OpenMed/multicare-articles huggingface dataset:
Autoimmune Thrombotic Thrombocytopenic Purpura: Two Rare Cases Associated with Juvenile Idiopathic Arthritis and Multiple Sclerosis
Authors: Despoina Dimopoulou, Athina Dimosiari, Eudokia Mandala, Theodoros Dimitroulas, Alaxandros Garyfallos
Journal: Front Med (Lausanne) (2017)
Keywords: autoimmune diseases, juvenile idiopathic arthritis, multiple sclerosis, rituximab, thrombotic thrombocytopenic purpura
MeSH terms: Case Reports

Secondary thrombotic microangiopathies are associated with several underlying conditions, with most of them being resolved after the treatment of background disease. Thrombotic thrombocytopenic purpura (TTP) is a rare microangiopathy presenting with anemia, thrombocytopenia, and neurological deficits, occurring most often in various autoimmune diseases due to inhibition of ADAMTS13 by autoantibodies, as well as in pregnant women with or without an autoimmune substrate. In this article, we report two newly diagnosed TTP cases, who have not been published so far. The first is a 27-year-old woman with a history of polyarticular rheumatoid factor negative juvenile idiopathic arthritis, who presented with thrombocytopenia, anemia, schistocytes on blood smear, headache, and active arthritis. Originally she was treated successfully with plasma exchange, intravenous prednisone, and vincristine, and a few months after the TTP episode, she was commenced on rituximab, resulting in remission of primary disease and no relapse of TTP. The second case refers to a 29-year-old pregnant woman complaining of dizziness and fatigue with microangiopathic hemolytic anemia. She was treated with plasma exchanges, intravenous prednisolone, and INN human normal immunoglobulin with full remission of the TTP episode. Six and half years later, she was diagnosed with multiple sclerosis and was commenced on interferon beta-1 alpha, with no recurrent episode of TTP. These cases broaden the spectrum of autoimmune disorders manifested or complicated clinically by TTP. Furthermore, biological agents such as rituximab appear to be an effective treatment option for refractory cases of TTP related to systemic rheumatic disease, indicating an alternative therapeutic solution in persistent cases of this disorder.
Case Report: Kawasaki Shock Syndrome With Polycyclic Eruption: A Peculiar Brain Imaging
Authors: Enrico Masiello, Danilo Buonsenso, Ilaria Lazzareschi, Antonio Gatto, Marco Piastra, Antonio Chiaretti, Piero Valentini
Journal: Front Pediatr (2021)
Keywords: cns inflammation in kawasaki disease shock syndrome, cns involvement in kawasaki disease, kawasaki disease, kawasaki disease shock syndrome, misc
MeSH terms: Case Reports

Kawasaki disease (KD) is a childhood vasculitis of unknown etiology. The present study describes a case of KD shock syndrome that occurred in an infant (age, 16 months) following 7 days of high fever and persistent rash characterized by target-like and purpuric skin lesions. The child developed neurological manifestations such as altered consciousness and irritability. Consequently, brain magnetic resonance imaging (MRI) was performed, revealing an inflammatory involvement of the anterior perforated substance and the hypothalamus. Cerebral involvement on brain MRI is rarely described in KD but when reported is characterized mostly by cerebral vasculitis. We illustrate for the first time in KD an inflammation in the brain not related to vasculitis, reporting peculiar neuroradiological findings. This last aspect has fascinated us in light of recent evidence about the immunological spectrum of Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki-like syndrome in the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak.
Conservative Treatment of Dentigerous Cyst by Marsupialization in a Young Female Patient: A Case Report and Review of the Literature
Authors: Layal Ghandour, Hisham F Bahmad, Samar Bou-Assi
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Dentigerous cysts (DCs) are the most prevalent developmental odontogenic cysts that occur in middle-aged individuals. They frequently originate from the epithelial remnants of tooth-forming organs. Hereby, we present a case of a 13-year-old young female patient presenting with DC that was treated successfully by marsupialization. The patient's chief complaint was the crowding of the anterior teeth. Clinical examination showed that the patient had all her permanent teeth present with a retained mandibular left second primary molar that was previously treated by pulpectomy. The radiographic examination revealed a unilocular radiolucent lesion with well-defined margins associated with a mesially-tipped unerupted mandibular left second premolar. The differential diagnosis confirmed that the lesion was a DC. The treatment consisted of surgical removal of the DC to allow proper eruption of the permanent tooth and to prevent the lesion from becoming an aggressive one causing gross expansion of bone with subsequent facial asymmetry, pain, displacement of teeth, and root resorption. A removable acrylic obturator was delivered to the patient keeping the path clear and guiding the eruption of the premolar until fully erupted.
Acute cholecystitis caused by ceftriaxone stones in an adult
Authors: Christian D Becker, Robert A Fischer
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Acute cholecystitis is a major health problem. There are multiple etiologies to be considered and early recognition of the condition is important to optimize management and outcome. We report the first case in the medical literature of symptomatic acute cholecystitis triggered by ceftriaxone-associated gallbladder sludge formation and, importantly, solid ceftriaxone gallstone formation in an adult patient with underlying mineral and pigment cholecystolithiasis, necessitating cholecystectomy. This case serves as a reminder for physicians to keep this uncommon cause of cholecystolithiasis and cholecystitis in mind in patients who receive prolonged ceftriaxone therapy. These patients should be cautioned to promptly report to their physicians any signs or symptoms of cholecystitis in order to ensure timely and appropriate evaluation.
Occurrence of Chordoid Glioma With Sodium Ion Metabolism Disorder 5 Years After Meningioma Surgery and Whole-Exome Sequencing: A Case Report and Literature Review
Authors: Mei Zhang, Baofeng Xu, Chang Li, Ziwei Liu, Yuanyuan Gao, Yuming Song, Rui Liu
Journal: Front Genet (2021)
Keywords: prkcad463h, chordoid glioma, fibrous meningioma, hypernatremia, hyponatremia, third ventricle, whole-exome sequencing
MeSH terms: Case Reports

Chordoid glioma (CG), a rare slow-growing brain tumor, mainly occurs in the region of the third ventricle. Although its degree of malignancy is relatively low, its clinical prognosis is poor due to obscure clinical manifestations and the particular growing position. Currently, gross total resection is the best available method for treatment of CG. However, the tumor is located in the deep structure of the brain and close to neurovascular structure so it is difficult to remove completely. This study reported a case of CG of the third ventricle 5 years after surgery of right frontal parietal fibrous meningioma, accompanied with peri and post-operative sodium ion metabolism disorder. Whole-exome sequencing (WES) revealed 25 gene mutations shared by meningioma and CG. In addition, the PRKCA D463H CG marker gene mutation also existed in this patient. We reviewed the latest literature on this rare brain tumor, summarized its clinical manifestations, imaging and pathological characteristics, and discussed the mechanism related to its occurrence and the reasons for sodium ion disorder.
Diagnostic Pitfalls in Papillary Muscle Rupture-Associated Acute Mitral Regurgitation after Acute Myocardial Infarction
Authors: Akiko Kameyama, Hiroshi Imamura, Hiroshi Kamijo, Kanako Takeshige, Katsunori Mochizuki, Kenichi Nitta
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Papillary muscle rupture (PMR) is a rare and fatal complication of acute myocardial infarction (AMI). We report a case of acute mitral regurgitation (MR) due to PMR with pulmonary edema and cardiogenic shock following AMI with small myocardial necrosis. An 88-year-old woman was brought to our emergency department in acute respiratory distress, shock, and coma. She had no systolic murmur, and transthoracic echocardiography was inconclusive. Coronary angiography showed obstruction of the posterior descending branch of the right coronary artery. Although the infarction was small, the hemodynamics did not improve. Transesophageal echocardiography established papillary muscle rupture with severe mitral regurgitation 5 days after admission. Thereafter, the patient and her family did not consent to heart surgery, and she eventually died of progressive heart failure. Physicians should be aware of papillary muscle rupture with acute mitral regurgitation following AMI in patients with unstable hemodynamics, no systolic murmur, and no abnormalities revealed on transthoracic echocardiography.
Acquired Umbilico-Inguinal Fistula with Persistent Discharge due to Suture Reaction: A Case Report and Review of the Literature
Authors: Muazez Cevik
Journal: Case Rep Med (2012)

The aim of this paper is to stay a very rare umbilico-inguinal fistula (UIF) resulting from a delayed suture reaction after the use of silk suture to repair an inguinal hernia. A 3-year-old boy presented with persistent umbilical discharge. The initial diagnosis was omphalitis and he was treated with broad-spectrum antibiotics but a UIF was subsequently diagnosed. Surgery was performed to ascertain the cause of the UIF. This case demonstrates that silk suture used in inguinal hernia repair can lead to a UIF, which should be considered in the differential diagnosis of a patient presenting with persistent umbilical discharge.
HIV Wasting Syndrome in a Nigerian Failing Antiretroviral Therapy: A Case Report and Review of the Literature
Authors: Dimie Ogoina, Reginald O Obiako, Haruna M Muktar
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

The HIV wasting syndrome represented the face of HIV/AIDS before the advent of highly active antiretroviral therapy (HAART). Although the incidence of wasting has declined since the introduction of HAART, weight loss remains common in patients receiving HAART, especially in the setting of a failing HAART regimen. As we are not aware of any previous reports from Nigeria, we report a case of the classical wasting syndrome in a Nigerian female who had both virological and immunological HAART failure due to poor adherence. The influence of a failing HAART regimen, socioeconomic status, and other clinical variables in the wasting syndrome are discussed.
PCDH19-Related Epilepsy in Early Onset of Chinese Male Patient: Case Report and Literature Review
Authors: Xiao Yang, Jing Chen, BiXia Zheng, Xianyu Liu, Zixuan Cao, Xiaoyu Wang
Journal: Front Neurol (2020)
Keywords: pcdh19, epilepsy, gene mutation, male, neurology
MeSH terms: Case Reports

Mutations in PCDH19 are associated with epilepsy, intellectual disability and behavioral disturbances, mostly related to females. The unique X-linked pattern of inheritance affects females predominantly, while usually is transmitted through asymptomatic males. Recently, new research has demonstrated that males with a mosaic pattern of inheritance could also be affected. As yet, PCDH19 mutations have been reported in hundreds of females; however, only 15 mosaic males were reported to exhibit epileptic seizures with the onset ranges between 6 and 31 months. These patients were usually reported to carry various mutations in the PCDH19. Here we describe a non-sense variant at the PCDH19 (c.498C>G; p.Y166*) in the Chinese male that exhibited early developmental delay and frequent seizures starting from the age of 5 months. We aim that this case report, focusing on studying clinical seizures, therapeutic approaches, and the patient's prognosis, will contribute to the cumulative knowledge of this rare and complex genetic disorder.
Acupuncture-Induced Tension Pneumothorax Presenting as Acute Heart Failure
Authors: Alia Arif Hussain, Jeppe Nygaard, Kasper Kofod Pedersen, Celi Anne Schoenike, Erik Kovacs, Steen Hylgaard Jørgensen
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Takotsubo syndrome (TSS) is a reversible, acute cardiomyopathy with transient heart failure, often secondary to other disorders. A 64-year-old woman, with no history of ischemic heart disease, was admitted to the emergency department after developing sudden-onset dyspnea after a planned acupuncture treatment for back pain. Acute echocardiography showed decreased left ventricular function with basal hypercontraction and apical akinesia and was interpreted, and treated, as acute heart failure. When the attending cardiologist arrived, the patient still had dyspnea with a declining blood pressure (97/65 mmHg) and tachycardia (111/minute). The cardiologist suspected a tension pneumothorax induced by the penetration of an acupuncture needle to the apex of the lung, as well as secondary TSS cardiomyopathy. An acute chest X-ray was performed, which showed a large left-sided rim pneumothorax. The attending surgeon placed a chest tube in the left 6th intercostal space in the midaxillary line, and the patient reported immediate pain relief and improvement in her dyspnea. The patient's clinical condition improved, and a control X-ray showed that the lung was fully expanded. The chest tube was removed, but after a few minutes, the patient developed a massive subcutaneous emphysema in the upper chest and in the face and her clinical condition deteriorated rapidly. A new chest tube was inserted, and the patient's tachycardia diminished, with her clinical condition improving immediately. The patient remained hospitalized for the next seven days. After three continuous days without any escaped air in the chest tube, the tube was removed, and the patient was observed for another 48 hours. This time, the removal was without any complications and within two days, the patient was ready for discharge. The follow-up echocardiography showed complete recovery of left ventricular function.
Case Report: Safety and Efficacy of Omalizumab in a 13-Year-Old Patient With Chronic Spontaneous Urticaria and Type 1 Diabetes
Authors: Paolo Del Barba, Federica Del Tedesco, Giulio Frontino, Maria Pia Guarneri, Riccardo Bonfanti, Graziano Barera
Journal: Front Immunol (2022)
Keywords: chronic spontaneous urticaria, glycemic, omalizumab, pediatrics, type 1 diabetes
MeSH terms: Anti-Allergic Agents / adverse effects, Chronic Urticaria / diagnosis, Chronic Urticaria / drug therapy, Diabetes Mellitus, Type 1 / complications, Diabetes Mellitus, Type 1 / drug therapy, Case Reports, Adolescent, Child, Chronic Disease, Female, Humans, Omalizumab / adverse effects, Anti-Allergic Agents, Omalizumab

Chronic urticaria (CU) is defined by the presence of itchy wheals, sometimes accompanied by angioedema, lasting for at least 6 weeks. CU is treated with second-generation antihistamines, increased up to four times the normal doses for second-line treatment. Omalizumab (a monoclonal antibody anti-IgE) may be recommended as third-line therapy in children aged over 12 years. Few reports have suggested that glucose homeostasis is impaired in some type 2 diabetic patients receiving omalizumab, and even in non-diabetic patients, fasting blood glucose and HOMA-IR values appeared to be significantly increased. We report the case of a 13-year-old girl with diabetes mellitus type 1 and chronic spontaneous urticaria (CSU) refractory to standard recommended therapy that we treated with omalizumab at a standard recommended dose of 300 mg every 4 weeks. We observed a rapid and complete remission of CSU after treatment with this humanized monoclonal antibody without detrimental effects on the patient's glucose control especially in terms of HbA1c (glycated hemoglobin), time in glycemic range (TIR), and daily insulin needs.
A Case of an Infantile Lingual Leiomyomatous Hamartoma
Authors: Thomas Z Gao, Austin Schafer, Abdulrahman Althubaiti, Bonita Fung, Charles Elmaraghy
Journal: Case Rep Otolaryngol (2022)
MeSH terms: Case Reports

Lingual leiomyomatous hamartomas are rare lesions of the tongue with largely unknown mechanisms of formation. These lesions are often asymptomatic, though they may present with symptoms, particularly relating to swallow function. Workup should include imaging of the head and neck, and diagnosis should be made histologically. Treatment is surgical excision. This case is a report of a 4-week-old female who presented for evaluation of an asymptomatic 1 × 1 cm dorsal midline tongue mass discovered at birth. The patient was monitored until the age of 9 months, at which time the mass was surgically excised. The patient had an uncomplicated postoperative course. Pathological analysis yielded a diagnosis of leiomyomatous hamartoma.
An Acute Jejunojejunal Intussusception Revealing a Metastatic Combined Lung Cancer
Authors: Feryel Letaief-Ksontini, Ryma Boujnah, Yosra Yahiaoui, Yosra Zaimi, Meriem Ksentini, Raoudha Aloui, Khedija Meddeb, Amel Mezlini
Journal: Case Rep Surg (2021)
MeSH terms: Case Reports

Intussusception is a relatively common disease in pediatric age but it is uncommon in adults. We report a case of a 49-year-old male who presented with an acute jejunojejunal intussusception revealed by abdominal pain and vomiting. He underwent an en bloc resection, and pathological findings concluded to a metastasis of a pulmonary combined small cell carcinoma and adenocarcinoma. A subsequent CT scan revealed the primitive mass of the right lung with no evidence of secondary localization. The biopsy was difficult to perform. The patient underwent a pneumonectomy with lymph node dissection confirming the same diagnosis. He made a good recovery from the surgery, and a postoperative chemotherapy was administrated, and he is in remission until this date.
Tacrolimus-Induced Type IV Renal Tubular Acidosis following Liver Transplantation
Authors: Christopher Schmoyer, Suraj Mishra, Frank Fulco
Journal: Case Reports Hepatol (2017)
MeSH terms: Case Reports

Calcineurin inhibitors remain an integral component of immunosuppressive therapy regimens following solid organ transplantation. Although nephrotoxicity associated with these agents is well documented, type IV renal tubular acidosis is a rare and potentially underreported complication following liver transplantation. Hepatologists must be able to recognize this adverse effect as it can lead to fatal hyperkalemia. We describe a case of tacrolimus-induced hyperkalemic type IV renal tubular acidosis in a patient following an orthotopic liver transplant for alcoholic cirrhosis.
Diffuse Leukoplakia of the Bladder Ostium-Sparing in Patient Treated with Leuprorelin for Breast Cancer
Authors: Antonio Nacchia, Ferdinando di Giacomo, Arcangelo Di Cerbo, Massimo Dante Di Somma, Giuseppe Patitucci, Giuseppe Disabato, Giulia Vita
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

Case:
A 55-year-old woman came to our attention in April 2020 referring haematuria, frequency and urgency. The patient referred previous treatment with leuprorelin 3.75 mg/2 ml for breast cancer three years ago. Urine culture was performed and resulted always negative for pathogens. Cystoscopy revealed a whitish plaque lesion on the fundus, dome, trigone, and left lateral wall of the bladder. Histology of the biopsy confirmed the diagnosis of leukoplakia of the bladder. The plan is to follow her up repeating a cystoscopy every three months and biopsy in 6 months. Literature search revealed very little information on pathogenesis and prognosis of this condition due to its rare occurrence. The main objective of our case study was to describe individual situation of a woman affected by diffuse leukoplakia of the bladder ostium-sparing with a previous treatment with leuprorelin 3.75 mg/2 ml for breast cancer and to show safety of follow-up by cystoscopy and biopsy.
Conclusions:
We showed a case of a woman treated with leuprorelin and with diffuse leukoplakia of the bladder. We support the recommended long-term follow-up and surveillance based on the literature review by cystoscopy with or without biopsy.
Left supraclavicular spindle cell lipoma
Authors: Oladejo Olaleye, Bertram Fu, Ram Moorthy, Charles Lawson, Myles Black, David Mitchell
Journal: Int J Otolaryngol (2010)
MeSH terms: Case Reports

Background. Spindle cell lipoma (SCL) is a benign lipomatous tumour, typically occurring in the posterior neck, shoulder or upper back of elderly males. They compose of fat, CD34 positive spindle cells, and ropey collagen on a myxoid matrix. This case highlights a rare presentation of SCL and the need for pre-operative diagnosis. Case Report. A 63-year-old gentleman presented with a pre-existing left supraclavicular mass that had recently increased in size. FNA and CT Scans were performed and results discussed in the mutidisciplinary team meeting. Excisional biopsy was recommended. Radiology. CT neck showed a left supraclavicular mass of fatty density with fine internal septations. A low-grade liposarcoma could not be excluded. Histopathology. FNA was indeterminate. Histology of specimen showed bland spindle cells with no evidence of malignancy. Immuno-histochemistry showed SCL with CD34 positivity and negative staining on CDK4 and p16. Management. Excision biopsy of the mass was performed which was technically difficult as the mass invaginated around the brachial plexus. The patient recovered well post-operatively with no neurological deficits. Conclusion. Spindle cell lipoma is a rare benign tumour and a pre-operative diagnosis based on the clinical context, imaging and immuno-histochemistry is crucial to management.
Endoscopic ultrasound fine needle aspiration in the diagnosis of lymphoma
Authors: Koen Creemers, Olaf van der Heiden, Jan Los, Joost van Esser, David Newhall, Remco S Djamin, Joachim G Aerts
Journal: J Oncol (2011)
MeSH terms: Case Reports

In recent years, endoscopic ultrasound techniques with Fine Needle Aspiration (FNA) have become an increasingly used diagnostic aid in the differentiation of mediastinal lymphadenopathy. Endobronchial ultrasound (EBUS) and endoesophageal ultrasound (EUS) are now available for clinicians to reach mediastinal and paramediastinal masses using a minimally invasive approach. These techniques are an established component for diagnosing and staging lung cancer and their benefit in the diagnosis of lymphoma's has been highlighted in a number of case studies. However, the lack of tissue architecture obtained by cytological FNA specimens decreases the diagnostic accuracy for benign causes of thoracic lymphadenopathies, lymphomas, and histopathological subtyping of lung cancer. Accordingly, our study group have adapted the FNA sampling technique, resulting in tissue fragments that can be used for histopathological examinations. As an illustration, we report a case of follicular non-Hodgkin lymphoma, diagnosed on tissue fragments obtained by adjusted EUS FNA. We believe that this relatively simple adjustment to routine FNA sampling can help to overcome the diagnostic limitations inherent in cytology obtained by routine FNA.