OpenMed/multicare-articles huggingface dataset:
A case of multiple sclerosis and celiac disease
Authors: H Z Batur-Caglayan, C Irkec, I Yildirim-Capraz, N Atalay-Akyurek, S Dumlu
Journal: Case Rep Neurol Med (2013)

Objectives. Multiple sclerosis (MS) is an inflammatory autoimmune disorder of the central nervous system (CNS). Since a correlation between gluten intake and incidence of MS had been reported, the relationship of antigliadin antibodies and MS was debated. Case Report. We report the case of a 45-year-old female MS patient who is under interferon treatment. After seven years of monitoring, during her routine gastroenterological assessment, she was diagnosed with celiac disease. Conclusion. Beside the neurological manifestations that have been demonstrated in about 10% of celiac disease (CD) patients, white-matter abnormalities in brain MRI are uncommon and controversial. But in the literature, MS seems to be associated with CD as in our patient. We suggest that MS patients with gastroenterological complaints should undergo an assessment for CD.
Triple Synchronous Primary Melanomas in a 77-Year-Old Sea Captain: Importance of Total Skin Examination
Authors: Aleksandra Nowicka, Christopher Rowland Payne
Journal: Cureus (2023)
Keywords: complete skin examination, diagonal ear lobe creases, dupuytren’s contracture, index lesion focused examination, multiple melanomas, multiple primary melanomas, synchronicity, synchronous melanomas, synchronous primary melanomas, total skin examination
MeSH terms: Case Reports

When it comes to skin diseases, melanomas are considered the most lethal. Triple synchronous primary melanomas (SPMs) are rare. Here we have reported a case of a 77-year-old white male with three SPMs. The patient presented with a nodular melanoma in the upper left back; total skin examination (TSE) revealed additional melanomas in the right retroauricular region and on the left arm. The patient was unaware of these two additional melanomas that were only found because of the routine TSE, and the index lesion focused examination would have missed both. We advocate that TSE should be practised routinely by all dermatologists for all new patients, and also, from time to time in patients attending long-term follow-up appointments. Early diagnosis means simpler treatments and more favourable outcomes.
Endobronchial Watanabe Spigots for Treatment of Pyopneumothorax due to Nontuberculous Mycobacteriosis in a Patient with Rheumatoid Arthritis: A Case Report Based on Past Experience
Authors: Norikazu Kawai, Takeshi Kawaguchi, Takashi Tojo, Takao Osa, Yoshifumi Yamamoto, Motoaki Yasukawa, Noriyoshi Sawabata, Shigeki Taniguchi
Journal: Case Rep Pulmonol (2018)
MeSH terms: Case Reports

Nontuberculous mycobacterial lung disease sometimes causes pneumothorax and empyema, which are often intractable because of patients' background factors. Biological products used in the treatment of rheumatoid arthritis have caused the problem of an increase in infection rates as a side effect, one of which is nontuberculous mycobacteriosis (NTM). On the basis of past experience, we report the case of a patient who had a history of undergoing treatment with biological products against rheumatoid arthritis. The patient was treated for NTM-induced pyopneumothorax by endoscopic bronchial occlusion therapy using endobronchial Watanabe spigots.
Spontaneous Aortic Dissection Limited to the Sinus of Valsalva: Report of Two Cases
Authors: Maryam Nabati, Babak Bagheri, Samira Eslami, Razhan Piran
Journal: J Tehran Heart Cent (2016)
Keywords: aorta, aortic valve insufficiency, dissection, echocardiography, transesophageal, sinus of valsalva
MeSH terms: Case Reports

Dissection of the sinus of Valsalva is a rare and life-threatening event. It often occurs during percutaneous coronary intervention in the right coronary artery (RCA). Dissection flap usually involves the RCA and the right sinus of Valsalva. Here we report two extremely rare cases of spontaneous dissection limited to the non-coronary sinus of Valsalva, causing severe aortic valve regurgitation: a male aged 51 years presenting with back pain, weakness, and presyncope and another male aged 71 years presenting with orthopnea and weakness. The dissection was found by transesophageal echocardiography. Surgical treatment was successful for both patients. One year after surgery, both patients were asymptomatic and follow- up transthoracic echocardiography did not show any abnormality.
Neurolymphomatosis in Recrudescent Diffuse Large B-cell Lymphoma
Authors: Antonio R Lopez, Aliyah R Sohani, Aileen O'Shea, Thomas S C Ng
Journal: Asia Ocean J Nucl Med Biol (2023)
Keywords: lymphoma, neurolymphomatosis, non-hodgkin
MeSH terms: Case Reports

Neurolymphomatosis is an uncommon manifestation of lymphoma, often presenting with painful polyneuropathy or polyradiculopathy and concomitant distal extremity weakness. Differentiation from other etiologies resulting in similar neuropathic symptoms such as compressive or inflammatory pathologies can be difficult and often results in delayed diagnosis. Here we describe a case of neurolymphomatosis affecting a 64-year-old man with a history of diffuse large B-cell lymphoma (DLBCL) in remission presenting with a right-sided foot drop following a gunshot wound. MRI at that time demonstrated thickening and enhancement of the cauda equina nerve roots. Over the course of the subsequent eight months, he developed left lower extremity sensory symptoms, left-sided foot drop and signs of upper motor neuron involvement, including left facial weakness, dysphonia, and dysphagia. 18F-FDG PET/CT revealed intensely avid left lumbosacral nerve roots, bilateral lower extremity and left upper extremity neurovascular bundles. Left sural nerve biopsies showed infiltration of DLBCL and confirmed neurolymphomatosis. We highlight the role of 18F-FDG PET/CT, with histological verification, for the diagnosis of an extended course of neurolymphomatosis occurring in the absence of typical painful neuropathy but with cranial and peripheral neuropathies.
Ligament Augmentation and Reconstruction System Failures in Repair of Grade V Acromioclavicular Joint Dislocation
Authors: Martin K-H Li, David Woods
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

The Ligament Augmentation and Reconstruction System® (LARS®) represents a popular synthetic anatomical reduction method for acromioclavicular joint dislocation by means of coracoclavicular ligament reconstruction. To our knowledge, no early failure has been documented in the literature. We present two unusual cases of LARS failure, one at four months after implant and the other at three weeks, without obvious causes, requiring re-do reconstruction, and discuss potential contributory factors.
Multi-organ failure induced by Nivolumab in the context of allo-stem cell transplantation
Authors: Julie Charles, Diane Giovannini, Nicolas Terzi, Carole Schwebel, Nathalie Sturm, Dominique Masson, Marie-Thérèse Leccia, Jean-Yves Cahn, Olivier Manches, Claude-Eric Bulabois, Laurence Chaperot
Journal: Exp Hematol Oncol (2019)
Keywords: allogeneic stem cell transplantation, gvhd, hodgkin lymphoma, immune-related adverse events, myositis, nivolumab, pd1
MeSH terms: Case Reports

Background:
Immune checkpoint inhibitors have radically changed the landscape of anti-tumor therapies in several malignancies. However the adverse events associated with immune checkpoint blockade in combination with other treatments remains to be thoroughly documented. Here we report the case of a 33-year-old male with classical Hodgkin lymphoma who was successfully treated for lymphoma but experienced serious and eventually fatal multisystem organ failure following nivolumab administration and allogeneic stem cell transplantation.
Case presentation:
The patient was diagnosed with stage IIIa nodular sclerosing Hodgkin lymphoma. Originally treated by chemotherapy and autologous stem cell transplantation, he subsequently received two allogeneic stem cell transplants from matched and haplo-identical siblings upon successive disease recurrences. Nivolumab treatment was administered prior to the second allograft, after which complete remission of lymphoma was achieved (year 10), as evidenced by clinical and radiographic examination. However within the next 3 months, the patient went on to develop a constellation of symptoms affecting multiple organs, including acute pneumonia with no evidence of bacterial infection, widespread cutaneous eruptions on trunk and lower limbs, mucosal ulcerations, myositis, diarrhea and colitis. Further complications included hepatic cytolysis, acute renal failure, pancreatitis, as well as complete heart block. Some of these injuries being suggestive of graft-versus-host disease, the patient was administered immunosuppressive therapy (mycophenolate, steroids and polyvalent immunoglobulins), but died shortly afterwards. Tissue biopsies revealed extensive lymphocytic infiltration (mostly CD3 + T cells) in skin, liver, and most peculiarly in muscles, including the myocardium. Massive lymphoid-histiocytic infiltration of muscle fibers was accompanied by acute necrotizing myositis and endomysial inflammation.
Conclusions:
Multi-organ failure represents a rare but potentially fatal outcome of immune checkpoint blockade in patients receiving allogeneic stem cell grafts. Nivolumab may induce atypical immune-mediated tissue inflammation and damage, such as the extensive muscular polymyositis described here in a patient with Hodgkin lymphoma. Nivolumab might also worsen GVHD symptoms in the context of allogeneic stem cell transplantation. Irrespective of the actual pathological mechanisms, clinicians should be alerted to these fatal drug-related toxicities.
Nodular Melanoma in an African American Female
Authors: Vincent Brown, Tom Reisler, Jake Laks
Journal: Eplasty (2019)
Keywords: exophytic mass, melanoma, nodular melanoma, skin cancer, skin lesion
MeSH terms: Case Reports

Melanoma incidence is increasing and is associated with the majority of skin cancer-related deaths. Most melanomas have an indolent growth and are difficult to diagnose, attributing to their increased risk of metastatic disease on initial presentation. Nodular melanoma accounts for roughly 15% to 30% of all the melanomas, making it the second most common melanoma. This case describes nodular melanoma, the atypical presentation, the diagnosis, and the treatment. This case is of special interest due to the rarity of the disease and this particular patient's disease presentation and management. Unfortunately, the patient refused further surgery, so definitive treatment was not achieved.
First report of generalized face processing difficulties in möbius sequence
Authors: Sarah Bate, Sarah Jayne Cook, Joseph Mole, Jonathan Cole
Journal: PLoS One (2013)
MeSH terms: Facial Expression, Mobius Syndrome / diagnosis, Case Reports, Adult, Computer Simulation, Emotions, Female, Humans, Male, Middle Aged, Models, Anatomic, Pattern Recognition, Visual, Reproducibility of Results

Reverse simulation models of facial expression recognition suggest that we recognize the emotions of others by running implicit motor programmes responsible for the production of that expression. Previous work has tested this theory by examining facial expression recognition in participants with Möbius sequence, a condition characterized by congenital bilateral facial paralysis. However, a mixed pattern of findings has emerged, and it has not yet been tested whether these individuals can imagine facial expressions, a process also hypothesized to be underpinned by proprioceptive feedback from the face. We investigated this issue by examining expression recognition and imagery in six participants with Möbius sequence, and also carried out tests assessing facial identity and object recognition, as well as basic visual processing. While five of the six participants presented with expression recognition impairments, only one was impaired at the imagery of facial expressions. Further, five participants presented with other difficulties in the recognition of facial identity or objects, or in lower-level visual processing. We discuss the implications of our findings for the reverse simulation model, and suggest that facial identity recognition impairments may be more severe in the condition than has previously been noted.
Clival Ectopic Pituitary Adenoma Mimicking a Chordoma: Case Report and Review of the Literature
Authors: Constantine L Karras, Isaac Josh Abecassis, Zachary A Abecassis, Joseph G Adel, Esther N Bit-Ivan, Rakesh K Chandra, Bernard R Bendok
Journal: Case Rep Neurol Med (2016)

Background. Purely ectopic pituitary adenomas are exceedingly rare. Here we report on a patient that presented with an incidental clival mass thought to be a chordoma. Endonasal resection, tumor pathology, and endocrinology workup revealed a prolactinoma. Case Presentation. A 41-year-old male presented with an incidental clival lesion presumed to be a chordoma. On MRI it involved the entire clivus, extended laterally to the petroclival junction, and invaded the cavernous sinuses bilaterally, encasing both internal carotid arteries, without direct extension into the sella. Intraoperatively, it was clear that the tumor originated from the clivus and that the sellar dura was completely intact. Frozen-section pathology was consistent with a pituitary adenoma. Immunostaining was positive for synaptophysin and prolactin with a low Ki-67 index, suggestive of a prolactinoma. Additional immunohistochemical stains seen in chordomas (EMA, S100, and Brachyury) and other metastatic tumors were negative. A postoperative endocrine workup revealed an elevated serum prolactin of 881.3 ng/mL (normal < 20). Conclusions. In conclusion, it is crucial to maintain an extensive differential diagnosis when evaluating a patient with a clival lesion. Ectopic clival pituitary adenomas, although rare, may warrant an endocrinological workup preoperatively as the majority may respond to medical treatment.
Single-Stage Craniectomy and Cranioplasty for Multilobular Osteochondrosarcoma Managed with a Custom Additive Manufactured Titanium Plate in a Dog
Authors: Galina M Hayes, Elena A Demeter, Eunju Choi, Michelle Oblak
Journal: Case Rep Vet Med (2019)
MeSH terms: Case Reports

A 9-year-old spayed female dachshund presented with a large multilobular osteochondrosarcoma of the crania, with obliteration of approximately 70% of the surface area of the dorsal calvaria and intracranial extension. The mass was excised with histologically clean lateral bone margins (2-4 mm) and invasion at the deep margin. The resulting defect was reconstructed with a custom titanium plate. The patient recovered routinely and was asymptomatic until 7 months postoperatively. The patient developed intractable seizures 7 months postoperatively and was euthanized. Post-mortem examination showed tumor regrowth within the brain parenchyma. No abnormalities were seen associated with the plate. The patient-specific, custom additive manufactured titanium plate provided an excellent option for anatomic reconstruction and protection of the brain over a relatively large area with no complications noted.
Neo-epitopes emerging in the degenerative hippocampal granules of aged mice can be recognized by natural IgM auto-antibodies
Authors: Gemma Manich, Elisabet Augé, Itsaso Cabezón, Mercè Pallàs, Jordi Vilaplana, Carme Pelegrí
Journal: Immun Ageing (2015)
Keywords: ageing, auto-antibody, hippocampus, igm, neo-epitope, periodic acid-schiff
MeSH terms: Case Reports

Background:
Degenerative granular structures appear progressively with age in the hippocampus of most mouse strains. We recently reported that these granules contain a neo-epitope that is recognised by IgM antibodies present as contaminants in many commercial antibodies obtained from mouse ascites and mouse or rabbit serum. We hypothesise that these anti-neo-epitope IgMs are in fact natural auto-antibodies that are generated spontaneously during the foetal stage without previous contact with external antigens and whose repertoire and reactivity pattern have been determined through evolution, being remarkably stable within species and even between species.
Findings:
In the present work we found that mice from the ICR-CD1, BALB/C and SAMP8 strains have anti-neo-epitope IgM antibodies in their plasma at all ages tested and even when maintained under specific opportunistic pathogen-free conditions. Moreover, we determined that these anti-neo-epitope IgMs are also present in rabbit, goat and rat serum. We also found that, in each mouse that presented hippocampal granules, the anti-neo-epitope IgMs contained in its plasma recognised the neo-epitopes in its own granules.
Conclusions:
This study led to the conclusion that anti-neo-epitope IgMs are widespread natural auto-antibodies contained in the plasma of mice and other species. The presence of these natural auto-antibodies not only explains why they are frequently found as contaminants in commercial antibodies, but also paves the way for a new approach to a treatment and diagnosis of pathological brain processes based on natural IgMs and neo-epitopes.
Acute demyelination in a person with amphetamine abuse
Authors: Serge Weis, Hans Sachs, Andreas Büttner
Journal: Case Rep Pathol (2011)
MeSH terms: Case Reports

We report the case of a 31-year-old woman, admitted to the hospital for chest pain, dying a few days later from septic multiorgan failure, and showing at autopsy foci of acute demyelination in the occipital lobe. Gas chromatography/mass spectrometry analysis revealed the presence of amphetamine in the demyelinated area, which might be considered as the pathogenic agent, since other causes for demyelination could be excluded. This case represents the first report showing a demyelinating process due to a street drug.
Through the HoloLens™ looking glass: augmented reality for extremity reconstruction surgery using 3D vascular models with perforating vessels
Authors: Philip Pratt, Matthew Ives, Graham Lawton, Jonathan Simmons, Nasko Radev, Liana Spyropoulou, Dimitri Amiras
Journal: Eur Radiol Exp (2018)
Keywords: augmented reality, computed tomography, hololens, three-dimensional (3d) reconstruction, vascular pedicle flap

Precision and planning are key to reconstructive surgery. Augmented reality (AR) can bring the information within preoperative computed tomography angiography (CTA) imaging to life, allowing the surgeon to 'see through' the patient's skin and appreciate the underlying anatomy without making a single incision. This work has demonstrated that AR can assist the accurate identification, dissection and execution of vascular pedunculated flaps during reconstructive surgery. Separate volumes of osseous, vascular, skin, soft tissue structures and relevant vascular perforators were delineated from preoperative CTA scans to generate three-dimensional images using two complementary segmentation software packages. These were converted to polygonal models and rendered by means of a custom application within the HoloLens™ stereo head-mounted display. Intraoperatively, the models were registered manually to their respective subjects by the operating surgeon using a combination of tracked hand gestures and voice commands; AR was used to aid navigation and accurate dissection. Identification of the subsurface location of vascular perforators through AR overlay was compared to the positions obtained by audible Doppler ultrasound. Through a preliminary HoloLens-assisted case series, the operating surgeon was able to demonstrate precise and efficient localisation of perforating vessels.
Hemi-central retinal artery occlusion following methanol toxicity
Authors: Mohammad Zarei, Sima Sheikhghomi, Masoud Aghsaei Fard
Journal: GMS Ophthalmol Cases (2022)
Keywords: hemi-central retinal artery occlusion, methanol toxicity
MeSH terms: Case Reports

Objective:
To describe a patient with hemi-retinal artery occlusion following methanol toxicity.
Methods:
Observational case report.
Results:
We report a case presented with an acute altitudinal visual field loss in the right eye following consumption of illicit alcoholic drink. In fundus photography, a well demarcated superior hemi-retinal whitening with foveal sparing was noted. Careful inspection of the optic nerve head in the right eye revealed that there was no main trunk of the central retinal artery anterior to the lamina cribrosa. Two separately emerging superior and inferior arterial trunks were noted. In fundus fluorescein angiography, earlier dye filling in the territory of the superior arterial trunk compared to the inferior arterial trunk was evident.
Conclusion:
Hemi-central retinal occlusion may happen as an ocular consequence of methanol toxicity in patients with a proximal bifurcation of the central retinal artery.
A Rare Case of Severe Isolated Right Heart Failure with Secundum Type Atrial Septal Defect and Mitral Regurgitation Without Pulmonary Hypertension
Authors: Muhammad S Sabri, Faiza Riaz, Nain Tara, Maheen Anwar, Muhammad Usman Khan
Journal: Cureus (2023)
Keywords: left heart failure (lhf), lutembacher syndrome (ls), mitral regurgitation (mr), pericardial effusion, pulmonary hypertension, secundum type atrial septal defect (asd)
MeSH terms: Case Reports

Typically, right heart failure (RHF) may occur following left heart failure (LHF) in chronic volume overload states such as chronic severe mitral regurgitation (MR) through chronically elevated pulmonary pressures. In Lutembacher syndrome (LS), the direct shunting through a secundum type atrial septal defect (ASD) results in congestive heart failure in the setting of severe mitral stenosis (MS) with or without elevated pulmonary arterial or venous pressures. We report a rare case of severe isolated RHF and bi-atrial enlargement resulting from the direct shunting through a secundum type ASD in the presence of a severe eccentric primary MR. There are no significant cases documented like this after a thorough search using PubMed, Medline, and Google Scholar. A review of the literature suggests that LS is also caused by a combination of mitral regurgitation and a secundum-type atrial septal defect without mitral stenosis, though rarely. Because this is a primary MR, we feel it is a case of LS with MR, ruling out a combination of secondary MR and secundum-type atrial septal defect.
Case Report: Nintedanib for Pembrolizumab-Related Pneumonitis in a Patient With Non-Small Cell Lung Cancer
Authors: Xiao-Hong Xie, Hai-Yi Deng, Xin-Qing Lin, Jian-Hui Wu, Ming Liu, Zhan-Hong Xie, Yin-Yin Qin, Cheng-Zhi Zhou
Journal: Front Oncol (2021)
Keywords: checkpoint inhibitor-related pneumonitis, nintedanib, non-small cell lung cancer, pembrolizumab, steroid therapy
MeSH terms: Case Reports

Pembrolizumab, an immune checkpoint inhibitor (ICI) approved for advanced non-small cell lung cancer (NSCLC) treatment, has shown superior survival benefits. However, pembrolizumab may lead to severe immune-related adverse events (irAEs), such as checkpoint inhibitor-related pneumonitis (CIP). The routine treatment of CIP was based on systemic corticosteroids, but the therapies are limited for patients who are unsuitable for steroid therapy. Here, we present the first successful treatment of nintedanib for pembrolizumab-related pneumonitis in a patient with advanced NSCLC.