OpenMed/multicare-articles huggingface dataset:
Severe atherosclerosis of donor hepatic arteries is a salvageable condition in liver transplantation to optimise the graft utilisation: A case series and review of the literature
Authors: Yuhki Sakuraoka, Amanda Pinter Carvalheiro da Silva Boteon, Rachel Brown, M Thamara P R Perera
Journal: Int J Surg Case Rep (2019)
Keywords: atherosclerosis, case report, endarterectomy, liver transplantation

Introduction:
The presence of atherosclerosis of the common hepatic artery (CHA) in donor livers potentially contributes to vascular complications after liver transplantation, thereby most of those organs are traditionally discarded. Herein, we describe the successful outcome of three patients transplanted with grafts that had severe atherosclerosis of the donor CHA up to the level of the gastroduodenal artery (GDA).
Presentation of case:
In all three cases, endarterectomies were performed by dissection between the atheromatous core and the artery intima using a dissecting spatula, allowing to secure the lumen of the vessel. The native CHA/GDA patch was aligned with the corresponding CHA/GDA patch from the graft for the arterial reconstruction. No vascular complications were seen post-operatively.
Discussion:
Endarterectomy and anatomical reconstitution of the arterial tree, without any redundancy or kinking, allowed for the successful transplantation of organs that would be otherwise discarded. Further, the straight alignment of the arteries may enhance flow dynamics, preventing thrombosis.
Conclusion:
This report might guide future studies targeting means to increase the utility of donor livers discarded due to arterial atherosclerosis.
Graves' Disease Presenting with Complete Atrioventricular Block
Authors: Young Sil Eom, Pyung Chun Oh
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Hyperthyroidism commonly causes tachyarrhythmias such as sinus tachycardia and atrial fibrillation. Impaired atrioventricular conduction is a very rare complication of hyperthyroidism. We report a case of a patient with hyperthyroidism due to Graves' disease presenting with syncope and complete atrioventricular block. Because lack of awareness of atypical presentation in patients with hyperthyroidism may delay diagnosis and treatment, the recognition that hyperthyroidism can be one of the reversible causes of complete atrioventricular block is important.
HTLV-2 infection in Manaus, Brazil: first description of HTLV-2c subtype in an urban area of the Western Amazon region
Authors: Gemilson Soares Pontes, Hygor Halyson Figueiredo Ribeiro, Diana Mota Toro, José Pereira de Moura Neto, Victor Souza, Maria Edilene Martins de Almeida, Valdinete Alves do Nascimento, Cristovão Alves da Costa, Felipe Gomes Naveca, Mike Santos, Antonio Carlos Rosário Vallinoto
Journal: Rev Soc Bras Med Trop (2020)
MeSH terms: HTLV-I Infections / diagnosis, HTLV-I Infections / epidemiology, HTLV-II Infections / diagnosis, HTLV-II Infections / epidemiology, Human T-lymphotropic virus 1 / genetics, Case Reports, Adult, Brazil / epidemiology, Human T-lymphotropic virus 2 / genetics, Humans, Male, Phylogeny

Introduction:
We investigated the prevalence of human T-cell lymphotropic virus types 1 and 2 (HTLV-1/2) infection in patients with hematological diseases from the western Amazon region of Brazil.
Methods:
Samples from 306 patients were submitted for the molecular diagnosis of HTLV-1/2 infection by real time PCR (qPCR), with amplification, sequencing, and phylogenetic analysis of the long terminal repeat (LTR) region.
Results:
A 29-year-old male carrier of sickle cell anemia with a history of multiple blood transfusions was diagnosed with the HTLV-2c subtype.
Conclusions:
This study describes the first known occurrence of HTLV-2c in the urban area of Brazil's western Amazon region.
A Retropubic Cartilaginous Cyst in a Context of Surgery for Prostate Cancer
Authors: Annelies Van Breda, Thibault Meert, Mathieu Lefere
Journal: J Belg Soc Radiol (2022)
Keywords: ct, mri, retropubic cartilaginous cyst, subpubic cartilaginous cyst, suprapubic cartilaginous cyst, symphysis pubis
MeSH terms: Case Reports

Teaching Point: Retropubic cartilaginous cysts are rare, benign lesions originating from the symphysis pubis that should be considered in the differential diagnosis of a small slow-growing retropubic nodule.
Idiopathic Hypoparathyroidism and Severe Hypocalcemia in Pregnancy
Authors: Carine Ghassan Richa, Ali Ihsan Issa, Akram Salim Echtay, Mohamad Souheil El Rawas
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

The objective of this study is to report a case of severe hypocalcemia secondary to hypoparathyroidism in a pregnant woman. We report a case of a 45-year-old woman who presented for tonico-clonic seizure in the third trimester of gestation. She was diagnosed with idiopathic hypoparathyroidism for the first time during pregnancy. She was successfully treated with calcium and calcitriol in the rest of her pregnancy with resolution of symptoms but her infant was born with hypercalcemia and secondary hyperparathyroidism due to the late maternal presentation. To the best of our knowledge, hypoparathyroidism is a disorder rarely observed during pregnancy, resulting in most cases from surgical thyroidectomy.
An Interdisciplinary Diagnostic Approach to Guide Therapy in C3 Glomerulopathy
Authors: Tilman Schmidt, Sara Afonso, Luce Perie, Karin Heidenreich, Sonia Wulf, Christian F Krebs, Peter F Zipfel, Thorsten Wiech
Journal: Front Immunol (2022)
Keywords: c3 glomerulopathy, fhl1, complement, eculizumab, factor h, membranoproliferative glomerulonephritis
MeSH terms: Complement C3, Glomerulonephritis, Membranoproliferative / diagnosis, Glomerulonephritis, Membranoproliferative / therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Complement Activation, Complement Pathway, Alternative / genetics, Female, Humans, Immunoglobulins / therapeutic use, Complement C3, Immunoglobulins

Since the re-classification of membranoproliferative glomerulonephritis the new disease entity C3 glomerulopathy is diagnosed if C3 deposition is clearly dominant over immunoglobulins in immunohistochemistry or immunofluorescence. Although this new definition is more orientated at the pathophysiology as mediated by activity of the alternative complement pathway C3 glomerulopathy remains a heterogenous group of disorders. Genetic or autoimmune causes are associated in several but not in all patients with this disease. However, prognosis is poorly predictable, and clinicians cannot directly identify patients that might benefit from therapy. Moreover, therapy may range from supportive care alone, unspecific immune suppression, plasma treatment, or plasma exchange to complement inhibition. The current biopsy based diagnostic approaches sometimes combined with complement profiling are not sufficient to guide clinicians neither (i) whether to treat an individual patient, nor (ii) to choose the best therapy. With this perspective, we propose an interdisciplinary diagnostic approach, including detailed analysis of the kidney biopsy for morphological alterations and immunohistochemical staining, for genetic analyses of complement genes, complement activation patterning in plasma, and furthermore for applying novel approaches for convertase typing and complement profiling directly in renal tissue. Such a combined diagnostic approach was used here for a 42-year-old female patient with a novel mutation in the Factor H gene, C3 glomerulopathy and signs of chronic endothelial damage. We present here an approach that might in future help to guide therapy of renal diseases with relevant complement activation, especially since diverse new anti-complement agents are under clinical investigation.
Disseminated peritoneal leiomyomatosis: a rare cause of enigmatic peritoneal masses
Authors: Shivaprakash Basavanthaiah Hiremath, Geena Benjamin, Amol Anantrao Gautam, Sathibhai Panicker, Aji Rajan
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Disseminated peritoneal leiomyomatosis (DPL) is an unusual extrauterine form of leiomyoma that has been found to coexist with its intrauterine counterpart in individuals who have previously undergone laparoscopic myomectomy. The presence of extrauterine masses with the density of smooth muscle on CT imaging and/or with a low signal intensity similar to that of smooth muscle on T 2 weighted MRI in a patient presenting with associated intrauterine leiomyoma and/or a history of previous laparoscopic myomectomy suggests the possibility of DPL. Imaging studies help in diagnosing and delineating the location and extent of the lesion and also follow-up the masses to look for sarcomatous transformation. Here we report the case of a 43-year-old female who presented initially with right lower quadrant pain. Her CT scan and MRI demonstrated a fundal fibroid with multiple intraperitoneal soft tissue masses of similar appearance and contrast enhancement in the sigmoid mesocolon, the left paracolic gutter and adjacent to the ascending colon. The suspected diagnosis of DPL was confirmed during abdominal hysterectomy, bilateral salphingo-oophorectomy and excision of peritoneal masses.
Müllerian Agenesis Masquerading as Secondary Amenorrhea
Authors: Gloria Tavera, Rina Lazebnik
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

The most common cause of primary amenorrhea is congenital malformation of the Müllerian ducts, including Müllerian agenesis, also known as Mayer-Rokitansky-Küster-Hauser syndrome (MRKH). Most general gynecologists and primary care physicians who see female adolescents will encounter MRKH in their careers. We present the case of an adolescent with MRKH who reported secondary, instead of primary amenorrhea. We discuss the subtleties of diagnosing MRKH, especially when patient history may not always be accurate. Because MRKH had not been included in the differential diagnosis for delayed menses, this patient was initially misdiagnosed. Delayed diagnosis of MRKH may harm patients by delaying assessment of concomitant renal, skeletal, hearing, and cardiac defects, which might otherwise impact the treatment plan.
COVID-19 mRNA Vaccine-Associated Myocarditis Presenting as STEMI in a 48-Year-Old Male
Authors: Mohammad Dlewati, Kyeeun Park, Saumya Rawat, Jorge Conte, Kashmira Bhadha
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Myocarditis has been recognized as a rare complication of coronavirus disease 2019 (COVID-19) mRNA vaccinations. Young adult and adolescent males < 30 years of age are the most commonly affected group, with decreased incidence with older age. This is a case of a 48-year-old male who presented with chest pain and EKG findings of STEMI shortly after receiving the second dose of the Moderna COVID-19 mRNA vaccine. Emergent left heart catheterization revealed normal coronaries. Subsequently, the patient had rapid resolution of his symptoms and improvement in serum markers. The exact etiology factors to this new and rare phenomenon are yet to be fully understood. This patient did have a history of previous viral myocarditis 7 years ago; however, it remains unclear if this could be a predisposing factor to the development of mRNA vaccine-associated myocarditis.
Tuberculous peritonitis in pregnancy: a case report
Authors: Mounia Lahbabi, Jihane Brini, Khalid Massaoudi
Journal: J Med Case Rep (2014)

Introduction:
Tuberculous peritonitis is one of the least common forms of extrapulmonary tuberculosis. In the literature, few cases in pregnancy have been previously published. Tuberculous peritonitis in pregnancy is a diagnostic challenge, especially in the absence of lung involvement. It mimics other diseases and clinical presentation is usually non-specific, which may lead to diagnostic delay and development of complications.
Case presentation:
We report here a new case of tuberculous peritonitis that occurred in a 31-year-old Caucasian pregnant woman at 22 weeks' gestation. She was complaining of abdominal pain, nausea and vomiting. These symptoms appeared 6 months prior to presentation. Initially, they were attributed to pregnancy, but they progressively became more severe during subsequent weeks. A laparoscopy showed the presence of yellow-white nodules on the peritoneal surface and a biopsy demonstrated caseous necrotic granuloma. She made a good physical recovery after being placed on antituberculous chemotherapy and gave birth to a healthy male neonate of 3100g at 37 weeks' gestation by vaginal delivery.
Conclusions:
Extreme vigilance should be used when dealing with unexplained abdominal symptoms to ensure timely diagnosis of tuberculous peritonitis. Diagnosis often requires a histopathological examination. In these patients early diagnosis with early antituberculous therapy are essential to prevent obstetrical and neonatal morbidity.
Rescue procedure for isolated dystonia after the secondary failure of globus pallidus internus deep brain stimulation
Authors: Suzhen Lin, Lingbing Wang, Yimei Shu, Shunyu Guo, Tao Wang, Hongxia Li, Chencheng Zhang, Bomin Sun, Dianyou Li, Yiwen Wu
Journal: Front Neurosci (2022)
Keywords: deep brain stimulation, dystonia, globus pallidus internus, pallidotomy, rescue procedures, subthalamic nucleus

Introduction:
Globus pallidus internus (GPi) deep brain stimulation (DBS) is widely used in patients with dystonia. However, 10-20% of patients receive insufficient benefits. The objectives of this study are to evaluate the effectiveness of bilateral subthalamic nucleus (STN) DBS along with unilateral posteroventral pallidotomy (PVP) in patients with dystonia who experienced unsatisfactory GPi-DBS and to address the reported rescue procedures after suboptimal DBS or lesion surgery in dystonia patients.
Methods:
Six patients with isolated dystonia who had previously undergone bilateral GPi-DBS with suboptimal improvement were included. Standardized assessments of dystonia using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and quality of life using SF-36 were evaluated before surgery and 1, 6 months, and last follow-up (LFU) after surgery. STN bilateral OFF (bi-OFF), unilateral ON (uni-ON), and bilateral ON (bi-ON) states were recorded at LFU. Specific items were used to find publications published before 10 April 2022 regarding rescue procedures after suboptimal DBS or lesion surgery in patients with dystonia for reference. Eleven original studies including case reports/series were identified for discussion.
Results:
Substantial clinical benefits were achieved in all six patients. Significant amelioration was achieved during the 1-month (6.5 ± 7.45; p = 0.0049), 6-month (5.67 ± 6.3; p = 0.0056) follow-ups, and at LFU (4.67 ± 4.72; p = 0.0094) when compared with the baseline (LFU of GPi DBS with on status) (17.33 ± 11.79) assessed by BFMDRS. The percentage of improvement reached 70.6, 74.67, and 77.05%, respectively. At LFU, significant differences were found between the stimulation bi-OFF and uni-ON (11.08 ± 8.38 vs. 9 ± 8.52, p = 0.0191), and between the stimulation bi-OFF and bi-ON (11.08 ± 8.38 vs. 4.67 ± 4.72, p = 0.0164). Trends depicting a better improvement in stimulation bi-ON compared with uni-ON (4.67 ± 4.72 vs. 9 ± 8.52, p = 0.0538) were observed.
Conclusion:
Our results suggest that bilateral STN-DBS plus unilateral PVP may be an effective rescue procedure for patients with isolated dystonia who experienced suboptimal movement improvement following GPi-DBS. However, given the heterogeneity of patients and the small sample size, these findings should be interpreted with caution.
Eosinophilia in Amoxicillin-Induced Rash in Infectious Mononucleosis
Authors: Ana Abreu, Sofia Nunes, Carmen Botelho
Journal: Cureus (2023)
Keywords: allergy, eosinophilia, epstein barr virus infections, exanthema, immunology
MeSH terms: Case Reports

A link between amoxicillin-induced rash in infectious mononucleosis and allergy has been previously reported. However, the pathophysiological cause and aspects are unclear. Additionally, the complex immunological interaction between the host and Epstein-Barr virus needs to be studied. This article reports a case of amoxicillin-induced rash in infectious mononucleosis resulting in an exuberant rash, facial edema, and marked eosinophilia, which prompted additional workup. Both the eosinophilia and the rash brought to light a possible association with a persistent delayed-type hypersensitivity. Further scientific discussion and investigation can identify predictive indicators that can portend clinical outcome.
Spontaneous epiglottic hematoma secondary to supratherapeutic anticoagulation
Authors: Cody A Koch, Steven M Olsen, Amy M Saleh, Laura J Orvidas
Journal: Int J Otolaryngol (2010)
MeSH terms: Case Reports

Hemorrhage into the soft tissues of the airway represents a potentially life-threatening complication of long-term anticoagulation. We report the case of a chronically anticoagulated 37-year-old male who developed a spontaneous hematoma of the epiglottis secondary to a supra-therapeutic INR. Epiglottic hematoma should be considered in the differential of any anticoagulated patient presenting with upper airway compromise. The airway should be secured in a controlled fashion, and the coagulopathy should be rapidly corrected.
Botulinum toxin type A for genitofemoral neuralgia: A case report
Authors: Yan Tereshko, Belgrado Enrico, Lettieri Christian, Simone Dal Bello, Giovanni Merlino, Gian Luigi Gigli, Mariarosaria Valente
Journal: Front Neurol (2023)
Keywords: botulinum toxin type a, genitofemoral nerve, genitofemoral neuralgia, neuralgia, pain
MeSH terms: Case Reports

Genitofemoral neuralgia is an uncommon pain disorder that could be resistant to conventional treatment. A 78-year-old woman with refractory right genitofemoral neuralgia was treated with BoNT/A subcutaneous injections; the treatment was performed three times with significant pain improvement, although temporary, and without adverse events. BoNT/A may be a promising alternative intervention in the setting of genitofemoral neuralgia refractory to oral and/or topical treatment.
Successful pregnancy outcome in Swyer-James-Macleod syndrome
Authors: Seema Chopra, Neelam Aggarwal, Vanita Suri, Meenakshi R Thami
Journal: Ann Thorac Med (2008)
Keywords: bronchiectasis, swyer-james syndrome, hyperlucent lung
MeSH terms: Case Reports

Swyer-James-MacLeod (SJM) syndrome is a chronic, progressive lung disease as a result of infection and bronchial obstruction that ultimately leads to emphysema. It is associated with chronic cough, sputum production and recurrent chest infections and is occasionally seen in women of reproductive age. The radiological finding of unilateral hyperlucent lung is considered synonymous with the disease entity.
Advanced prostate cancer presenting as hemolytic uremic syndrome
Authors: R Ramos, F Lopes, T Rodrigues, N Rolim, I Rodrigues, H Monteiro
Journal: Case Rep Urol (2013)

Introduction. Hemolytic uremic syndrome (HUS) is characterized by endothelial dysfunction, consumption thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure. HUS generally has a dismal prognosis, except when associated with gastroenteritis caused by verotoxin-producing bacteria. Cancer associated HUS is uncommon, and there are only scarce reports on prostate cancer presenting with HUS. Case Presentation. A 72-year-old man presented to the emergency department with oliguria, hematuria, and hematemesis. Clinical evaluation revealed acute renal failure, hemolysis, normal blood-clotting studies, and prostate-specific antigen value of 1000 ng/mL. The patient was started on hemodialysis, ultrafiltration with plasma exchange, and androgen blockade with bicalutamide and completely recovered from HUS. The authors review the 14 published cases on this association. Conclusion. The association of HUS and prostate cancer occurs more frequently in patients with high-grade, clinically advanced prostate cancer. When readily recognized and appropriately treated, HUS does not seem to worsen prognosis in prostate cancer patients.
Black Pepper (Piper nigrum) for Tobacco Withdrawal: A Case Report
Authors: Jeremy Weleff, Samyukta Dore, Akhil Anand, Brian S Barnett
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Tobacco use continues to be one of humanity's most significant public health concerns, causing more than 8-million deaths annually. Existing treatments for tobacco use disorder are limited in efficacy and there is a strong need for identifying effective novel treatments. Small clinical trials indicate that black pepper (Piper nigrum) essential oil may be helpful for treating nicotine withdrawal and craving. However, we are unaware of any cases reporting the use of black pepper for these purposes in nonresearch settings. Here we present the case of a patient who inhaled combusted black pepper to self-medicate nicotine withdrawal when lacking access to tobacco cigarettes while incarcerated. Based on our patient's report, inhalation of combusted black pepper may have alleviated his tobacco withdrawal and cravings by reducing his automatic motor urge to smoke, quelling withdrawal-associated anxiety, and mimicking the sensorimotor experience of smoking tobacco cigarettes. Notably, our patient reported that inhalation of combusted black pepper for treatment of nicotine craving and withdrawal was common in his correctional facility. Though combusted black pepper is highly unlikely to be an appealing treatment outside of a correctional setting, this case suggests that further investigation of vaporized black pepper essential oil for tobacco cessation may be warranted.
Persistence of Natural Killer (NK) cell lymphocytosis with hyposplenism without development of leukaemia
Authors: Sujoy Khan, K Myers
Journal: BMC Clin Pathol (2005)

Background:
Natural killer (NK) cell lymphocytosis usually has an indolent course and can progress into massive lymphocytosis with development of cytopenias and neoplastic diseases. NK-cells usually express one or more "NK-associated" antigens (CD16, CD56, CD57). Reactive expansions are seen in autoimmune diseases, viral infections, solid tumours and non-Hodgkin's lymphoma.
Case presentation:
We report a lady with a benign clinical course over 10 years and persistent CD8+/CD3-/CD57+/CD16+ LGL proliferation with presence of Howell-Jolly bodies (functional hyposplenism), an association not previously described.
Conclusion:
We discuss the possible causes of clonal expansion and conclude that this may be part of the spectrum of immune dysregulation associated with NK-cell lymphocytosis.