OpenMed/multicare-articles huggingface dataset:
Case Report of an Acute Myocardial Infarction as a Result of Spontaneous Coronary Artery Dissection in a Patient with Fibromuscular Dysplasia
Authors: A Kalinskaya, D Skrypnik, A Kostin, E Vasilieva, A Shpektor
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Background:
Spontaneous coronary artery dissection (SCAD) is an underdiagnosed and rare cause of myocardial infarction (MI). SCAD is defined as the separation of the coronary artery wall by hemorrhage with or without intimal tear. It causes acute coronary syndrome in 1.7% to 4% of cases.
Case summary:
We report a case of a patient with acute MI caused by SCAD with marked progression of dissection within 4 days and spontaneous healing in 2 months. Fibromuscular dysplasia (FMD) of the arteries is an associated condition of SCAD that was found in our patient.
Conclusion:
In young women admitted to the clinic with signs of acute myocardial infarction, SCAD should be suspected. FMD as an associated condition that should be ruled out in every SCAD patient. Conservative treatment of SCAD is the most preferable strategy.
Autosomal Dominant Hypophosphatemic Rickets Presenting in a Phenotypically Normal Adult Female
Authors: Hala Mualla, Su Ah Bae, Abid Yaqub
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

We describe a presentation of Autosomal Dominant Hypophosphatemic Rickets (ADHR) in a 22-year-old female with normal pubertal growth and development and a negative family history in first-degree relatives. The patient presented with a 2-year history of upper and lower extremity proximal muscle pain and weakness and bilateral femoral neck and pubic bone insufficiency fractures. She had a normal serum calcium but a low phosphate as well as 25-hydroxyvitamin D (25(OH)D) levels leading initially to a diagnosis of osteomalacia. Urine phosphate reabsorption was low confirming a phosphate wasting disorder. She had an elevated Fibroblast Growth Factor 23 (FGF23) level. After Tumor-Induced Osteomalacia was ruled out by extensive imaging, she was sent for genetic testing for hereditary rickets which showed a previously reported missense variant in FGF23. Subsequently, she found out that her father's maternal aunt and grandfather had 'bone disorder' and were wheelchair-bound in adulthood. After replenishment of vitamin D, treatment with calcitriol and phosphate leads to complete resolution of patient's symptoms and laboratory abnormalities.
Shigella sonnei Bacteremia Presenting with Profound Hepatic Dysfunction
Authors: Oluwaseun Shogbesan, Andrew Rettew, Bilal Shaikh, Abdullateef Abdulkareem, Anthony Donato
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Worldwide, Shigellosis is a significant public health issue, associated with nearly one million deaths annually. About half a million cases of Shigella infection are reported annually in the United States. Shigella bacteremia is uncommon and generally seen in children and immunocompromised adults. We present a case of a Shigella sonnei bacteremia with marked hepatic derangement in a 27-year-old previously healthy homosexual male with history of Roux-en-Y gastric bypass, who presented to the emergency room with a 4-day history of loose watery stool, abdominal cramps, nausea and vomiting, and yellow skin of 2-day duration. He reports similar diarrhea illness in two close contacts in preceding days. On examination, he was fully oriented but dehydrated, icteric, and febrile. Laboratory data revealed WBC of 2200/μL, elevated AST and ALT (201 IU/L, 73 IU/L resp.), normal alkaline phosphatase, elevated total and direct bilirubin of 8.2 mg/dL and 4.4 mg/dL, albumin of 3.2 g/dL, INR of 2.9, prothrombin time of 31.7, and platelet of 96,000/μL. Workup for infectious, autoimmune and medication-induced hepatitis, Wilson's disease, and hemochromatosis was negative. Abdominal ultrasound and computed tomography of the abdomen showed hepatic steatosis and right-sided colitis. Stool and blood cultures were positive for Shigella sonnei. He was treated with ciprofloxacin with improvement in liver function. Follow-up blood test 4 months later was within normal limits.
Response of fibroblastic rheumatism to infliximab
Authors: Ricardo Romiti, Mauricio Levy Neto, Marcello Menta Simonsen Nico
Journal: Dermatol Res Pract (2009)
MeSH terms: Case Reports

Onset is usually sudden with symmetrical articular involvement of both small and large joints, occurrence of solid skin nodules, and rapid progression. Treatment is generally unrewarding. Here we report a severe and disabling case of FR responding favorably to infliximab therapy. After 32 weeks of continuous treatment, skin lesions dramatically improved and arthropathy partially regressed.
Chronic anemia due to transmural e-PTFE anti-adhesive barrier mesh migration in the small bowel after open incisional hernia repair: A case report
Authors: Francesca Ceci, Linda D'Amore, Elena Annesi, Lucia Bambi, Maria Romana Grimaldi, Francesco Gossetti, Paolo Negro
Journal: Int J Surg Case Rep (2018)
Keywords: anti-adhesive barrier, case report, mesh erosion, mesh migration, mesh-related complications

Introduction:
Meshes are commonly employed in abdominal hernia repair to reduce recurrence rates. Prosthetic repair, however, increases the risk of mesh related complications, including migration into adjacent viscera and erosion which can occur as uncommon and can be difficult to be diagnose.
Presentation of case:
This is a case of transmural migration of composite mesh into the bowel, presenting as chronic abdominal pain and anemia 14 years after incisional hernia repair.
Discussion:
Mesh implantation in hernia repair has increased the incidence of complications, such as seroma, hematoma and infection. Migration into adjacent viscera and erosion may present as complications related to the use of meshes. Their precise frequency after abdominal wall hernia repair is not well known and their late occurrence can make the diagnosis difficult.
Conclusion:
Transmural migration of composite mesh is an uncommon complication of incisional hernia repair. Its pathogenesis is still not completely clear but it has been reported many years after implant surgery. It should be considered in a typical presentation of patients with history of previous prosthetic ventral hernia repair.
Non-traumatic fractures following seizures: two case reports
Authors: Koussay Ach, Ines Slim, Sihem Trimech Ajmi, Molka Chadli Chaieb, Amel Maaroufi Beizig, Larbi Chaieb
Journal: Cases J (2010)

Introduction:
Seizures with or without trauma may cause fractures that occur commonly in epileptic seizures. Fracture risk is less reported in non-epileptic seizures. Some metabolic conditions leading to a decrease in bone mineral density may cause fractures secondary to non-epileptic seizure.
Case presentation:
We describe two cases of non-traumatic acetabular and vertebrae fractures following seizures without history of epilepsy. They occurred in two male patients, 18 and 48 years old suffering respectively from hypercorticism and poorly controlled diabetes mellitus. Seizures, occurring inside hospital, were secondary to hypertensive encephalopathy crisis with hypokaliemia in the first case and severe hypoglycaemia in the second one. Fracture was promoted by a decrease in mineral bone density caused respectively by hypercorticism and diabetic chronic renal failure.
Conclusion:
These observations emphasize that fracture prevention among patients with decreased mineral bone density should include the avoidance of metabolic causes of seizure.
An innovative approach to reducing pain in patients with peripheral neuropathy related to HIV: A single case study
Authors: Natalie A Benjamin, Jennifer Jelsma
Journal: Afr J Disabil (2014)
MeSH terms: Case Reports

Introduction:
Peripheral neuropathy (PN) is the most common neurological condition seen in people living with human immunodeficiency virus (HIV) and has been estimated to be present in up to 30% of people with AIDS. Prevalence may be increasing as it appears to be related to the use of antiretroviral therapy in many cases, particularly medication containing stavudine. It is often characterised by burning and numbness in the feet. It can interfere severely with function and sufferers resort to a large number of strategies in an attempt to reduce pain.
Case presentation:
A 50-year-old man presented with severe PN and showed symptoms of extreme weakness and sensitivity of both lower limbs. His symptoms gradually worsened over a period of 18 months to such an extent that he was unable to walk. Medication had no effect on his pain or related symptoms. The authors tested the use of a Vibromat clinical vibrator to treat his PN symptoms. The patient was treated using the same modality for five evenly spaced (monthly) sessions.
Outcome:
The patient showed marked improvement in pain, numbness and pins and needles symptoms after the first session. He was able to walk a short distance with assistance. Treatment was continued and after the third session he was able to walk unaided. Symptom relief was maintained for 4 months.
Conclusion:
This is the first case demonstrating the use of the Vibromat in successfully treating the signs and symptoms of PN. This is important for clinicians who manage patients with HIV-related PN and pain.
13-Year-Old Boy Presenting with Bilateral Femur Fractures in the Setting of Severe Vitamin D Deficiency
Authors: Marianne Jacob, Marisa Censani
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Background:
Femur fractures in adolescents are rare. Severe vitamin D deficiency has important implications for bone health. We describe the case of a 13-year-old boy with autism spectrum disorder (ASD) who presented with low-impact bilateral femur fractures in the setting of severe vitamin D deficiency. Case Presentation. A 13-year-old boy with ASD presented with bilateral leg pain after an unwitnessed fall. Laboratory investigations revealed severe hypocalcemia (S. calcium 4.9 mg/dL) and severe vitamin D deficiency (25(OH)D < 4 ng/mL). Lower extremity X-rays revealed bilateral distal femoral metaphyseal fractures.
Conclusion:
This is the youngest known case of bilateral femoral fractures in the setting of severe 25(OH)D deficiency. Children with ASD are especially at risk for 25(OH)D deficiency as many have inadequate nutritional intake. As such, primary care providers may provide a pivotal role in the routine laboratory screening of 25(OH)D in this population.
A Case of Acute Autoimmune Hepatitis Superimposed on Chronic Hepatitis B Infection
Authors: Vanessa Sostre, Hiren G Patel, Abdalla Mohamed, Ariy Volfson
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Autoimmune hepatitis has been associated with chronic HCV infection, but there are only few cases reported of HBV infection as a possible trigger. We present a case of a young male who was diagnosed with acute autoimmune hepatitis superimposed on existent chronic HBV infection. A 30-year-old Hispanic male with no past medical history presented to the hospital with complaints of few days of generalized weakness. Laboratory findings were significant for elevated liver enzymes: AST, 1164 U/L; ALT, 1461 U/L; total bilirubin, 2 MG/DL; and alkaline phosphatase, 75 IU/L. Extensive workup was done to find the etiology for elevated liver enzymes. Only blood work that came back positive was for chronic HBV infection and elevated immunoglobulin G (IgG) level 1937 mg/dL. HBV viral load was 42,900,000 IU/mL. The patient was started on tenofovir 300 mg daily. Liver biopsy was done which was consistent with autoimmune hepatitis. Prednisone 60 mg daily was started. Six months later, blood work showed completely normal liver enzymes and total IgG. Hepatotropic viruses have been proposed as triggering factors for several autoimmune diseases. There are theories suggesting that similarity in viral epitope and self-proteins expression on liver cells' surface causes a cross-reactive immunologic response and possible viral-induced autoimmune hepatitis.
Case report: The first description of a Dieulafoy's lesion in the gastric mucosa of a dog
Authors: Daniel Felipe Barrantes Murillo, Michael Tillson, Jennifer W Koehler, Maninder Sandey
Journal: Front Vet Sci (2022)
Keywords: dieulafoy's lesion, animal, dog, domestic animal, stomach
MeSH terms: Case Reports

An approximately 12-year-old, 31 kg, male neutered Labrador Retriever was presented to the referring hospital with an acute onset (less than 1 day) of hematemesis and melena. The dog was treated supportively for a presumptive gastric ulcer for 4 days with intravenous fluids, gastro protectants, such as pantoprazole, misoprostol, sucralfate, and barium, as well as an anti-emetic (maropitant) and analgesics (fentanyl, gabapentin, and tramadol). Throughout medical management, the dog continued to require blood transfusions approximately every 24 h. Given the poor medical response, the patient was subjected to an exploratory laparotomy. During surgery, a grossly raised, blister-like lesion on the mucosal surface of the stomach was appreciated on the lesser curvature of the stomach. A partial gastrectomy was performed, and the segment was submitted for histological evaluation. Histologically, there were multiple, tortuous, medium-caliber muscular arteries (>1.0 mm in diameter) in the submucosa. A single large-caliber artery (>0.75 mm in diameter) containing a partially occlusive thrombus extruded through the mucosa and projected on the ulcerated surface. The patient's signs were similar clinically and histopathologically to Dieulafoy's lesion in people. A Dieulafoy's lesion is a potentially life-threatening disorder that causes gastrointestinal (GI) hemorrhage. This lesion is characterized by a dilated, large-caliber, aberrant submucosal artery that erodes through the epithelium and ruptures, resulting in massive and potentially fatal hemorrhage. This lesion has never been documented previously in a dog.
Exogenous lipid pneumonia related to long-term use of Vicks VapoRub® by an adult patient: a case report
Authors: I Cherrez Ojeda, J C Calderon, J Guevara, D Cabrera, E Calero, A Cherrez
Journal: BMC Ear Nose Throat Disord (2016)
Keywords: case report, exogenous lipoid pneumonia, petroleum jelly, rhinitis
MeSH terms: Case Reports

Background:
Use of petroleum-based over the counter remedies such as Vicks VapoRub to alleviate symptoms of rhinitis is common and can be effective, but carries under-appreciated risks of adverse side effects. In this case report we highlight Exogenous Lipoid Pneumonia (ELP), an uncommon condition that results from accumulation of exogenous lipids in the alveoli, as an adverse side effect of long-term Vicks VapoRub use.
Case presentation:
We present the case of an 85-year-old female patient with ELP apparently due to continuous application of Vicks VapoRub® to her nostrils to alleviate chronic rhinitis. She was diagnosed incidentally via chest radiograph and computed tomography (CT) scan done as follow up to finding elevated C-reactive Protein during a routine exam. The CT scan revealed a pulmonary consolidation in the lower lobe of the right lung with fat density combined with low density areas associated with focal ground-glass opacities. The patient was advised to discontinue use of petroleum-based products, and was prescribed intranasal corticosteroids for her rhinitis. Follow up 2 years later showed that the lipid consolidation had diminished in size by approximately 10 %.
Conclusion:
Physicians must be aware that ELP can develop as a result of long-term application of petroleum-based oils and ointments to the nose and discourage such use of these products. Patients who have used petroleum-based products in this way should be screened for ELP. CT scan is the best imaging modality for establishing the diagnosis. The treatment of this condition is not well defined, but, as shown in this case, the size of the lipid mass can decrease after use of petroleum based substances is discontinued.
Perioperative Management of Congenital Diaphragmatic Hernia Repair in a Patient With Univentricular Circulation: A Case Report
Authors: Natsuki Suzuki, Hisakatsu Ito, Shota Sakai, Katsuhisa Hirano, Kentaro Tamura
Journal: Cureus (2023)
Keywords: congenital diaphragmatic hernia, congenital heart disease, perioperative management, pulmonary hypoplasia, univentricular heart
MeSH terms: Case Reports

The survival rate in congenital diaphragmatic hernia (CDH) with complex heart defects is low. Although the current consensus on the indications for surgical repair of CDH without heart defects has improved surgical outcomes, the surgical indication for CDH with complex heart defects remains unclear. Herein, we report the perioperative management of a patient with univentricular circulation who underwent CDH repair. Thus, patients with CDH complicated by univentricular anatomy may tolerate surgery depending on preserved respiratory function.
Functional parathyroid cyst in a patient with systemic lupus erythematosus: a case report
Authors: Jingjing Jiang, Mei Zhang, Ronghua He, Meiping Shen, Wei Liu
Journal: Endocrinol Diabetes Metab Case Rep (2015)

Functional parathyroid cysts are a rare cause of primary hyperparathyroidism and are often mistaken for thyroid cysts. Systemic lupus erythematosus (SLE) is also a very rare cause of hypercalcemia. We report the case of a 62-year-old woman, who was diagnosed with SLE 30 years ago, presenting with clinical and biochemical features of primary hyperparathyroidism. Laboratory investigation revealed increased serum calcium and parathyroid hormone (PTH) levels; neck ultrasonography (USG) revealed 40×34×26 mm cystic mass in the left lobe of thyroid gland. PTH level in the cysts was >2500 pg/ml, determined by USG-guided fine-needle aspiration (FNA). In this case, no evidence for potential pathogenic association between parathyroid cyst and SLE was uncovered. However, the recognition of this association is very important because the therapeutical strategy is completely different. Operative management is usually straightforward and alleviates symptoms and any biochemical abnormalities caused by the cyst.
Learning points:
Functional parathyroid cysts are the rare cause of primary hyperparathyroidism and are often mistaken for thyroid cysts.SLE is also a very rare cause of hypercalcemia.Ultrasound-guided FNA of cystic fluid with assay for PTH level is an accurate method of differentiating parathyroid cyst from thyroid cyst.Appropriate management of functional parathyroid cysts is surgical excision.
Huge mucinous cystic neoplasms with adhesion to the left colon: A case report and literature review
Authors: Haijun Tang, Zhihong Shen, Baochun Lu
Journal: Open Med (Wars) (2022)
Keywords: colon, mucinous cystic neoplasms, precancerous conditions, tissue adhesions
MeSH terms: Case Reports

Mucinous cystic neoplasms (MCN) are rare premalignant neoplasms of the pancreas typically found as single lesions in the pancreatic body and tail of women in the fifth and sixth decade of life, constituting 2-5% of pancreatic neoplasms. We present a 50-year-old female patient with a large tail mass of the pancreatic body (size of 15 cm × 12 cm) with elevated tumor indicators. Computed tomography and magnetic resonance imaging revealed a large cystic lesion with septa and wall nodules. During the operation, the tumor capsule wall adhered to the left half colon and mesentery and could not be detached. Splenectomy and left hemicolectomy were performed. The postoperative pathological examination of the specimens confirmed a premalignant pancreatic mucous cystic tumor with moderate heterocytosis. The preoperative diagnosis of pancreatic MCN and MCN with invasive carcinoma is discussed, considering the characteristics of this case. Age, tumor size, texture, tumor marker elevation, and cystic wall condition are important characteristics of malignant MCN. Nevertheless, it is still very difficult to determine accurately whether an MCN is malignant or not before an actual pathological examination of the resected specimen.
Angiosarcoma mimicking rhinophyma
Authors: Maurizio Lo Presti, Caterina Mazzella, Ambra Monfrecola, Jessica Falleti
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

We report the case of a 61-year-old man showing persistent erythematous macules, plaques, and partially confluent nodules with irregular borders, developed on his nose for one year. During that time the patient underwent several dermatological consultations, and all produced the same diagnosis: rhinophyma. So antibiotic and steroid treatment was carried out without any improvement while the lesions kept growing. When the patient came to our observation, physical examination revealed large, infiltrative, oedematous, erythematous plaques and rare nodules, with superficial telangiectatic vessels. Cervical lymphadenopathy was not detectable. Routine laboratory analysis was normal. Punch biopsy was performed, and histopathology and immunohistochemical studies were consistent with cutaneous angiosarcoma. This is the report of a face angiosarcoma with an unusual and very deceptive clinical presentation.
Febrile neutropenia following with single-low-dose methotrexate for the treatment of ectopic pregnancy: a case report
Authors: Burak Bayraktar
Journal: Pan Afr Med J (2021)
Keywords: ectopic pregnancy, case report, medical therapy, methotrexate, pharmacogenetics
MeSH terms: Abortifacient Agents, Nonsteroidal / adverse effects, Febrile Neutropenia / chemically induced, Methotrexate / adverse effects, Case Reports, Abortifacient Agents, Nonsteroidal / administration & dosage, Adult, Female, Humans, Injections, Intramuscular, Methotrexate / administration & dosage, Pregnancy, Pregnancy, Ectopic / drug therapy, Abortifacient Agents, Nonsteroidal, Methotrexate

Methotrexate (MTX) is an effective, economical and safe drug used in the treatment of ectopic pregnancy. Complications are very rare. Herein, we reported a case of febrile neutropenia following single low-dose methotrexate for the treatment of ectopic pregnancy. Febrile neutropenia developed on day 4 of single-dose methotrexate administered intramuscularly. Although methotrexate single-dose regimen is quite effective and safe in ectopic pregnancy, febrile neutropenia can occur very rarely.