OpenMed/multicare-articles huggingface dataset:
Trichohepatoenteric Syndrome or Syndromic Diarrhea-Report of Three Members in a Family, First Report from Iran
Authors: F E Mahjoub, F Imanzadeh, S Mahdavi Izadi, A Nahali Moghaddam
Journal: Case Rep Pathol (2016)

Introduction. Intractable diarrhea of infancy (IDI) includes several types of early onset diarrhea; one of the rare etiologies is trichohepatoenteric (THE) syndrome, also known as syndromic diarrhea (SD) which was primarily described by Stankler et al. Hereby we report a family with several affected members which to our knowledge is the first case report from Iran. Report of Cases. A three-year-old boy referred with short stature, poor weight gain, and intermittent steatotic diarrhea to our center. He was born to healthy, relative parents (cousins). He did not gain any weight after four months of age and began having intermittent steatotic diarrhea, abdominal distension, and fever. He was hospitalized several times. Two other children in the family also showed somewhat similar symptoms. Two sweat tests were negative for cystic fibrosis. Workup for Celiac disease was performed several times which was negative; however, gluten-free diet was tried several times which was not effective. Workup for Hirschsprung's disease was performed but colon was ganglionic. Evidence of liver involvement was approved by elevated liver enzymes and coarse echo of liver on sonography. Discussion. Trichoenterohepatic syndrome should be put in mind in cases of intractable diarrhea presenting in a family with several affected members. Early diagnosis would save patients from unnecessary workups.
Peripheral Gangerene, an Unusual Presentation of Infantile Kawasaki: A Case Report and Literature Review
Authors: Fatemeh Tahghighi, Maryam Bakhtiari Koohsorkhi, Vahid Ziaee
Journal: Case Rep Rheumatol (2021)
MeSH terms: Case Reports

Introduction:
Diagnosing infantile Kawasaki disease with atypical symptoms is difficult, and it also has higher risk of coronary abnormalities which is one of the most common complications of KD. Other complications such as pericardial effusion, mitral insufficiency, congestive heart failure, myocardial systolic dysfunction, and systemic vasculitis were also reported. Peripheral gangrene and necrosis are among the rare complications of this systemic vasculitis. Case Presentation. We report an 8-month-old girl with prolonged fever, generalized petechial rash, cracked erythematous lips, edema, and coronary ectasia who received two doses of IVIG in another center, but short after her discharge, she started to develop a necrotic plaque on her knee. She was admitted in our hospital, and the repeat echocardiography showed sustained coronary ectasia. She received 3 doses of methylprednisolone pulse therapy and was discharged with aspirin and prednisolone. In the follow-up visits, the coronary ectasia was resolved and the necrotic ulcer was healing with a scar.
Conclusions:
The diagnosis of Kawasaki disease and echocardiographic evaluation of the coronary arteries should be considered in young infants with prolonged fever of unknown origin. Peripheral gangrene is a rare but important complication of infantile Kawasaki disease, although the exact mechanism in not fully understood.
Advanced HCC with amplified mesenchymal epithelial transition factor receptor responds well to savolitinib: a case report
Authors: Ningning Yan, Ziheng Zhang, Sanxing Guo, Shujing Shen, Xingya Li
Journal: Front Med (Lausanne) (2023)
Keywords: met, met-tki, liver cancer, savolitinib, tyrosine kinase inhibitors
MeSH terms: Case Reports

Objective:
Current treatment agents for HCC are mostly immune checkpoint inhibitors (ICIs) plus bevacizumab and multitarget tyrosine kinase inhibitors (TKIs); however, their limited overall response rate and shorter median progression-free survival (PFS) discourage their frequent use. The development of Mesenchymal Epithelial Transition Factor receptor (MET) Tyrosine Kinase Inhibitors (MET-TKI) has transformed the treatment pattern in MET-altered solid tumors and improved their prognosis. However, the benefits of MET-TKIs in MET-amplified hepatocellular carcinoma (HCC) remain unclear.
Methods:
Here, we present a case of advanced HCC amplified with MET treated with savolitinib, a MET-TKI, after progression from first-line treatment with bevacizumab plus sintilimab.
Results:
The patient achieved a partial response (PR) to savolitinib in the second line setting. The progression-free survival (PFS) of first-line of bevacizumab plus sintilimab and sequential second-line treatment with MET-TKI, savolitinib, are 3 and over 8 months, respectively. furthermore, the patient still had continuous PR status with manageable toxicities.
Conclusions:
The present case report provides first-hand evidence that savolitinib may be beneficial for patients with advanced MET-amplified HCC and offers a promising treatment option.
Case Report: Unusual Presentation of Myositis Ossificans of the Elbow in a Child Who Underwent Excessive Postoperative Rehabilitation Exercise
Authors: Jin Cao, Hua Jiang Zheng, Jing Hua Sun, Huan Ye Zhu, Chao Gao
Journal: Front Pediatr (2021)
Keywords: bone health, child, conservative treatment, excessive postoperative rehabilitation exercise, myositis ossificans
MeSH terms: Case Reports

Traumatic myositis ossificans (MO) is an unusual complication after muscle injury and is predominantly seen in young adults and adolescents. Pediatric MO cases are even rarer. We report an 8-year-old girl who was diagnosed with a lateral humeral condyle fracture. She was treated surgically, and her elbow joint was fixed with plaster. Rehabilitation exercise was administered 1 month after the operation. Due to the wrong exercise method, a palpable bony mass appeared around the elbow 1 month later. The clinical radiological diagnosis showed MO, and conservative treatment was administered. After 3 years of follow-up, the affected limb functioned well, with no sign of recurrence. Here, we report this long-term follow-up case of MO resulting from excessive rehabilitation exercise.
Hemophagocytic Syndrome Associated with Hodgkin's Lymphoma First Presenting as Fever and Pancytopenia
Authors: Ramon Andrade Bezerra de Mello, Elsa Fonseca, Manuela Brochado, João Manuel Quinaz
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Background. Hemophagocytic syndrome (HPS) is characterized by a hyperinflammatory reaction followed by alteration in cytotoxic function of Th1 lymphocytes and natural killer cells. We report a rare case of a patient that presented with fever and pancytopenia due to HPS associated with Hodgkin's lymphoma (HL). Case Report. A 69-year-old Caucasian woman was admitted presenting with complaints of fever, seizures, and low back pain that had lasted for two weeks. Laboratorial data showed pancytopenia. Bone marrow biopsy revealed infiltration by Reed-Sternberg cells and hemophagocytosis signs. Imaging studies showed mediastinal lymph nodes (stage IV B). She had been treated with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) followed by a good response. Conclusion. HPS associated with HL is a very rare and lethal disease, with mortality rates of about 15% to 60%. The prompt diagnosis of the underlying lymphoma may be an important strategy for optimizing the clinical approach and outcome.
The Evidence before One's Eyes: A Case Report on Schizo-Obsessive Disorder
Authors: Elliott B Martin Jr
Journal: Case Rep Psychiatry (2012)

Obsessive compulsive disorder is still considered primarily an anxiety disorder, though historically there has always been a question of whether obsessive-compulsive symptoms may be more properly considered psychotic in nature, the so-called schizo-obsessive disorder or subtype. A case is presented here of a middle-aged man with debilitating obsessive-compulsive symptoms of sudden onset in his late teens. Given the nature of onset and symptomatology, and the failure of prior therapies, the case was approached as a primary psychotic disorder. The neuroleptic-naive patient had remarkable response to low-dose antipsychotic medication, as well as to psychodynamic psychotherapy modeled along the lines of neuroplasticity. The case illustrates the blurred distinctions among anxiety, mood, and psychotic disorders and the improved outcomes when the proper underlying disorder is addressed.
Chylous Ascites: A Rare Adverse Effect of Methimazole Treatment for Grave's Disease-A Case Report and Review of the Literature
Authors: Tawfik Khoury, Ronen Schneider
Journal: Case Rep Endocrinol (2015)

A 40-year-old woman was admitted due to an urticarial rash that was attributed to recent onset of methimazole treatment for a diagnosis of Grave's disease. The patient had no prior significant medical history and used no medications, including over-the-counter or herbal medications. Her sister had Grave's disease. On admission, the patient received corticosteroids with improvement in her rash. On the second day of the hospitalization, the patient complained of abdominal discomfort. Abdominal ultrasound revealed a large amount of new onset ascites. Peritoneal tap yielded a milky fluid with high triglyceride level (12.2 mmol/L or 1080 mg/dL), consistent with chylous ascites. After discontinuation of the methimazole, the ascites disappeared. The patient later underwent therapeutic thyroidectomy, after which all features of thyrotoxicosis had improved.
The Infection Returns: A Case of Pulmonary Sporotrichosis Relapse after Chemotherapy
Authors: Samid M Farooqui, Houssein Youness
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Background:
Pulmonary sporotrichosis is a rare disease caused by a dimorphic fungus, Sporothrix schenckii. It is rarely found in association with malignancy. We present a case of pulmonary sporotrichosis recurrence after chemotherapy.
Case presentation:
A 44-year-old man, treated for pulmonary sporotrichosis in the past, presented with dysphagia and was found to have squamous cell carcinoma of the esophagus. After undergoing chemotherapy, extensive cavitary lesions were observed on thoracic computed tomography scan. A bronchoalveolar lavage revealed the presence of Sporothrix schenckii sensu lato. Despite treatment with itraconazole, he eventually required a left pneumonectomy for progressive destructive cavitary lesions involving the left lung.
Conclusion:
This case highlights the importance of considering past fungal infections, albeit cured, in patients initiating immunosuppressive therapy.
Weight-Loss Cognitive-Behavioural Treatment and Essential Amino Acid Supplementation in a Patient with Spinal Muscular Atrophy and Obesity
Authors: Marwan El Ghoch, Paola Vittoria Bazzani, Simona Calugi, Riccardo Dalle Grave
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Spinal muscular atrophy is a genetic neuromuscular disease characterised by muscle atrophy, hypotonia, weakness, and progressive paralysis. Usually, these patients display increased fat mass deposition and reductions in fat-free mass and resting energy expenditure-an unfavourable condition that facilitates the development of obesity. However, weight management of these patients remains poorly described. Hence, the aim of this case report was to describe the clinical presentation and weight management of a 31-year-old male patient with spinal muscular atrophy type III, class I obesity, and metabolic syndrome treated for 1 year by means of a personalised multistep cognitive-behavioural treatment for obesity. The treatment produced a weight loss of 7.2 kg (7.1%), which was associated with a marked improvement in both the patient's self-reported general conditions and obesity-related cardiometabolic profile, and no adverse effects in terms of spinal muscular atrophy (i.e., reductions in fat-free mass or resting energy expenditure).
Twenty-year survival of gastric cancer with peritoneal metastases using long-term normothermic intraperitoneal 5-fluorouracil and systemic mitomycin C: A case report
Authors: Paul H Sugarbaker
Journal: Int J Surg Case Rep (2019)
Keywords: 5-fluorouracil, case report, hipec, intraperitoneal chemotherapy, mitomycin c, nipec

Background:
Primary gastric cancer that presents with peritoneal metastases has few options for successful treatment.
Methods:
A simplified treatment plan started with total gastrectomy and hyperthermic intraperitoneal chemotherapy. After placement of an intraperitoneal port combined intraperitoneal and systemic chemotherapy was given for six months.
Results:
The treatments were tolerated well and associated with an acceptable quality of life and no adverse events. The patient is a 20-year survivor of her disease.
Conclusions:
Gastric cancer with peritoneal metastases was successfully treated with a combination of gastrectomy plus intraperitoneal and systemic chemotherapy. Further studies using this simplified approach may be indicated.
An unusual case of extensive contiguous cervicothoracic spinal tuberculosis involving fourteen damaged segments: A case report
Authors: Ifran Saleh, Didik Librianto, Phedy Phedy, Toto Suryo Efar, Anissa Feby Canintika
Journal: Int J Surg Case Rep (2020)
Keywords: cervicothoracic spinal tuberculosis, multilevel contagious involvement
MeSH terms: Case Reports

Introduction:
Cervicothoracic spinal tuberculosis (CTSTB) is a rare and disabling disease involving the mobile, transitional zone between the lordotic cervical and the kyphotic thoracic spine. Approximately half of those cases involves one or two segments of cervicothoracic vertebrae. We reported a 28-year-old female with tuberculous involvement of fourteen contiguous vertebral segments.
Presentation of case:
A 28-year-old female presented with tuberculous involvement of fourteen contiguous vertebral segments is presented. A series of radiographic and CT scan depicted multiple vertebral body destruction anteriorly, along with facet joint dislocation and mild retrolisthesis of C4-C5 segments. MR images of the cervical region was demonstrated pathologic contrast enhancement on C4 to T7 vertebrae, a total of fourteen contiguous segments.
Discussion:
Of all spinal tuberculosis, CTSTB accounts for only 5%. In addition to its rarity as a site for tuberculosis, the cervicothoracic junction has anatomical and clinical peculiarities, as a reversal of the mobile-lordotic cervical vertebrae to rigid-kyphotic thoracic vertebrae occurs at this location. Most CTSTB involves only two segments; however, in this case, we found a very extensive case wherein there were fourteen damaged segments.
Conclusions:
Our report demonstrates one of the longest involvement of extensive contiguous CTSTB who was treated with one-stage posterior-only approach. However, as this is only a report of one case, further studies are required to investigate the safety and efficacy of such approach for treating extensive CTSTB.
Bilateral Avulsion Fracture of the Fibula Head of the Knee Associated with Avulsion Fracture of the Iliotibial Band: A Rare Case of Fracture Segond Associated with Arcuate Fracture
Authors: Jonatas Brito de Alencar Neto, Clodoaldo José Duarte de Souza, Márcio Bezerra Gadelha Lopes, Maria Luzete Costa Cavalcante, Luiz Holanda Pinto Neto
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Fibular head avulsion fractures are rare and are so-called the arcuate signal. Avulsion fracture of the iliotibial band and anterolateral ligament is known as a Segond fracture, and it is another rare entity. We describe the case of a 27-year-old woman who was hit by a car and suffered polytrauma, mainly suffering injuries to both knees. Radiographs of the knees showed a Segond fracture associated with the arched signal bilaterally. The aim of this study is to present a rare case report and literature review of a bilateral fibular head avulsion fracture associated with an anterolateral tibial avulsion fracture.
Disseminated Intravascular Coagulation as an Initial Manifestation of Metastatic Prostate Cancer Emergently Treated with Docetaxel-Based Chemotherapy
Authors: Kavita Agrawal, Nirav Agrawal, Levin Miles
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

A 70-year-old male presented with hematuria and bruising of arms and legs for the last three days. He also complained of urinary frequency and hesitancy and weight loss of 40 pounds over a span of four months. Initial blood tests showed prothrombin time (PT) of 25.1 seconds, international normalized ratio (INR) of 2.5, partial thromboplastin time (PTT) of 43.9 seconds, fibrinogen of 60 mg/dl, fibrin degradation products (FDP) of more than 20 μg/ml, and platelets of 88,000/μl. The impression was disseminated intravascular coagulation (DIC). A search was initiated to determine the underlying etiology precipitating DIC. Due to urinary symptoms and weight loss, prostate-specific antigen (PSA) was ordered. PSA was elevated at 942 μg/dl. Computed tomography (CT) of the abdomen and pelvis without contrast showed an enlarged prostate with mass effect on the bladder base, left-sided hydronephrosis, and numerous enlarged pelvic lymph nodes. A bone scan of the whole body showed increased sclerosis of the L3 vertebral body. There was a concern for metastatic prostate cancer precipitating DIC. On first admission, our patient's DIC was stabilized with FFP and cryoprecipitate transfusions. He refused chemotherapy, and degarelix was not economically feasible. Accordingly, he was started on androgen deprivation therapy (ADT), bicalutamide, and leuprolide as an inpatient, pending the tissue biopsy. The patient refused a prostate biopsy. A bone marrow biopsy was performed which confirmed metastatic prostate adenocarcinoma. The patient was stable for discharge with a plan for outpatient chemotherapy. Subsequently, he was lost to follow-up with the oncology. Six months after the initial presentation, he was readmitted with hematuria. Repeat PSA worsened to 1,970 μg/dl. Blood work was consistent with acute DIC. He refused chemotherapy again. So, he was restarted on ADT. However, his hematuria and DIC panel were worsening. He was emergently started on docetaxel as an inpatient (after patient agreement). Within three days of starting chemotherapy, his hematuria resolved and DIC panel showed consistent improvement.
Patellar Transskeletal Traction for the Treatment of Chronic Patellar Pseudoarthrosis
Authors: José Leonardo Rocha de Faria, Dieno Mol Souza Portella, Victor Elias Titonelli, Naasson Trindade Cavanellas, Rodrigo Pires E Albuquerque, Eduardo Branco de Sousa, João Maurício Barretto
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Patellar fractures, which constitute approximately 1% of bone lesions, may lead to severe impairment of the extensor mechanism. When conservative or surgical treatment fails, the patella may develop pseudoarthrosis. Neglect or delayed treatment of this type of injury may lead to significant diastasis between the patellar fragments. There is no consensus regarding the best treatment for such cases. This study is aimed at describing a rare case of patellar pseudoarthrosis in a patient who underwent two-step surgical treatment comprising transskeletal patellar traction followed by osteosynthesis with a tension band. A 17-year-old male patient presented with a left patellar fracture that resulted from a fall from a standing height 8 years ago. He did not undergo any type of surgical treatment during that time, but the fracture was immobilized for only 2 weeks. The two-step surgical treatment with transskeletal patellar traction and patellar osteosynthesis was performed and provided satisfactory functional clinical results in this patient. This two-step surgical treatment can be performed in cases similar to ours with satisfactory results.
Fulminant nonocclusive mesenteric ischemia just after hip arthroplasty
Authors: Maria Auxiliadora-Martins, Gil Cezar Alkmin-Teixeira, Omar Feres, Olindo Assis Martins-Filho, Anibal Basile-Filho
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Nonocclusive mesenteric ischemia (NOMI) is not a rare clinical entity in intensive medicine, and it can be a consequence of several clinical or surgical situations. This pathology results from reduced intestinal microvascular blood supply associated with an acute inflammatory process, culminating with bowel necrosis. This is a case on a female patient who developed immediate postsurgical NOMI following hip arthroplasty and died. Since diagnosis of this potentially fatal condition remains a dilemma, NOMI should always be considered an eventual postoperative complication in high-risk surgical patients such as elderly individuals with previous history of nicotine abuse, congestive heart failure, and essential hypertension. The present paper highlights the importance of early diagnosis and prompt adequate treatment of NOMI in subjects with diminished cardiac output and severe abdominal pain.
Salvage therapy with high dose Intravenous Immunoglobulins in acquired Von Willebrand Syndrome and unresponsive severe intestinal bleeding
Authors: Massimo Cugno, Alberto Tedeschi, Simona Maria Siboni, Francesca Stufano, Federica Depetri, Franca Franchi, Samantha Griffini, Flora Peyvandi
Journal: Exp Hematol Oncol (2014)
Keywords: acquired von willebrand syndrome, gastrointestinal bleeding, intravenous immunoglobulin
MeSH terms: Case Reports

A 91-year-old woman affected with acquired Von Willebrand (VW) syndrome and intestinal angiodysplasias presented with severe gastrointestinal bleeding (hemoglobin 5 g/dl). Despite replacement therapy with VW factor/factor VIII concentrate qid, bleeding did not stop (eleven packed red blood cell units were transfused over three days). High circulating levels of anti-VW factor immunoglobulin M were documented immunoenzimatically. Heart ultrasound showed abnormalities of the mitral and aortic valves with severe flow alterations. When intravenous immunoglobulins were added to therapy, prompt clinical and laboratory responses occurred: complete cessation of bleeding, raise in hemoglobin, VW factor antigen, VW ristocetin cofactor and factor VIII levels as well as progressive reduction of the anti-VWF autoantibody levels.
Lactococcus lactis Endocarditis in an Immunocompromised Patient
Authors: Austin Mitchell, Sarah Gorn, Alex Cheung, Spogmai Khan, Cynthia Anneski
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

Lactococcus lactis infections are rarely reported in the medical literature. L. lactis is a commonly used fermenting agent which may be difficult to identify with common microbiology identification processes. This factor may contribute to its lack of recognition in medical journals. We report a case of an immunosuppressed 80-year-old female with L. lactis bacteremia, subsequently, found to have aortic valve vegetation, who responded clinically to a six-week duration of ceftriaxone therapy. Afterward, a brief updated literature review is presented on L. lactis infections.
Case report: Death caused by 1, 3-dichloropropene, a novel fumigant used in China
Authors: Zhiqiang Zhou, Lanlan Guo, Zixin Wen, Ping Dai, Tongyue Zhang, Wenjun Wang, Xiangdong Jian
Journal: Front Public Health (2023)
Keywords: 1, 3-dichloropropene, acute renal failure, brain edema, fumigant, self-protection
MeSH terms: Pesticides, Case Reports, China, Humans, Male, Middle Aged, Soil, Pesticides, Soil

As an efficient and broad-spectrum soil fumigant, 1, 3-dichloropropene is widely used in the control of nematodes, soil pests, and plant pathogens. However, as a volatile chlorine-containing organic compound, 1, 3-dichloropropene is harmful to human health, although no deaths caused by inhalation of 1, 3-dichloropropene have been reported. This article describes the case of a 50-year-old man who died of acute renal failure and brain edema after inhaling 1, 3-dichloropropene at work. This case demonstrates that 1, 3-dichloropropene can be absorbed through the respiratory tract and that exposure to 1, 3-dichloropropene in a confined environment without any protective measures can cause death in humans.