OpenMed/multicare-articles huggingface dataset:
Triglyceride Levels Greater Than 10,000 mg/dL in a 49-Year-Old Female without Evidence of Pancreatitis
Authors: Anika Toor, Amit Toor, Koroush Khalighi, Mahesh Krishnamurthy
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

We present a rare case of a 49-year-old female with very severe hypertriglyceridemia (HTG) having a total triglyceride (TG) count of > 10,000 mg/dL in the absence of pancreatitis. Based on literature review, this is one of the highest recorded TG counts in an adult without evidence of pancreatitis. HTG is a common occurrence in clinical practice, but rarely do numbers exceed 2000 mg/dl. It is crucial to evaluate and rapidly lower TG levels to prevent potentially life-threatening complications such as severe pancreatitis. Removal of potential predisposing medications, control of underlying diseases known to cause HTG, and maintenance therapies are essential to prevent reoccurrence.
Inferior vena cava thrombus secondary to blunt abdominal trauma
Authors: Chadi Diab, Anthony Abou Karam, Shaked Laks, Noemi Brunner
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

A 15-year-old female presented to the emergency department of a level 1 trauma centreafter being involved in a high-speed motor vehicle accident. The patient underwent a contrast-enhanced CT scan of the abdomen and pelvis obtained with a 60-70 s delay as part of the institution's polytrauma protocol. The CT scan demonstrated multiple hepatic lacerations and a filling defect in the suprahepatic inferior vena cava adjacent to the cavoatrial junction. Inferior vena cava thrombus secondary to blunt abdominal trauma is extremely rare, and to our knowledge, this is the first reported case of acute thrombus diagnosed by CT at the time of initial injury. There is limited literature on management of this entity. Possible treatments range from conservative approaches to anticoagulation and placement of IVC filters.
Intractable hiccups (singultus) abolished by risperidone, but not by haloperidol
Authors: Tadashi Nishikawa, Yoichiro Araki, Teruo Hayashi
Journal: Ann Gen Psychiatry (2015)
Keywords: antipsychotic, dopamine, hiccups, risperidone, serotonin
MeSH terms: Case Reports

Hiccups or singulata are rhythmic involuntary movements of the diaphragm, caused by a variety of conditions that interfere with the functions of the nerve nuclei in the medulla and supra-spinal hiccup center. Although neurotransmitters and receptors involved in the pathophysiology of hiccups are not defined well, dopamine has been considered to play an important role. In some cases, chlorpromazine or other antipsychotics are used for the treatment of intractable hiccups but their efficacy is often limited. This report involves an 18-year-old patient who experienced two episodes of intractable hiccups triggered by stress, which lasted for weeks or even months. In both episodes, haloperidol was initially used, but there was no significant effect. In contrast, risperidone, the second-generation antipsychotic that possesses a dopamine-serotonin antagonist property, completely abolished the hiccups 6 hours after administration. This is one of few case reports in which two antipsychotics were challenged for a single patient with hiccups, and the effects of the drugs were obviously different. Our finding suggests that, in addition to dopaminergic system, the serotonergic systems may be involved in the pathophysiology of some hiccup cases and that the serotonin-acting antipsychotics such as risperidone should be considered as a choice in the drug treatment of intractable hiccups.
Cisplatin induced cerebral sinus venous thrombosis in cervical cancer patients treated with concurrent chemoradiation: a case series
Authors: Deepthi Valiyaveettil, Swapna Jilla, Jonnalagadda Mohan Krishna, Raja Kollu, Chandrasekhar Patil, Ranadheer Gupta
Journal: Ecancermedicalscience (2021)
Keywords: csvt, carcinoma cervix, cisplatin, radiation
MeSH terms: Case Reports

Cisplatin is a widely used chemotherapeutic agent. Concurrent chemotherapy with cisplatin is an important component in the management of carcinoma cervix. The common side effects of cisplatin chemotherapy include nausea, vomiting, dyselectrolytemia, nephrotoxicity, etc. These side effects are anticipated and managed during chemotherapy. Thromboembolic events are rare complications with cisplatin. We present three cases of cisplatin related cerebral sinus venous thrombosis (CSVT). These patients were receiving concurrent chemoradiation for carcinoma cervix. These patients presented with neurological symptoms and were evaluated and diagnosed with CSVT. They recovered after appropriate management. Clinicians should be aware that CSVT, though uncommon, is a life threatening complication during cisplatin chemotherapy which should be appropriately evaluated and effectively managed.
Connatal Urinary Ascites in a Female Preterm
Authors: Barbara Brunner, Elisabeth Ralser, Elisabeth D'Costa, Kathrin Maurer, Ursula Kiechl-Kohlendorfer, Elke Griesmaier
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Background:
Connatal urinary ascites is rare in females without associated malformations and occurs following bladder rupture.
Case presentation:
A female very preterm was delivered by caesarean section because of abnormal Doppler findings. The mother suffered from viral pneumonia requiring intensive care in the third trimester of pregnancy. Serial fetal ultrasound examinations showed a megacystis and ascites. Postnatally, pronounced isolated ascites was drained and its urinary nature was confirmed. The bladder leak was demonstrated when blue dye, instilled via a Foley catheter, appeared in the ascitic drain. After removal of the catheter spontaneous micturition was unremarkable. A micturating cystourethrogram showed spontaneous closure of the bladder leak.
Conclusion:
The female infant experienced fetal bladder rupture and connatal urinary ascites due to maternal pneumonia and intensive care. The use of blue dye is an effective alternative method to any contrast media radiography and should be considered, especially in very preterm infants.
Case report: Corticosteroid-resistant acute fibrinous and organizing pneumonia with myelodysplastic syndrome
Authors: Dingyuan Jiang, Xueying Chen, Jun Li, Ling Zhao, Huaping Dai
Journal: Front Med (Lausanne) (2023)
Keywords: acute fibrinous and organizing pneumonia, case report, corticosteroid-resistant, fever of unknown origin, interstitial lung disease, myelodysplastic syndrome, pulmonary consolidation
MeSH terms: Case Reports

Acute fibrinous and organizing pneumonia (AFOP) is a lung disease with an unusual pathological pattern. The definitive diagnosis of AFOP relies on pathological evidence of intra-alveolar fibrin exudate, lymphoplasmacytic infiltrate, and the absence of a hyaline membrane. Furthermore, its etiology is difficult to confirm, and corticosteroids are usually effective. Herein, we report the case of a young male who presented with high fever, hemocytopenia, and consolidation in both lungs. The initial misdiagnosis was community-acquired pneumonia. Subsequently, a lung biopsy revealed abundant fibrin and fibroblast exudates in the alveolar spaces, indicating AFOP. In addition, bone marrow biopsy and karyotype analysis demonstrated that the patient simultaneously had myelodysplastic syndrome (MDS) and hemophagocytic lymphohistiocytosis. In this case, the AFOP was considered secondary to MDS; however, the disease did not respond to glucocorticoid treatment or chemotherapy. Hence, AFOP should be considered in patients with underlying hematological diseases, and early identification and diagnosis are important. Furthermore, the management of patients with severe AFOP requires further investigation.
The Lost Crown: A Case of an Aspirated Tooth Crown Causing Post-Obstructive Pneumonia
Authors: Gabriella Primera, Jessika Matta, Louis Eubank, Puncho Gurung
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Non-asphyxiating foreign body aspiration (FBA) is an uncommon occurrence in adults, but it can lead to serious complications and sequelae. Diagnosis of FBA can be difficult as symptoms can mimic other respiratory diseases and the majority of foreign bodies are not visible on chest X-ray. We report a case of an older male who presented with respiratory failure secondary to pneumonia after aspiration of a dental crown. The patient improved after antibiotic therapy and removal of the foreign body by bronchoscopy. Our case is unusual because the diagnosis was delayed after the aspiration event because the patient was asymptomatic before presenting with pneumonia two years later. This case emphasizes the importance of early recognition and management of possible aspiration events to prevent life-threatening sequelae.
Case report: A case of severe retropharyngeal edema after COVID-19 successfully treated with intravenous immunoglobulin
Authors: Takanori Suzuki, Toya Kono, Hisada Satoshi, Hidetoshi Uchida, Seiichiro Ota, Ichiro Tateya, Tetsushi Yoshikawa
Journal: Front Pediatr (2023)
Keywords: covid-19, ivig (intravenous immunoglobulin) administration, mis-c, kawasaki disease (kd), retropharyngeal edema
MeSH terms: Case Reports

Multisystem inflammatory syndrome in children (MIS-C) has been widely reported, mainly in Western countries. The clinical features of MIS-C and Kawasaki disease are similar. The latter is common in Asian countries, including Japan. Meanwhile, the incidence of MIS-C seems to be low in Japan. Retropharyngeal edema is relatively common in older patients with Kawasaki disease and has been reported in a few patients with MIS-C. We describe a case of severe retropharyngeal edema after coronavirus disease 2019 (COVID-19) that improved quickly with high-dose of intravenous immunoglobulin treatment. Onset of retropharyngeal edema was 3 weeks after COVID-19. The patient received appropriate intravenous antibiotics for 5 days, but his symptoms worsened. Therefore, we suspected that his retropharyngeal edema was caused by suspected MIS-C even though he did not have the typical clinical symptoms of suspected MIS-C such as gastrointestinal symptoms and shock. Retropharyngeal edema was refractory to antibiotic therapy but lessened quickly with high-dose immunoglobulin therapy, without other typical clinical manifestations of MIS-C, suggesting that early immunoglobulin therapy might prevent the progression of MIS-C.
Lumbar Intraspinal Osteolipoma Presenting as Cauda Equina Syndrome: A Case Report and Review of Literature
Authors: S Dilip Chand Raja, Rishi Mugesh Kanna, Ajoy Prasad Shetty, S Rajasekaran
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Introduction:
Osteolipomas are uncommon variants of lipoma. These lesions have been usually reported to arise from the oral cavity, brain, and neck and scarcely from the knee and thigh. Intraspinal osteolipomas are rare. A single case of intraspinal osteolipoma has been reported in the cervical and thoracic spine in the literature. To our knowledge, there is no report of osteolipomas in the lumbar spine.
Case presentation:
We report a very rare case of a solitary lumbar intraspinal osteolipoma, presenting as a cauda equina syndrome. The intraspinal osteolipoma was excised en bloc and fusion was performed as it required partial resection of the facet joint within 24 hours of presentation. He has since then improved neurologically, and there has been no recurrence of the lesion so far. The clinical presentation, radiological characteristics, treatment course, and histopathological features of this lesion along with the clinical outcomes and a pertinent literature review were done and have been discussed.
Discussion:
The heterogeneous signal intensity of the lesion in MRI differentiates it from other dural-based lesions, and this should raise suspicion of an osteolipoma, which warrants a CT. Although intraspinal osteolipomas are benign lesions and generally have good prognosis, they need to be removed en bloc as they may result in rapid neurological deterioration.
Spinal cord compression: an unusual presentation of hepatocellular carcinoma
Authors: Hileni Taleni Nangolo, Larrea Roberto, Innocent Lule Segamwenge, Andreas Voigt, Fredrick Kidaaga
Journal: Pan Afr Med J (2014)
Keywords: hepatocellular carcinoma, spinal cord compression, spine metastases
MeSH terms: Carcinoma, Hepatocellular / diagnostic imaging, Liver Neoplasms / diagnostic imaging, Spinal Cord Compression / diagnostic imaging, Spinal Cord Compression / etiology, Spinal Cord Neoplasms / complications, Spinal Cord Neoplasms / diagnostic imaging, Case Reports, Carcinoma, Hepatocellular / complications, Carcinoma, Hepatocellular / pathology, Diagnosis, Differential, Humans, Liver Neoplasms / complications, Liver Neoplasms / pathology, Male, Middle Aged, Radiography, Thoracic, Spinal Cord Neoplasms / secondary, Tomography, X-Ray Computed

Hepatocellular carcinoma is the 5(th) most common cancer in men and the 2(nd) common cause of death from cancer worldwide. The tumour commonly metastasizes to the lungs, regional lymph nodes and bone. Spinal cord compression secondary to metastatic disease as a first presentation is uncommon. We describe a patient who presented with paraplegia as a first presentation of hepatocellular carcinoma. 46 year old Namibian man presented with progressive leg weakness that was associated with a dull back ache and inability to pass urine and stool. He had no history of trauma nor did he have chronic cough, night sweats or fevers. He has been treated several times for alcohol dependence. On examination he was wasted, power 0/5 in both lower limbs and a sensory level at T12. He also had a non-tender hepatomegaly with Alpha-fetoprotein of 2000. The Chest X-ray and Chest CT showed nodular opacities indicating metastatic disease and the X-ray and CT of the thoracic spine showed osteolytic lesion with destruction of the pedicle of L1. Liver and spinal biopsy confirmed the hepatocellular carcinoma. The extra hepatic manifestations of HCC are diverse and Spinal cord metastasis is of pertinent clinical importance and should thus be greatly considered.
Case Report: A Novel Mutation in NFKB1 Associated With Pyoderma Gangrenosum
Authors: Ran Fang, Jun Wang, Xiao-Yun Jiang, Shi-Hao Wang, Hao Cheng, Qing Zhou
Journal: Front Genet (2021)
Keywords: nf-κb signaling pathway, nfkb1, inflammation, novel mutation, pyoderma gangrenosum
MeSH terms: Case Reports

Pyoderma gangrenosum (PG) is a rare, destructive inflammatory skin disease of which a painful nodule or pustule breaks down to form a progressively enlarging ulcer. Ulcerations associated with PG may occur after trauma or injury to the skin. The etiology has not been clearly elucidated. Our report described a PG patient with a heterozygous splice-donor-site mutation in NFKB1 (c.730+5G>A) causing the absence of exon 8 and the formation of truncated p105 (p.Asp191_Lys244delinsGlu; p105delEx8), which led to distinct symptoms of high fever and excessive inflammation in wound area after routine surgical procedures. The functional analysis showed that the variant caused reduced phosphorylation of p105 and resulted in the decreased processing of p105 to p50. We conclude that the patient's symptoms were caused by dysregulation of the NF-κB signaling pathway.
Myasthenia gravis with achalasia secondary to thymoma: a case report and literature review
Authors: Nourelhoda A Haridy, Eman M Khedr, Asmaa M Hasan, Ahmed A Maghraby, Essam Abdelmohsen, AbdelHamid M Aly
Journal: Egypt J Neurol Psychiatr Neurosurg (2023)
Keywords: achalasia, case report, dysphagia, high-resolution esophageal manometry, myasthenia gravis, thymoma
MeSH terms: Case Reports

Background:
Myasthenia gravis is an autoimmune neuromuscular junction disorder characterized by fatigable muscle weakness and autoantibodies. Frequent associations exist between myasthenia gravis and thymic abnormalities, including hyperplasia and thymoma. Several autoimmune illnesses have been identified to be associated with thymoma; however, a few case reports have linked thymoma and achalasia, and the underlying mechanism is unknown.
Case report:
A 43-year-old man with thymoma-associated myasthenia gravis presented with dysphagia that was refractory to conventional treatment of myasthenia gravis. This dysphagia was challenging to diagnose even after multiple gastroenterology consults and upper endoscopy. The diagnosis of achalasia type II was established after a comprehensive evaluation, including upper endoscopy, barium swallow, and high-resolution esophageal manometry. The patient underwent elective pneumatic balloon dilatation, which successfully alleviated his dysphagia.
Conclusion:
This case confirmed the association between myasthenia gravis secondary to thymoma and achalasia and showed how the diagnosis of achalasia was challenging. Awareness of this association is crucial for early diagnosis and treatment, improving affected patients' quality of life.
Severe hyperkalemia and bilateral adrenal metastasis
Authors: Michael Nagler, Beat Müller, Verena Briner, Ralph Winterhalder
Journal: J Oncol (2009)
MeSH terms: Case Reports

Adrenal metastases are a common finding in metastatic lung and breast cancer. Often there are no clinical symptoms suggesting them. In this paper, we present a case of a 66-year-old man with metastatic lung cancer suffering from severe hyperkaliemia due to hypoaldosteronism as a result of bilateral adrenal metastasis.
Individualized Treatment for Advanced Non-Small Cell Lung Cancer: A Case Report and Literature Review
Authors: Qianqian Sun, Weiqing Li, Taorui Liu, Huiqin Guo
Journal: Front Oncol (2022)
Keywords: nsclc, chemotherapy, immunotherapy, individualized treatment, surgery, targeted therapy
MeSH terms: Review

The incidence of lung cancer is high and about 75% of the patients with lung cancer are found in the middle and advanced stage, which has a limited treatment strategy. Non-small cell lung cancer (NSCLC) accounts for about 85% of all lung cancers. In this article, we delineate the treatment process of a middle-aged male patient with advanced-stage lung cancer to explain the significance of individualized chemotherapy combined with immunotherapy and surgery. This patient has extensive bone metastasis with PS scores of 2. After nine cycles of preoperative neoadjuvant chemotherapy, surgery, and two cycles of postoperative adjuvant chemotherapy, the patient achieved complete response (CR) and his PS score was 0. Although there is a standard chemotherapy regimen for lung adenocarcinoma, the treatment effect varies because of individual differences. Comprehensive analysis of the characteristics of patients through a variety of means to develop a precise individualized chemotherapy plan will be a major direction of lung cancer treatment in the future. Additionally, surgical treatment for advanced lung cancer patients after chemotherapy can effectively reduce the primary lesion and prolong the survival time of patients.
A Case of Parvovirus-Related Haemophagocytic Lymphohistiocytosis in a Patient with HbH Disease
Authors: Veeraraghavan Meyyur Aravamudan, Chaozer Er, Ikram Hussain, Nicholas Wong Wai Cheong, Chong Chern Hao, Navin Kuthah, Emily En-Xian Tan, Bingwen Eugene Fan
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Hemophagocytic lymphohistiocytosis (HLH) is rare and life-threatening medical emergency. Parvovirus infection is rarely associated with HLH. We report a case of parvovirus-related HLH in a patient with alpha thalassaemia (HbH disease). The patient responded well to a course of dexamethasone without the need of etoposide. Based on our literature search, this is the first case of parvovirus related HLH in a patient with HbH disease in the medical literature.
Case report: Double filtration plasmapheresis (DFPP) for severe rhesus-D alloimmunization in two pregnant patients
Authors: Yuling Liang, Tenghui Wang, Wenjian Zhu, Xiaohua Wang, Xuemei Zhang, Zhihua Zheng, Yan Lei
Journal: Front Pediatr (2023)
Keywords: anti-d antibodies, double filtration plasmapheresis, erythrocyte alloimmunization, intrauterine blood transfusion, pregnancy
MeSH terms: Case Reports

Maternal erythrocyte alloimmunization is one of the most important causes of fetal anemia. The standard treatment for anemic fetuses is intrauterine blood transfusion (IUT). However, IUT may have adverse effects, particularly before 20 weeks of gestation. In this report, two women who had previously had severely affected alloimmunized pregnancy developed high titers of anti-D antibodies before 20 weeks of gestation. Ultrasound Doppler showed severe fetal anemia, and intrauterine transfusion was expected to be unavoidable. To prolong pregnancy to a gestation in which intravascular IUT was possible, we used repeated double filtration plasmapheresis (DFPP) as a rescue therapy. The titers of IgG-D, IgG-A, and IgG-B decreased after DFPP treatment. One woman successfully prolonged pregnancy until 20 weeks of gestation. Subsequently, she underwent four cycles of IUTs and delivered at 30 weeks of gestation by emergency cesarean section due to fetal bradycardia during the fifth intrauterine transfusion. The other woman successfully delayed intrauterine transfusion until 26 weeks of gestation. The favorable results of the two patients indicate that DFPP may be an effective and safe treatment modality for RhD immunity in pregnant women. Moreover, DFPP is potentially helpful for reducing the occurrence of ABO hemolytic disease in neonates due to the clearance of IgG-A and IgG-B antibodies (e.g., O pregnant women harbored A/B/AB neonates). However, more clinical trials are needed to verify the results.
Obstetrical Challenges in Robinow Syndrome
Authors: Yingao Zhang, Marco Casanova, Matthew Shanahan, V Reid Sutton, Karin Fox
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Robinow syndrome is a genetically heterogenous syndrome that exhibits great pleiotropy, involving skeletal genital, cardiac, and craniofacial developmental anomalies. Fertility is not always compromised, and many individuals may be able to have a healthy pregnancy. Similar to other more common skeletal dysplasias and growth disorders such as achondroplasia, there are several challenges to be addressed in managing physiologic differences that occur in the context of pregnancy, and published literature centers on pregnant people with achondroplasia. We present a patient with Robinow syndrome (ROR2 variant), follow her clinical course through three of her pregnancies (one 20-week loss followed by two preterm cesarean deliveries at 36-week gestation), and highlight the major obstetrical considerations in her individualized care.
A Rare Presentation of Cardiac Tamponade from Metastatic Urothelial Carcinoma of the Bladder
Authors: Sowmya Palam, Ridhima Kapoor, Jacquelyn Kulinski
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

A 62-year-old man presented with 2 weeks of progressive dyspnea and chest pain. He was previously diagnosed with high-grade invasive urothelial carcinoma (UC) of the bladder and underwent neoadjuvant chemotherapy followed by radical cystectomy 10 months earlier, resulting in pathologic complete remission. Clinical evaluation and echocardiographic imaging was consistent with a diagnosis of cardiac tamponade. Due to a history of malignancy, the patient was referred for a surgical pericardial window, to include biopsy of the pericardium. Pericardial fluid and pericardial biopsy specimens were consistent with metastatic UC. Cardiac tamponade due to metastatic UC is a rare presentation, and, to our knowledge, there have been only 5 cases reported in the English literature. We report a rare case of cardiac tamponade due to isolated pericardial metastases from high grade UC of the bladder and discuss the symptoms, treatment, and prognosis of this pathologic condition. We also present a brief review of previously published literature. Through this discussion, we would like to emphasize the (1) consideration of cardiac metastases in the differential diagnosis for patients with a history of UC presenting with cardiac or pulmonary symptoms and (2) improved diagnostics with pericardial biopsy and pericardiocentesis over pericardiocentesis alone.