OpenMed/multicare-articles huggingface dataset:
Hydrogen Peroxide Induced Colitis: A Case Report and Literature Review
Authors: Dushyant Pawar, Anna Calara, Roy Jacob, Nancy Beck, Alan N Peiris
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Constipation is a common condition. Hydrogen peroxide enemas have rarely been reported as a home remedy for constipation in the pediatric age group. We present a case report and literature review of hydrogen peroxide induced colitis in pediatric siblings, aged 2 years and 9 years. The siblings presented with vomiting and bloody diarrhea an hour following the enema. Physical exam, vital signs, blood, and electrolyte counts were normal, but CT scans showed mucosal thickening of the rectum and colon. Their symptoms resolved after oral intake was curtailed and fluids were replaced intravenously. We discuss existing reports of complications from hydrogen peroxide enemas. Patients may present with abdominal pain and bloody diarrhea. Onset of symptoms varied from minutes to a day and bowel ulceration with necrosis and perforation has occurred, although fatality is rare. Diagnostic tests included computed tomography (CT) scan, sigmoidoscopy, or biopsy. Recovery period ranged from 3 days to 8 months. Public education regarding the dangers of hydrogen peroxide enemas is needed.
Cushing's disease presenting with gastrointestinal perforation: a case report
Authors: Takuma Hara, Hiroyoshi Akutsu, Tetsuya Yamamoto, Eiichi Ishikawa, Masahide Matsuda, Akira Matsumura
Journal: Endocrinol Diabetes Metab Case Rep (2013)

Gastrointestinal perforation is a complication associated with steroid therapy or hypercortisolism, but it is rarely observed in patients with Cushing's disease in clinical practice, and only one case has been reported as a presenting symptom. Herein, we report a rare case of Cushing's disease in which a patient presented with gastrointestinal perforation as a symptom. A 79-year-old man complained of discomfort in the lower abdomen for 6 months. Based on the endocrinological and gastroenterological examinations, he was diagnosed with Cushing's disease with a perforation of the descending colon. After consultation with a gastroenterological surgeon, it was decided that colonic perforation could be conservatively observed without any oral intake and treated with parenteral administration of antibiotics because of the mild systemic inflammation and lack of abdominal guarding. Despite the marked elevated levels of serum cortisol, oral medication was not an option because of colonic perforation. Therefore, the patient was submitted to endonasal adenomectomy to normalize the levels of serum cortisol. Subsequently, a colostomy was successfully performed. Despite its rarity, physicians should be aware that gastrointestinal perforation may be associated with hypercortisolism, especially in elderly patients, and immediate diagnosis and treatment of this life-threatening condition are essential. If a perforation can be conservatively observed, endonasal adenomectomy prior to laparotomy is an alternative treatment option for hypercortisolism.
Learning points:
Thus far, only one case of gastrointestinal perforation as a presenting clinical symptom of Cushing's disease has been reported.Physicians should be aware that gastrointestinal perforation might be associated with hypercortisolism in elderly patients because elevated levels of serum cortisol may mask the clinical signs of perforation. Because of this masking effect, the diagnosis of the perforation also tends to be delayed.Although parenteral administration of etomidate is a standard treatment option for decreasing the elevated levels of serum cortisol, endonasal adenomectomy prior to laparotomy is an alternative treatment option if etomidate therapy is unavailable.
Cannabinoid Hyperemesis Syndrome: A Case Report of Cyclic Severe Hyperemesis and Abdominal Pain with Long-Term Cannabis Use
Authors: Julia Hermes-Laufer, Lola Del Puppo, Ihsan Inan, François-Xavier Troillet, Omar Kherad
Journal: Case Rep Gastrointest Med (2016)

Introduction. Cannabinoid Hyperemesis Syndrome (CHS) is a rare condition that includes cyclic severe vomiting in subjects who have been consuming large doses of cannabis for several years. One of the major diagnostic criteria is the alleviation of symptoms by hot showers. The syndrome was first described in 2004 and is so far neither completely understood nor well known. The latter leads to continued morbidity in concerned subjects and unnecessary expenses for futile investigations. Standard treatments of vomiting as 5-HT3 or D2-receptor antagonists have been shown to be ineffective in alleviating the symptoms. The only long-term satisfying treatment option is the complete abstinence from cannabis consumption. Case Summary. In this case report we describe a 26-year-old male Caucasian long-term cannabis consumer who repeatedly presented in our emergency room with cyclic severe nausea and vomiting ceased by hot showers and resistant to all other treatments. The final diagnosis was not established until his third visit to the ER. Conclusion. CHS is an important differential diagnosis in patients who present with cyclic vomiting and abdominal pain with a history of long-term cannabis use. Recognition of this syndrome is important in order to avoid unnecessary clinical testing and to help the patients break the cycle of drug use.
Neuropsychological and Psychological Functioning Aspects in Myotonic Dystrophy Type 1 Patients in Italy
Authors: Edward Callus, Enrico G Bertoldo, Maria Beretta, Sara Boveri, Rosanna Cardani, Barbara Fossati, Elisa Brigonzi, Giovanni Meola
Journal: Front Neurol (2018)
Keywords: myotonic dystrophy, neuropsychological assessment, neuropsychological functioning, patient empowerment, psychological assessment, psychological funtioning

Introduction: Myotonic Dystrophy Type 1 (DM1) is an autosomal dominant genetic illness, characterized by a progressive loss of strength. Important deficits in cognitive functioning and a significant prevalence of psychiatric disorders have been previously reported. Methods:A neuropsychological and psychological assessment was carried out in 31 DM1 patients (61% males) in order to measure the cognitive functioning and explore their personality profiles. The MMSE Mini-Mental State Examination, Frontal Assessment Battery (FAB), ENB-2 Battery assessing memory (short term, long term and working memory), integration capacities, visual-spatial ability, attention (selective, divided, shifting/switching) executive functions, praxis, discrimination and logic capabilities and psychopathology Symptom Check List 90-R (SCL-90-R) were administered. The neuropsychological and psychological evaluation of DM1 patients was carried out taking into consideration the clinical parameters (CTG repeat, age at onset, disease duration, Muscular Impairment Rate Scale (MIRS), Medical Research Council Scale (MRC) and the Epworth Sleepiness Scales (EPS)). Results: Regarding psychopathology 19.4% of patients scored a moderate or high level of symptoms intensity index (GSI), 12.9% reported a high number of symptoms (PST) and 16.1% reported a high intensity level of the perceived symptoms (PSDI). Fatigue and daytime sleepiness resulted as being associated with higher levels of psychoticism (PSY). Only 1 patient reported a severe impairment in the spatial and temporal orientation, memory, language, praxis, attention and calculation. Longer disease duration was also associated with cognitive impairment evaluated through ENB-2 (p < 0.05). Discussions and Conclusions:There are indications of the utility of neuropsychological and psychological screening and support for these patients and their families due to the link between disease duration and cognitive performances. A proposal of a clinical protocol, with an illustration of a clinical case report of a family is presented.
A New Mechanism of Silicone Oil-Induced Glaucoma and Its Management
Authors: Harsh Kumar, Dinesh Talwar, Mithun Thulasidas, Surbi Taneja
Journal: Case Rep Ophthalmol Med (2022)
MeSH terms: Case Reports

Purpose:
To describe a case of secondary acute angle closure glaucoma due to silicone oil migration into the posterior chamber causing entrapment of aqueous and its successful management. Case Presentation. A 69-year-old female presented with decreased vision and pain in the left eye (LE) for one month. She had a history of complicated phacoemulsification with nucleus drop and retinal detachment in LE, for which vitreoretinal surgery with silicone oil endotamponade was done. She was also a known case of primary open angle glaucoma on medications. The corrected distance visual acuity was 20/20 and 20/125 in the right eye (RE) and LE, respectively. The intraocular pressure (IOP) was 18 mmHg in RE and 45 mmHg in LE. Anterior segment examination of LE revealed 270° of iridocorneal apposition in the periphery of the anterior chamber. Fundus examination of LE showed silicone oil filled vitreous cavity with attached retina. Given the recent history of silicone oil injection and elevated IOP despite maximum antiglaucoma medications, we decided to perform laser peripheral iridotomy (LPI) in the area of iridocorneal apposition. Following LPI, the IOP in LE came down to 17 mmHg and remained stable within the normal range for one month, after which the patient was taken up for silicone oil removal.
Conclusion:
This case report highlights a new mechanism of silicone oil-induced glaucoma and the technique of performing LPI in the area of iridocorneal apposition, for the first time in the literature. Silicone oil migration into the posterior chamber from the vitreous cavity in the presence of zonular dehiscence can push the iris forward and lead to iridocorneal apposition, resulting in an acute rise in IOP. Performing LPI within the area of iridocorneal apposition can help the aqueous seep into the anterior chamber and release the silicone oil globule trapped behind the iris to enter the anterior chamber, thus relieving the iridocorneal adhesions and lowering the IOP.
A new approach for severe aortic regurgitation in porcelain aorta with sutureless Perceval valve: A case report
Authors: Gian Luca Martinelli, Attilio Cotroneo, Edmond Stelian, Diana Benea, Marco Diena
Journal: Int J Surg Case Rep (2019)
Keywords: aortic regurgitation, aortic valve replacement, porcelain aorta, sutureless valve, transcatheter aortic valve implantation

Introduction:
The association of pure aortic regurgitation and porcelain aorta represents a challenging situation. In the Transcatheter Aortic Valve Implantation (TAVI) era, porcelain aorta (PA) becomes an additional risk for patient treatment and sometimes serves as the primary indication for the TAVI approach, even in low-risk patients. Devices currently on the market are not yet validated for the treatment of pure aortic regurgitation (AR) in PA and mid/long-term results are still not available. Furthermore, small calcified sinotubular junction and the association of small Valsalva sinus with low origin of coronaries ostia represent a relative contraindication of TAVI.
Presentation of case:
We report a case of severe symptomatic AR associated with a PA in a patient successfully treated with a sutureless Perceval valve.
Discussion:
The sutureless Perceval valve may represent an excellent option. This valve requires less manipulation of the ascending aorta and no manipulation of the aortic annulus except for the aortic valve leaflets removal. Furthermore, it can be implanted also in a small and calcified sino-tubular junction because the valve is collapsible before the implant.
Conclusion:
The present case represents a proof that self-expandable cardiac valve technology can be employed to treat, either by surgery or by catheter, selected cases of AR. We have observed an excellent mid term result with no paravalvular leak at 2 years.
Partial and complete trisomy 14 mosaicism: clinical follow-up, cytogenetic and molecular analysis
Authors: Consuelo Salas-Labadía, Esther Lieberman, Roberto Cruz-Alcívar, Pilar Navarrete-Meneses, Samuel Gómez, Consuelo Cantú-Reyna, Karin Buiting, Carola Durán-McKinster, Patricia Pérez-Vera
Journal: Mol Cytogenet (2014)
Keywords: deletion 14q112, marker chromosome 14, microarray analysis, trisomy 14 mosaicism
MeSH terms: Case Reports

Background:
Trisomy 14 mosaicism is a rare chromosomal abnormality. It is associated with multiple congenital anomalies. We report a 15 year-old female with an unusual karyotype with three cell lines: 47,XX,+mar/47,XX,+14/46,XX. At six months old she had short stature, cleft palate, hyperpigmented linear spots in arms and legs and developmental delay. At present, she has mild facial dysmorphism and moderate mental retardation.
Methods:
Cytogenetic analysis was performed in peripheral blood lymphocytes and in the light and dark skin following standard methods. DNAarray - Oligo 180 k was carried out using Agilent Technologies and FISH analysis was accomplished using DNA BACs probes to confirm the result obtained by DNAarray. Methylation-Specific PCR (MS-PCR) of the MEG3 promoter and microsatellite analysis were performed.
Results:
Microarray analysis confirmed partial trisomy 14 mosaicism; the marker chromosome was found to be from chromosome 14, the result was confirmed with FISH. Methylation (14q32.3) and microsatellite (14q11-14q32.33) analysis were carried out and UPD was discarded. The global result was: mos 47,XX,+del(14)(q11.2)[45]/47,XX,+14[10]/46,XX[45].
Conclusions:
This is a unique case because of the coexistence of two abnormal cell lines, including one with +14 and another with +del(14)(q11.2). To our knowledge, only three patients have been reported with trisomy 14 and another abnormal cell line. The array analysis identified the marker chromosome and characterized the breakpoint. The del(14)(q11.2) does not seem to be related to any particular phenotypic characteristic of the patient; the clinical features of our patient observed until now, can be attributed to trisomy 14 mosaicism. Nevertheless, we cannot discard the manifestation of new symptoms related to her karyotype in the future.
Ectopic Cushing's Syndrome Unveiling a Metastatic Parotid Carcinoma
Authors: Sofia Castro Oliveira, João Sérgio Neves, Pedro Souteiro, Sandra Belo, Ana Isabel Oliveira, Helena Moreira, Paulo Mergulhão Gomes, Lígia Coelho, Cristina Sarmento, Elsa Fonseca, Celestino Neves, Paula Freitas, Davide Carvalho
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Introduction:
Adrenocorticotropic hormone (ACTH) ectopic production is a rare cause of Cushing syndrome (CS). The most commonly associated tumours are small-cell lung carcinoma along with bronchial and thymic carcinoids. To date, only 5 cases have been published in the literature featuring ectopic ACTH secretion from metastatic acinic cell carcinoma (ACC) of the parotid gland. We hereby describe a very uncommon case of ectopic CS (ECS) unveiling a metastatic parotid ACC.
Case presentation:
A 46-year-old man with hypertension and dyslipidemia diagnosed 4-months before, as well as new-onset diabetes mellitus unveiled 1-month earlier, was referred to emergency department for hypokalemia. Hormonal study and dynamic biochemical tests performed indicated ECS. Imaging and cytological findings pointed toward a likely primary right parotid malignancy with liver metastases. Somatostatin receptor scintigraphy has shown an increased uptake in the parotid gland and mild expression in liver metastasis. The patient underwent right parotidectomy, and histopathologic examination confirmed ACC. Meanwhile, hypercortisolism was managed with metyrapone, ketoconazole, and lanreotide. Despite chemotherapy onset, a rapid disease progression and clinical course deterioration was observed.
Conclusion:
The present report highlights a rare ECS, exposing a metastatic parotid ACC, with an aggressive and challenging clinical course, representing the first case whose diagnosis of ECS came prior to ACC.
Concurrent Bilateral Anterior Tibial Stress Fractures and Vitamin D Deficiency in an Adolescent Female Athlete: Treatment With Early Surgical Intervention
Authors: Jane S Chung, Meagan J Sabatino, Amanda L Fletcher, Henry Bone Ellis
Journal: Front Pediatr (2019)
Keywords: adolescent athlete, anterior tibial diaphyseal stress fractures, bone health, high risk stress fractures, intramedullary nailing, vitamin d deficiency
MeSH terms: Case Reports

Case: A 16-year-old African American multi-sport female athlete presents with bilateral worsening activity-related leg pain for 5 months. Multiple bilateral anterior tibial diaphyseal stress fractures and significant vitamin D deficiency were identified. She was treated with a combination of vitamin D supplements and static intramedullary nailing of the bilateral tibias resulting in clinical and radiographic healing and return to sports. Discussion: Vitamin D deficiency and high level of activity in a young athlete may be the etiology to atypical multiple stress fractures. In athletes who may want to return to sport rapidly, early operative intervention and correction of vitamin D deficiency may be treatment options. Level of Evidence: Level V- case report.
Hypopigmented Mycosis Fungoides in an 11-Year-Old Palestinian Boy
Authors: Duha Rabi, Balqis Shawer, Ahmad Rabee, Mohammad Qudaimat, Mohammad Milhem, Izzeddin Bakri
Journal: Case Rep Dermatol Med (2023)
MeSH terms: Case Reports

Cutaneous T-cell lymphoma (CTCL) is a lymphoproliferative disorder of the skin. The most common subtype of CTCL in pediatrics is mycosis fungoides (MF). There are multiple variants of MF. The hypopigmented variant represents more than 50% of MF cases in pediatrics. Misdiagnosis of MF can occur because it may resemble other benign skin pathologies. This is a case of an 11-year-old Palestinian boy presented with generalized nonpruritic hypopigmented maculopapular patches with progressive course for 9-months. Biopsy samples from a hypopigmented patch revealed appearances diagnostic of MF. Immunohistochemical staining was positive for CD3 and CD7 (partial) and a mixture of CD4 and CD8 positive cells. The patient's case was managed with narrowband ultraviolet B (NBUVB) phototherapy. After a few sessions, the hypopigmented lesions improved significantly.
Bilateral, Simultaneous, Acute Angle Closure Glaucoma in Pseudophakia Induced by Chlorthalidone
Authors: Indra Durai, Mrunali Mohan Dhavalikar, Chandran Prem Anand, Venkatraman Ganesh, Ramaswami Krishnadas
Journal: Case Rep Ophthalmol Med (2016)

Purpose. To report two persons with acute, bilateral, and simultaneous angle closure glaucoma in pseudophakia secondary to uveal effusions induced by administration of chlorthalidone. Methods.
Case reports:
Results. Bilateral shallow anterior chambers and high intraocular pressure with decline in visual acuity were reported in two patients within days of intake of chlorthalidone for systemic hypertension. Gonioscopy confirmed appositional angle closure while choroidal detachment and ciliochoroidal detachment were revealed on ultrasonographic studies. Discontinuing chlorthalidone and institution of aqueous suppressants to reduce IOP and cycloplegics reversed angle closure and glaucoma. Conclusions. Reports of angle closure glaucoma in pseudophakic eyes induced by idiosyncratic reaction to chlorthalidone confirms that osmotic changes in the crystalline lens has no role in the pathogenesis of drug induced glaucoma and reaffirms that glaucoma is secondary to ciliochoroidal detachment and ciliary body rotation and edema.
Septic Pulmonary Emboli and Renal Abscess Caused by Staphylococcus aureus in an HIV-Infected Patient
Authors: Isaí Medina-Piñón, Alan Ledif Reyes-Mondragón, Michel Fernando Martínez-Reséndez, Adrián Camacho-Ortiz
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Staphylococcus aureus is a common cause of bacteremia in the general population and can lead to serious metastatic infection particularly in immunocompromised persons. However, prompt diagnosis and management can result in favorable outcomes. In the following case report, the clinical course of an HIV-infected man is presented; he developed bloodstream infection (BSI) and associated complications: septic pulmonary embolism, right renal abscess, and ipsilateral renal vein thrombosis. Methicillin-resistant Staphylococcus aureus (MRSA) was identified as the cause of sepsis and successfully treated with surgery and antimicrobials. Intravenous vancomycin was the primary therapy, followed by oral linezolid after resolution of bacteremia.
Malignant Transformation in Ollier's Disease: A Novel Stem for a Tibial Megaprosthesis
Authors: Vincent Y Ng, Philip Khoury
Journal: Cureus (2023)
Keywords: chondrosarcoma, enchondroma, endoprosthesis, malignant transformation, megaprosthesis, ollier’s disease, tibial reconstruction
MeSH terms: Case Reports

Ollier's disease is a rare syndrome characterized by multiple enchondromas with the potential for malignant transformation. The treatment for secondary chondrosarcoma is surgical resection, which can be a morbid procedure depending on the location and size of the tumor. We present a successful limb salvage in which the majority of the tibia was removed and replaced with a megaprosthesis. The complex reconstruction in this case required the use of a novel uncemented stem.
Disseminated Herpes Simplex Virus with Fulminant Hepatitis
Authors: Bassam H Rimawi, Joseph Meserve, Ramzy H Rimawi, Zaw Min, John W Gnann Jr
Journal: Case Reports Hepatol (2015)

Disseminated herpes simplex virus (HSV) is a rare cause of acute fulminant liver failure. We hereby present a case series of three patients with acute disseminated HSV with necrotizing hepatitis successfully treated with a week course of acyclovir. Early empiric administration of acyclovir therapy while awaiting confirmatory tests is critical in this potentially lethal disease.
Case report: Epstein-Barr virus and constrictive pericarditis-An unusual combination
Authors: M Panebianco, E Limonjani, R Formigari, V Bordonaro, A Secinaro, E Cetrano, A Carotti, L Galletti, S Albanese
Journal: Front Pediatr (2023)
Keywords: epstein–barr virus, constrictive pericarditis, effusive-constrictive pericarditis, mononucleosis, ventricular mechanics
MeSH terms: Case Reports

Constrictive pericarditis is a chronic inflammatory process that can lead to heart failure if not diagnosed and treated correctly. Although Epstein-Barr virus (EBV)-related pericarditis is a very rare condition, it should still be considered for a differential diagnosis. We report the case of an 18-year-old male, who was surgically treated for constrictive pericarditis, in which in situ hybridization to Epstein-Barr virus-encoded RNA (EBER) probe of the excised pericardium led to the subsequent etiological diagnosis of chronic pericarditis caused by EBV.
CMR Features in Cardiac Sarcoidosis
Authors: Sparsh Prasher, Phong T Lee, Marc Dweck, John R Payne
Journal: Case Rep Radiol (2011)
MeSH terms: Case Reports

Sarcoidosis is a multisystemic disorder of unknown aetiology characterised by the formation of noncaseating epithelioid cell granuloma involving various organ systems. Cardiac involvement has an important prognostic factor as it can present with life-threatening arrythmias and sudden death. Here, we present a case of cardiac sarcoidosis in a 46-year-old gentleman who presented with nonspecific signs and symptoms. We also discuss diagnostic difficulties especially when cardiac involvement is the only clinical sign. In this case, cardiac magnetic resonance (CMR) played an important role in the diagnosis and followup of our patient.