systemic lupus erythematosus (SLE) is an autoimmune disease with multi-system involvement as the main manifestation, and has complex and diverse clinical features. Studies on large samples have revealed that SLE patients have a significantly increased risk of thrombotic events, which are also one of the important causes of morbidity and mortality in SLE patients. Antiphospholipid syndrome (APS) is a rare autoimmune disorder characterized by recurrent arterial and venous thrombosis, pregnancy-related complications, and the persistence of antiphospholipid antibodies at a 12-week interval. There are few reports about SLE coexisting with APS in children. This paper reported a school-age patient who started the disease with gross hematuria after bumping into the waist. The initial diagnosis of renal contusion was then confirmed by color Doppler ultrasound as renal vein and inferior vena cava embolism. She suddenly developed severe chest pain and dyspnea 3 days after hospitalization. And imaging supported pulmonary embolism with massive proteinuria, hypoalbuminemia, and hypercholesterolemia. The initial diagnosis was nephrotic syndrome (NS) with arteriovenous embolization, and popliteal vein embolism occurred again 5 years later, and she was thus diagnosed with SLE coexisting with APS. Afterwards, we discussed the possible mechanism and therapeutic strategies of SLE&APS that started with nephrotic syndrome, in order to achieve early identification and treatment of the disease and improve the prognosis of children.
Hippocampal Damage and Atrophy Secondary to Status Epilepticus in a Patient with Schizophrenia
Authors: Elaine Keiko Fujisao, Nathalia Raquel Cristaldo, Aline Marques da Silva Braga, Paulina Rodrigues Cunha, Seizo Yamashita, Luiz Eduardo Betting
Journal: Front Neurol (2017)
Keywords: eeg, hippocampal sclerosis, neuroimaging, schizophrenia, temporal lobe epilepsy
MeSH terms: Case Reports

A 59-year-old man was admitted with respiratory tract infection, compromised conscience and generalized tonic-clonic seizures. His medical history included schizophrenia diagnosis, for which he had been being treated since he was 27 years old. EEG disclosed non-convulsive status epilepticus. A magnetic resonance image (MRI) acquired 3 days later showed increased left hippocampal volume with hyperintensity on T2-weighted and FLAIR sequences. After being treated with antibiotics and antiepileptic medications, the patient's condition improved. A follow-up MRI showed reduction of the left hippocampus. The relationship between epilepsy and schizophrenia is not yet clear. This case illustrates this interaction. Hippocampal atrophy may have been caused by environmental aggression in the present patient with schizophrenia, perhaps in association with a predisposing genotype.
First endoscopic submucosal dissection of gastroesophageal junction carcinoma in a 72-year old male from Saudi Arabia
Authors: Abdullah AlShammari, Sreyoshi Fatima Alam, Mohamed Khan, Mohammad Aburahmah
Journal: Int J Surg Case Rep (2019)
Keywords: adenocarcinoma, case report, endoscopic submucosal dissection, gastroesophageal junction

Introduction:
Esophageal and gastric tumors are very lethal malignancies. Their most common histology is adenocarcinoma for more than 90% of all gastroesophageal tumors.
Case presentation:
Herein, we report a case of endoscopic submucosal dissection for gastroesophageal junction carcinoma, the first of its kind to be performed in the Kingdom of Saudi Arabia for a 72-year-old patient, who was found to have a gastroesophageal junction mass extending to the cardia. Complete excision was performed via endoscopic submucosal dissection. There were no complications in the postoperative period and the patient was discharged in good condition.
Discussion:
Over time, the management of gastroesophageal junction carcinoma has evolved along with the surgical approach. Endoscopic submucosal dissection preserves the anatomical structures and not only leads to a better quality of life, but also decreases morbidity and mortality. The procedure shows favorable results for early-stage gastroesophageal junction carcinoma as a treatment option with excellent en bloc resection rates.
Conclusion:
Endoscopic submucosal dissection is an acceptable management for T1 gastroesophageal junction carcinoma.
Using spectral-domain optical coherence tomography to follow outer retinal structure changes in a patient with recurrent punctate inner choroidopathy
Authors: Kimberly E Stepien, Joseph Carroll
Journal: J Ophthalmol (2011)
MeSH terms: Case Reports

Punctate inner choroidopathy (PIC) is a rare idiopathic inflammatory disorder of the retina and choroid usually affecting healthy, young, myopic females and presenting with photopsia, paracentral scotomata, and blurred vision. It is characterized by yellow-white chorioretinal lesions concentrated in the posterior pole, no vitritis, relapsing inflammatory activity of the retina and choroid, and frequent development of choroidal neovascular membranes. Here we describe a case in which spectral-domain optical coherence tomography (SD-OCT) imaging was used to monitor outer retinal structure changes associated with recurrent PIC over time. SD-OCT, which is both quantative and objective, provides an efficient, non-invasive way to follow recurrent inflammatory chorioretinal lesion activity, choroidal neovascular membrane development, and treatment response in patients with recurrent PIC.
Potential of IL-1, IL-18 and Inflammasome Inhibition for the Treatment of Inflammatory Skin Diseases
Authors: Gabriele Fenini, Emmanuel Contassot, Lars E French
Journal: Front Pharmacol (2017)
Keywords: il-1, il-18, il-1alpha, il-1beta, inflammasome, inflammatory skin conditions
MeSH terms: Review

In 2002, intracellular protein complexes known as the inflammasomes were discovered and were shown to have a crucial role in the sensing of intracellular pathogen- and danger-associated molecular patterns (PAMPs and DAMPs). Activation of the inflammasomes results in the processing and subsequent secretion of the pro-inflammatory cytokines IL-1β and IL-18. Several autoinflammatory disorders such as cryopyrin-associated periodic syndromes and Familial Mediterranean Fever have been associated with mutations of genes encoding inflammasome components. Moreover, the importance of IL-1 has been reported for an increasing number of autoinflammatory skin diseases including but not limited to deficiency of IL-1 receptor antagonist, mevalonate kinase deficiency and PAPA syndrome. Recent findings have revealed that excessive IL-1 release induced by harmful stimuli likely contributes to the pathogenesis of common dermatological diseases such as acne vulgaris or seborrheic dermatitis. A key pathogenic feature of these diseases is IL-1β-induced neutrophil recruitment to the skin. IL-1β blockade may therefore represent a promising therapeutic approach. Several case reports and clinical trials have demonstrated the efficacy of IL-1 inhibition in the treatment of these skin disorders. Next to the recombinant IL-1 receptor antagonist (IL-1Ra) Anakinra and the soluble decoy Rilonacept, the anti-IL-1α monoclonal antibody MABp1 and anti-IL-1β Canakinumab but also Gevokizumab, LY2189102 and P2D7KK, offer valid alternatives to target IL-1. Although less thoroughly investigated, an involvement of IL-18 in the development of cutaneous inflammatory disorders is also suspected. The present review describes the role of IL-1 in diseases with skin involvement and gives an overview of the relevant studies discussing the therapeutic potential of modulating the secretion and activity of IL-1 and IL-18 in such diseases.
Primary intradural extramedullary extraosseous Ewing's sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
Authors: Feifei Pu, Jianxiang Liu, Zhicai Zhang, Tao Guo, Zengwu Shao
Journal: Open Med (Wars) (2021)
Keywords: piees/pnet, chemotherapy, radiotherapy, surgical resection, thoracolumbar
MeSH terms: Case Reports

We present a rare case of a primary intradural extramedullary Ewing's sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) in the thoracolumbar spine and review the current literature. We describe the imaging manifestations, pathological features, surgical methods, and patient survival to shed light on the clinical management of this rare tumor. A 32-year-old man experienced progressive low back pain for more than 1 month. An intradural extramedullary tumor from T12 to L2 was detected on magnetic resonance imaging. He underwent a thoracolumbar laminotomy for decompression, complete excision of the intradural extramedullary tumor, and internal fixation with pedicle screws. A histopathological examination confirmed that the tumor was a PIEES/PNET via an immunohistochemical study of the surgically resected tissues. Postoperatively, the patient received chemotherapy and radiotherapy. No recurrence, metastasis, or failure of internal fixation were noted at a 17-month post-surgery radiographic examination. PIEES/PNET of the thoracolumbar spine is extremely rare. Treatment is difficult because the current literature is sparse and cases are rare. Complete resection combined with chemotherapy and radiotherapy effectively reduces recurrence and metastasis.
Gamma Knife radiosurgery for locally recurrent choroidal melanoma following plaque radiotherapy
Authors: Osama A Sorour, John E Mignano, Jay S Duker
Journal: Int J Retina Vitreous (2018)
Keywords: brachytherapy, choroidal, gamma knife, melanoma, ocular, radiation, radiosurgery, tumor, uveal
MeSH terms: Case Reports

Background:
For the majority of eyes with choroidal melanoma, radiation therapy is the treatment of choice. Local recurrence after radiation therapy can occur, however, and when it does, salvaging the globe with useful vision is atypical.
Case presentation:
We report a case of late, local failure 7 years following previous brachytherapy successfully managed with Gamma Knife radiosurgery (GKR). With 3 years of follow up after GKR, the visual acuity is 20/20 and there is no evidence of systemic metastases.
Conclusion:
To our knowledge, this is the first report of successful salvage GKR therapy after brachytherapy failure in an eye with choroidal melanoma. GKR is an option for select cases of local recurrence after radiation plaque brachytherapy.
Page kidney of renal allograft following blunt trauma
Authors: Avneesh Kumar, Martin Wilkie, Peter Wg Brown, Chidambaram Nathan
Journal: Clin Nephrol Case Stud (2015)
Keywords: page kidney, renal allograft, trauma
MeSH terms: Case Reports

We report a case of the Page kidney phenomenon which occurred in a patient with a renal allograft following blunt trauma. The injury occurred following an accidental trip resulting in a trivial fall. The patient presented with acute graft dysfunction with no localizing symptoms or signs. His renal function deteriorated further and he also became hypertensive. Serial ultrasounds showed an increase in the size of perinephric hematoma and evidence of renal compression. Prompt surgical evacuation of the hematoma was performed and renal function returned to baseline. Serial ultrasound examinations and timely surgical intervention can prevent graft loss in this unusual situation.
Case Report: 1-Year Follow-Up of Vagus Nerve Stimulation in a Dog With Drug-Resistant Epilepsy
Authors: Junya Hirashima, Miyoko Saito, Hirotaka Igarashi, Satoshi Takagi, Daisuke Hasegawa
Journal: Front Vet Sci (2021)
Keywords: case report, dog, drug-resistant epilepsy, epilepsy surgery, neurostimulation, vagus nerve stimulation
MeSH terms: Case Reports

A vagus nerve stimulation (VNS) system was surgically implanted to treat drug-resistant epilepsy in a 5-year-old male Shetland Sheepdog. At regular visits during a 1-year follow-up, treatment efficacy and adverse effects were assessed, and programmable stimulation parameters were adjusted to optimize stimulation intensity while avoiding adverse effects. The frequency of generalized tonic-clonic seizures was reduced by 87% after the initiation of VNS. The owner reported that the dog regained his personality, and the quality of life of both the dog and owner improved. The only adverse effect of VNS was a cough that was controlled by adjusting stimulation parameters. There were no surgical complications or other issues with the VNS device. This is the first long-term evaluation of VNS therapy in a dog, and the results obtained suggest that gradual adjustments of VNS parameters facilitate optimum VNS dosing.
Novel Variation in Acyl-CoA Synthetase Long Chain Family Member 6 (ACSL6) Results in Protein Structural Modification and Multiple Non-Related Neoplasia in a 46-Year-Old: Case Report
Authors: María Isabel Castillo, Erick Freire, Vanessa I Romero, Benjamín Arias-Almeida, Carlos Reyes, Kazuyoshi Hosomichi
Journal: Front Oncol (2022)
Keywords: acsl6, astrocytoma, breast, missense, thyroid
MeSH terms: Case Reports

Multiple non-related neoplasia does not have an established approach or benefits for performing whole-exome sequencing (WES) analysis. We report on a 46-year-old woman who developed astrocytoma, thyroid, and breast cancer within 10 years. The WES analysis found a novel missense variant in the ACSL6 gene, and the protein modeling showed altered secondary and tertiary structures, which modify the binding to cofactors and substrates. ACSL6 is involved in lipid metabolism, expressed in the brain, thyroid, and breast tissues, and is associated with diverse types of cancer. Our study demonstrates the benefit of WES analysis compared with commercial panels in patients with non-related neoplasia.
A case report of Arnold Chiari type 1 malformation in acromesomelic dwarf infant
Authors: Miteshkumar Rajaram Maurya, Renju Ravi, Sona Ajit Pungavkar
Journal: Pan Afr Med J (2021)
Keywords: arnold chiari 1 malformation, acromesomelic dwarfism, case report, hydrocephalus, neural tube defects
MeSH terms: Arnold-Chiari Malformation / diagnostic imaging, Dwarfism / diagnostic imaging, Hydrocephalus / diagnostic imaging, Osteochondrodysplasias / diagnostic imaging, Case Reports, Brain / diagnostic imaging, Female, Humans, Infant, Male, Pregnancy, Ultrasonography, Prenatal, Acromesomelic dysplasia

Arnold Chiari malformation is one of the commonest cause of congenital hydrocephalus. Cause of fetal development of cerebellar tonsils remains unknown and may be diagnosed at later in life. The association of Arnold Chiari malformation with acromesomelic dwarfism is not known. We report male infant diagnosed with acromesomelic dwarfism at end of gestation period on basis of antenatal ultrasonography findings. An ultrasound scan of infant head at fifth month of birth was performed in view of increasing head circumference that revealed aqueductal stenosis with dilated posterior horn of lateral ventricles in brain.
Traumatic posterior sternoclavicular joint dislocation in a child: a case report
Authors: Gabriel Ngom, Azhar Salim Mohamed, Mohamed Ould El Housseine, Oumar Ndour
Journal: Pan Afr Med J (2014)
Keywords: ct scan, sternoclavicular joint, child, closed reduction, dislocation
MeSH terms: Arm Injuries / diagnostic imaging, Joint Dislocations / diagnostic imaging, Sternoclavicular Joint / injuries, Case Reports, Arm Injuries / surgery, Child, Humans, Joint Dislocations / surgery, Male, Plastic Surgery Procedures, Radiography, Thoracic, Sternoclavicular Joint / diagnostic imaging, Tomography, X-Ray Computed, Wounds, Nonpenetrating

Sternoclavicular joint dislocation is a rare event. It occurs most often in a violent trauma. The authors report the case of a10 years old child, received at emergencies for right shoulder blunt trauma after been punched by another child. He presented with right shoulder pain, right upper limb functional impairment and right sternoclavicular joint depression. Standard chest radiographs were normal. Chest CT scan showed posterior dislocation and allowed us to determine its variety. Twelve hours after the trauma, a closed reduction has been done under general anesthesia. A control CT scan showed a restoration of normal joint anatomy. After 18 months, the shoulder was painless and mobile in all directions. It is an isolated recent posterior sternoclavicular joint dislocation in a child. With this observation the authors emphasizeon the unusual mechanism of such a dislocation occurrence, the primary role of CT scan in the diagnosis and early closed reduction.