OpenMed/multicare-articles huggingface dataset:
Coexistence of Primary Sjögren's Syndrome and Autoimmune Gastritis With Pernicious Anemia and Subacute Combined Degeneration of the Spinal Cord: Case Report and Literature Review
Authors: Hao-Su Zhan, Xin Yao, Hai-Yi Hu, Yan-Fei Han, Bing Yue, Li-Ying Sun, Yong-Jun Wang
Journal: Front Immunol (2022)
Keywords: autoimmune gastritis, case report, pernicious anemia, primary sjögren’s syndrome, subacute combined degeneration of the spinal cord
MeSH terms: Anemia, Pernicious / complications, Anemia, Pernicious / diagnosis, Gastritis / complications, Gastritis / diagnosis, Sjogren's Syndrome / complications, Sjogren's Syndrome / diagnosis, Subacute Combined Degeneration / complications, Subacute Combined Degeneration / etiology, Case Reports, Review, Research Support, Non-U.S. Gov't, Aged, Female, Humans

Background:
Autoimmune gastritis (AIG) and Primary Sjögren's syndrome (pSS) are both autoimmune diseases with low prevalence in China. Subacute combined degeneration (SCD) of the spinal cord is the most common neurological manifestation of vitamin B12 deficiency. Until now, a patient with pSS and complications of AIG including SCD has not been reported.
Case presentation:
A 69-year-old woman presented with palpitations and symmetrical and progressive numbness in her hands and feet. The patient had a sense of stepping on cotton and could not write or walk without help. We reviewed the patient's history and analyzed her blood tests, imaging, gastroscopic findings, and pathological results. The patient fulfilled the criteria of AIG, pSS, spinal cord SCD and early pernicious anemia (PA) simultaneously. Although pSS can lead to reduction of vitamin B12, this is the first overlapping case of pSS with spinal cord SCD. After symptomatic treatment, the patient returned to a normal life.
Conclusions:
This first report about the coexistence of pSS and complications of AIG including SCD and PA will promote a better understanding of the relationship between these diseases.
Poorly Controlled Type 3c Diabetes due to Use of Veterinarian Insulin Syringes
Authors: Francisco Barrera, Natia Murvelashvili
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Initiation of insulin therapy can be challenging for patients; proper training should be given by physicians and certified educators to ensure correct and safe use for outpatient population. Different insulin strengths are now available in the US; while U-40 insulin does not exist in the United States for humans, it is a very common strength used in animals. We are reporting a 30-year-old male that became insulin dependent after hospitalization for necrotizing pancreatitis who was using U-40 syringes to draw from the prescribed insulin U-100 and also presented with repeated hypoglycemic episodes.
Efficacy of Hydrochlorothiazide and low renal solute feed in Neonatal Central Diabetes Insipidus with transition to Oral Desmopressin in early infancy
Authors: Mary B Abraham, Shripada Rao, Glynis Price, Catherine S Choong
Journal: Int J Pediatr Endocrinol (2014)
Keywords: desmopressin, hydrochlorothiazide, hyponatremia, low renal solute feeds, neonatal central diabetes insipidus

Background:
The treatment of central diabetes insipidus (DI) with desmopressin in the neonatal period is challenging because of the significant risk of hyponatremia with this agent. The fixed anti-diuresis action of desmopressin and the obligate high fluid intake with milk feeds lead to considerable risk of water intoxication and hyponatremia. To reduce this risk, thiazide diuretics, part of the treatment of nephrogenic DI, were used in conjunction with low renal solute feed and were effective in a single case series of neonatal central DI.
Aim:
We evaluated the efficacy of early treatment of neonatal central DI with hydrochlorothiazide with low solute feed and investigated the clinical indicators for transition to desmopressin during infancy.
Methods:
A retrospective chart review was conducted at Princess Margaret Hospital, Perth of neonates diagnosed with central DI and treated with hydrochlorothiazide, between 2007 and 2013. Four newborns were identified. Mean sNa and mean change in sNa with desmopressin and hydrochlorothiazide treatment were recorded along with episodes of hyponatremia and hypernatremia. Length and weight trajectories during the first 12 months were assessed.
Results:
The mean change in sNa per day with hydrochlorothiazide and low renal solute feed was 2.5 - 3 mmol/L; on desmopressin treatment, the mean change in sNa was 6.8-7.9 mmol/L. There was one episode of symptomatic hyponatremia with intranasal desmopressin with no episodes of hyponatremia or hypernatremia during treatment with hydrochlorothiazide or following transition to oral desmopressin. Transition to oral desmopressin between 3 to 12 months of age was associated with good control of DI. Following introduction of solids, sNa remained stable but weight gain was slow. This improved following transition to desmopressin in one infant.
Conclusions:
Hydrochlorothiazide with low renal solute feed is a safe and effective treatment option in neonatal central DI. However, transition to desmopressin should be considered early in infancy following initiation of solids to facilitate growth.
Rehabilitation assisted by Space technology-A SAHC approach in immobilized patients-A case of stroke
Authors: Chrysoula Kourtidou-Papadeli, Christos Frantzidis, Ilias Machairas, Christos Giantsios, Emmanouil Dermitzakis, Nikolaos Kantouris, Evdokimos Konstantinids, Panagiotis Bamidis, Joan Vernikos
Journal: Front Physiol (2023)
Keywords: artificial gravity, cardiac output, deconditioning, exercise, graph theory, mean arterial pressure, rehabilitation, short-arm human centrifuge

Introduction: The idea behind the presentation of this case relates to utilizing space technology in earth applications with mutual benefit for both patients confined to bed and astronauts. Deconditioning and the progressiveness of skeletal muscle loss in the absence of adequate gravity stimulus have been of physiological concern. A robust countermeasure to muscle disuse is still a challenge for both immobilized patients and astronauts in long duration space missions. Researchers in the space medicine field concluded that artificial gravity (AG) produced by short-radius centrifugation on a passive movement therapy device, combined with exercise, has been a robust multi-system countermeasure as it re-introduces an acceleration field and gravity load. Methods: A short-arm human centrifuge (SAHC) alone or combined with exercise was evaluated as a novel, artificial gravity device for an effective rehabilitation strategy in the case of a stroke patient with disability. The results reveal valuable information on an individualized rehabilitation strategy against physiological deconditioning. A 73-year-old woman was suddenly unable to speak, follow directions or move her left arm and leg. She could not walk, and self-care tasks required maximal assistance. Her condition was getting worse over the years, also she was receiving conventional rehabilitation treatment. Intermittent short-arm human centrifuge individualized protocols were applied for 5 months, three times a week, 60 treatments in total. Results: It resulted in significant improvement in her gait, decreased atrophy with less spasticity on the left body side, and ability to walk at least 100 m with a cane. Balance and muscle strength were improved significantly. Cardiovascular parameters improved responding to adaptations to aerobic exercise. Electroencephalography (EEG) showed brain reorganization/plasticity evidenced through functional connectivity alterations and activation in the cortical regions, especially of the precentral and postcentral gyrus. Stroke immobility-related disability was also improved. Discussion: These alterations were attributed to the short-arm human centrifuge intervention. This case study provides novel evidence supporting the use of the short-arm human centrifuge as a promising therapeutic strategy in patients with restricted mobility, with application to astronauts with long-term muscle disuse in space.
Spontaneous Free Peritoneal Perforation of an Infected Pancreatic Fluid Collection Managed with Laparoscopic Drainage and Necrosectomy
Authors: W G P Kanchana, A D Dharmapala, B K Dassanayake, W M A S B Wasala, K B Galketiya
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Introduction:
Free peritoneal perforation of pancreatic fluid collections is extremely rare and only few case reports exist in the literature. Many of these patients undergo emergency exploratory laparotomy due to sepsis and haemodynamic instability requiring sepsis control. The use of laparoscopic techniques in this circumstance is limited by the haemodynamic stability of the patient and the technical challenges. But effective laparoscopic management is associated with less morbidity to the patient. Case Presentation. A 28-year-old patient presented with worsening generalized abdominal pain with increased inflammatory markers. She required persistent inotropic support despite adequate fluid resuscitation. She had transient acute renal impairment and acute respiratory distress, which improved with noninvasive support. CECT (contrast-enhanced computed tomography) showed an infected pancreatic fluid collection with peritoneal free fluid. Aspiration of pelvic collection showed purulent fluid. Based on these clinical and imaging findings, she was diagnosed with a free peritoneal perforation of an infected pancreatic fluid collection. She underwent a laparoscopic drainage and necrosectomy of the infected pancreatic collection and peritoneal washout. She had a gradual recovery. All inotropes were omitted on the second day following surgery. She was sent to the ward from the ICU (intensive care unit) on the 4th postoperative day.
Conclusion:
The laparoscopic approach is a viable option in managing ruptured pancreatic fluid collections when patient and technical factors are supportive. It reduces surgical morbidity, thereby reducing the overall strain on physiological reserves. When opted for laparoscopic drainage, the procedure must be guided by imaging findings. Multidisciplinary participation is critical in the overall management.
Recurrent acute pancreatitis probably induced by rosuvastatin therapy: a case report
Authors: Jayakrishna Chintanaboina, Deepa Gopavaram
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Context. Approximately 1.4-2% of all cases of acute pancreatitis are drug related in general population. The literature on statin-induced pancreatitis consists primarily of anecdotal case reports. We report a case of possible rosuvastatin-induced pancreatitis. Case Report. A 67-year-old female presented with progressively worsening abdominal pain and vomiting for 7 days. Home medications included rosuvastatin and clonidine. CT scan of abdomen, with intravenous contrast, showed findings consistent with acute pancreatitis. She responded to conservative management. Rosuvastatin was resumed at the time of discharge from the hospital, and she presented two months later with recurrence of acute pancreatitis. Further workup ruled out all likely causes of acute pancreatitis. Rosuvastatin was stopped completely when she was discharged the second time, and she did not have any further episodes of acute pancreatitis. She was completely asymptomatic throughout the 18-month follow-up period. Conclusion. This paper reinforces the possible association of rosuvastatin, a novel statin, with acute pancreatitis, even though the exact underlying mechanism of statin-induced pancreatitis remains unknown.
Bedside Transcatheter Patent Ductus Arteriosus Device Occlusion in an Extremely Low Birth Weight Neonate: A Novel Approach in a High-Risk Population
Authors: Tiffany M Pouldar, Robert Wong, Myriam Almeida-Jones, Evan Zahn, Lorraine Lubin
Journal: Case Rep Anesthesiol (2021)
MeSH terms: Case Reports

Extremely low birth weight (ELBW) infants weighing less than 1 kilogram are at a high-risk for delayed patent ductus arteriosus (PDA) closure. Percutaneous PDA closure offers a less invasive approach when compared with surgical PDA closure, which may provide faster recovery times and less transfusion requirements. However, this procedure involves transporting tenuous, unstable patients from the neonatal intensive care unit (NICU) to the catheterization laboratory which introduces many potential risks for the neonate. Performing percutaneous PDA closure at the bedside offers a successful alternative to performing the procedure in the catheterization laboratory and avoiding risk associated with transporting ELBW neonates.
A rare presentation of pellet injury in the neck
Authors: Bulbul Gupta, Achal Gulati, Divya Gupta
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Penetrating neck injuries are dangerous and deserve emergency treatment by virtue of the vital structures present underneath. There is a potential risk of unrecognized vascular injury and retained foreign bodies with their associated complications in these wounds. Therefore, an early diagnostic workup to localize the site of injury and an immediate neck exploration are important.
Case Report: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Relapse With COVID-19
Authors: Mark Woodhall, James W Mitchell, Emily Gibbons, Sarah Healy, Patrick Waters, Saif Huda
Journal: Front Neurol (2020)
Keywords: devic's disease, autoimmune diseases, myelin-oligodendrocyte glycoprotein (mog), optic neuritis, post-infectious, visual loss
MeSH terms: Case Reports

A 39-year-old lady with relapsing myelin oligodendrocyte glycoprotein antibody (MOG-IgG) associated disease developed coryzal symptoms, malaise, sweating, and postural dizziness. Six days later she presented with painful progressive right visual loss consistent with optic neuritis. COVID-19 was confirmed by nasopharyngeal swab and MOG-IgG serological reversion was noted. Visual function improved following steroids and plasma exchange. This case highlights a possible causal association between inflammation due to COVID-19 and a relapse of MOG-IgG associated disease. It also highlights the clinical relevance of reporting MOG-IgG titers in MOG-IgG associated disease.
Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Meningitis and Cerebral Abscess in a Neonate: Therapeutic Challenge
Authors: Surasak Puvabanditsin, Marianne Jacob, Maaz Jalil, Samhita Bhattarai, Qaiser Patel, Mehrin Sadiq, Rajeev Mehta
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

We report a case of a 12-day-old term neonate with extended-spectrum beta-lactamase (ESBL) producing Escherichia coli (E. coli) meningitis and cerebral abscess. The patient received a 7-day course of antibiotics just few days prior to the infection. The incidence of infections from ESBL-producing E. coli is increasingly emerging. Antimicrobial agents must be vigilantly utilized to prevent the new highly resistant bacteria.
Case report: Simultaneous occurrence of primary pulmonary lymphoma and opportunistic infections in a patient with chronic myeloid leukemia
Authors: Yazhen Bi, Saran Feng, Jinyu Shang, Qian Liu, Yan Wang
Journal: Front Oncol (2022)
Keywords: antibiotic therapy, biopsy, chronic myeloid leukemia, opportunistic infections, pathology, primary pulmonary lymphoma
MeSH terms: Case Reports

Background:
The occurrence of primary pulmonary lymphoma (PPL) as a secondary malignancy in patients diagnosed with chronic myeloid leukemia (CML) is extremely rare. As the clinical manifestations are atypical, most patients with PPL tend to be misdiagnosed with pneumonia. When the radiographic features of PPL and pulmonary infection overlap, clinicians can be confused about the diagnosis. Here, we report the first case of coexistence of PPL and opportunistic infections in a patient with CML in chronic phase (CML-CP).
Case presentation:
A 55-year-old woman presented with three weeks of hemorrhage of the oral mucosa at the Department of Hematology. After undergoing various examinations, she was diagnosed with CML-CP and was started on imatinib (400 mg/daily). Due to sudden respiratory distress, the patient was admitted to the respiratory intensive care unit 11 months later. Chest computed tomography (CT) revealed ground-glass opacities, patchy shadows, and multiple nodules in both lungs and enlarged mediastinal lymph nodes. The combination of biapenem and voriconazole antibiotic treatments was effective. The patient's respiratory distress was relieved, but there was intermittent coughing. In the following time, the patient developed a fever, and the imaging findings indicated progression of the disease in both lungs. Bronchoalveolar lavage (BAL) identified pathogens of multiple opportunistic infections. The coexistence of lymphomatoid granulomatosis (LYG) was not confirmed in this patient until a second CT-guided biopsy was performed. Ultimately, the patient underwent chemotherapy in time and is currently alive today.
Conclusions:
When the patient's recurrent respiratory symptoms and imaging findings do not coincide, secondary tumors should be considered in addition to infection as a diagnosis. In these cases, multiple pathological tissue biopsies should be performed.
Case report: Heart retransplant from a donor after circulatory death and extended transport period with normothermic perfusion
Authors: Patpilai Kasinpila, Chawannuch Ruaengsri, Tiffany Koyano, Yasuhiro Shudo
Journal: Front Cardiovasc Med (2023)
Keywords: donor after circulatory death, donor distance, heart retransplantation (rtx), normothermic ex vivo perfusion, organ preservation
MeSH terms: Case Reports

A 55-year-old man with end-stage heart failure, who had an orthotopic heart transplant 21 years prior, underwent heart retransplantation using a heart from a donor with circulatory death in a distant location and an extended transport period with normothermic ex vivo perfusion. Owing to the persistent and worsening shortage of donor hearts, this case illustrates that expanding the donor acceptance criteria to include more distant donor locations and enrolling recipients with extended criteria (e.g., heart retransplantation) is feasible.
Chronic Myeloid Leukemia Relapsing 25 Years after Allogenic Stem Cell Transplantation
Authors: Håkon Reikvam, Jørn Skavland, Stein-Erik Gullaksen, Randi Hovland, Tobias Gedde-Dahl, Øystein Bruserud, Bjørn Tore Gjertsen
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Chronic myeloid leukemia (CML) is a myeloproliferative disorder in which neoplastic cells exhibit the Philadelphia chromosome and the related oncoprotein BCR-ABL1. Allogeneic stem cell transplantation (allo-SCT) was considered the first-line treatment for CML, before the introduction of tyrosine kinase inhibitors (TKIs). However, patients are at risk for relapse years after transplantation. We present a patient who relapsed 25 years after allo-SCT for chronic phase CML. Polymerase chain reaction (PCR) detected gradually evaluated levels of BCR-ABL1 transcripts, eventually leading to the diagnosis of relapsed disease. Additional mutational analyses did not reveal mutations in the BCR-ABL1 gene, or other cooperating mutations. The patient was successfully treated with imatinib 400 mg daily, leading to new molecular remission. The case presentation emphasizes the need for long-term follow-up of such patients and the potential benefit of initiating TKI treatment with early signs of relapse.
Asymmetric posterior reversible encephalopathy syndrome in patient with hyperplastic anterior choroidal artery
Authors: Andrea Romano, Pugliese Silvia, Pierallini Alberto, Francesca Tavanti, Giuliano Sette, Sara La Starza, Luigi Maria Fantozzi, Alessandro Bozzao
Journal: J Headache Pain (2011)
MeSH terms: Brain Edema / diagnosis, Carotid Artery, Internal / physiopathology, Cerebrovascular Disorders / diagnosis, Hypertension / complications, Hypoxia-Ischemia, Brain / diagnosis, Ischemic Attack, Transient / diagnosis, Case Reports, Brain Edema / pathology, Carotid Artery, Internal / pathology, Cerebrovascular Disorders / pathology, Humans, Hypoxia-Ischemia, Brain / pathology, Ischemic Attack, Transient / pathology, Male, Middle Aged, Treatment Outcome

We describe a case of asymmetric PRES due to the presence of hyperplastic anterior choroidal artery (AChA) in a man affected by sever hypertension. Posterior reversible encephalopathy syndrome (PRES) has become synonymous with a unique pattern of brain vasogenic edema and predominates in the parietal and occipital regions, accompanied by clinical neurological alterations. Sever hypertension is a risk factor that exceeds the limits of brain autoregulation, leading to breakthrough brain edema. In our knowledge this is the first case reported in literature, in which a similar vascular abnormality is linked to a PRES syndrome.
Preoperative imatinib and laparoscopic intersphincteric resection for large rectal gastrointestinal stromal tumor: A case report
Authors: Shinnosuke Nagano, Norikatsu Miyoshi, Tsuyoshi Takahashi, Hiroaki Itakura, Shiki Fujino, Takayuki Ogino, Hidekazu Takahashi, Mamoru Uemura, Chu Matsuda, Tsunekazu Mizusima, Masaki Mori, Yuichiro Doki
Journal: Int J Surg Case Rep (2020)
Keywords: imatinib, laparoscopic intersphincteric resection, rectal gastrointestinal stromal tumor
MeSH terms: Case Reports

Introduction:
Anus-preserving surgery for a large rectal gastrointestinal stromal tumor (GIST) may be difficult because of the location of the tumor in the pelvis. Therefore, rectal GIST might require extensive surgery, such as abdominoperineal resection. In recent years, preoperative imatinib therapy has been used to reduce tumor size and preserve the anus in some cases. However, there have been few reports of laparoscopic anal-preserving surgery for giant rectal GIST.
Presentation of a case:
We present the case of a 55-year-old man who was referred to our hospital for examination of a 10-cm pelvic mass in the lower rectum. Endoscopic ultrasound with fine needle aspiration was performed, and the pathological findings resulted in a diagnosis of GIST. The mass had spread to the prostate and left levator ani muscles, and as a result, surgery was deemed difficult to perform without damaging the pseudo-capsule. Therefore, preoperative chemotherapy with imatinib mesylate (IM) was performed for 8 months. The mass was reduced to 7.8 cm, and laparoscopic intersphincteric resection (ISR) was performed.
Discussion:
We also review prior cases of rectal GIST where patients had undergone anal-preserving surgery following preoperative chemotherapy with IM. Our case represented the largest tumor size in a review of cases of patients who had successful anal-preserving laparoscopic surgery following preoperative chemotherapy with IM.
Conclusion:
Preoperative chemotherapy with imatinib mesylate was effective for reducing the rectal GIST, and laparoscopic ISR was useful for anal preservation, even when a tumor is large.
DKA-Induced Takotsubo Cardiomyopathy in Patient with Known HOCM
Authors: Ayla Gordon, Gina LaCapra, Roberto Roberti
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

The first published case of Diabetic Ketoacidosis-induced Takotsubo cardiomyopathy was in 2009. Our patient is the 1st reported case of Diabetic Ketoacidosis- (DKA-) induced Takotsubo cardiomyopathy (TC) in a patient with known hypertrophic cardiomyopathy (HOCM) in the United States. In the literature, there are only two examples linking DKA to TC; however, this report focuses on the biochemical and physiological causes of TC in a patient with known HOCM and new-onset DKA. TC in previously diagnosed HOCM poses particular complications. With the above patient's baseline outflow tract obstruction due to septal hypertrophy, the acute reduction in EF due to TC resulted in transient drop in brain perfusion and, therefore, syncope.