OpenMed/multicare-articles huggingface dataset:
Treatment of Symptomatic Vitreomacular Adhesion with Expansile Sulfur Hexafluoride (SF6) Gas
Authors: Dominic M Buzzacco, Sugat S Patel
Journal: Open Ophthalmol J (2017)
Keywords: adhesion, diabetes, expansile, intravitreal, sulphur hexaflouride, vitreomacular
MeSH terms: Case Reports

Background:
To evaluate intravitreal injection of expansile sulfur hexafluoride (SF6) as a low cost and effective treatment for symptomatic vitreomacular adhesion (sVMA).
Methods:
Retrospective analysis of all patients with sVMA treated with pneumatic vitreolysis using SF6 gas presenting to a clinical practice from January 2005 and June 2013.
Results:
Six cases were included in the study. Five patients (83%) experienced complete resolution of the vitreomacular adhesion. One patient had a partial release of the vitreomacular adhesion. Four patients (67%) had a one line improvement in best corrected visual acuity.
Conclusion:
Due to its low cost, wide availability, and apparent efficacy, intravitreal injection of expansile SF6 should be investigated further as a possible treatment modality for sVMA.
Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse
Authors: Diana Silva, Mafalda Mota, Andreia Bilé, Mário Ramalho, Sara Pinto, Graça Pires, Susana Teixeira, Isabel Prieto
Journal: GMS Ophthalmol Cases (2019)
Keywords: b-cell acute lymphoblastic leukemia (all-b), acute angle closure, ocular infiltration, relapse
MeSH terms: Case Reports

Objective: Unilateral ocular leukemic infiltration with acute angle closure is an infrequent complication of B-cell acute lymphoblastic leukemia (ALL-B). We present a clinical case of leukemic ocular infiltration as the sole manifestation of ALL-B relapse. Methods: Case description Results: A 15-year-old female with a history of acute lymphoblastic leukemia in remission for 2 years and pulmonary tuberculosis treated in the past year presented with ocular redness and decreased visual acuity in the left eye (LE) with 5 days of evolution. Visual acuity was 20/20 in the right eye (RE) and absence of light perception in the left eye (LE). Biomicroscopy of LE showed a small hypopion, anterior chamber cells 4+, vitreous cells 3+, and a large white mass in the vitreous with associated vitreous hemorrhage in organization. In LE fundoscopy, the vitreous mass occupying most of the vitreous cavity and associated hemorrhage prevented retina visualization. B-scan ultrasound showed a multilobulated mass occupying virtually the entire vitreous cavity with associated choroidal detachment. Forty-eight hours later, she developed acute angle closure of LE with an IOP of 55 mmHg. A flow cytometric analysis of the anterior chamber and vitreous showed leukemic tumor cells. The microbiologic exam and PCR for Mycobacterium tuberculosis were negative. No other signs of relapse of the disease were identified after investigation by the oncology department. Rescue treatment of the underlying disease was started, with symptomatic improvement. Conclusion: Leukemic ocular infiltration can be the only manifestation of ALL-B relapse.
Complication of solar branding: Report of a case and the review of the literature
Authors: Mohammed Asif, Luis Quiroga, Anthony Sabo, Julie Caffrey
Journal: Clin Case Rep (2018)
Keywords: electrosurgery, skin grafting, wound healing
MeSH terms: Case Reports

Branding is a type of scarification, a body modification that permanently transforms the skin by causing a visible scar. For centuries, it has been used on the skin of animals and slaves as well as criminals to convey ownership and also as a proof of guilt. More recently (in the 20th and 21st centuries), branding has become a symbol of personal identity, rites of passage, spiritual beliefs, and body decoration in some particular microcultures. Different means have been classically used to perform the desired branding designs including electrocautery, laser, chemicals, freezing, or a heated metal stencil. Solar branding is a new concept that involves using a focusing lens and a light source, usually the sunlight, to induce thermal injury. It is an emerging technique to perform body modifications and tattooing. As with other types of branding, solar branding also has its complications which may require surgical excision and grafting. We present a case of an acute skin infection following solar branding body modification, which to our knowledge is the first case reported in the literature.
A Rare Case of Craniopharyngioma in the Temporal Lobe
Authors: Sasan Razmjoo, Seyed Nematollah Jazayeri, Mohammad Bahadoram, Maedeh Barahman
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Herein, we report on a rare case of craniopharyngioma arising in the left temporal lobe with no prior history of head trauma or surgery. There was a solid-cystic mass in the left temporal lobe on MR images. To the best of our knowledge, this is the second case of a craniopharyngioma occurring in the temporal lobe.
Atypical Complications of Graves' Disease: A Case Report and Literature Review
Authors: Khaled Ahmed Baagar, Mashhood Ahmed Siddique, Shaimaa Ahmed Arroub, Ahmed Hamdi Ebrahim, Amin Ahmed Jayyousi
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Graves' disease (GD) may display uncommon manifestations. We report a patient with rare complications of GD and present a comprehensive literature review. A 35-year-old woman presented with a two-week history of dyspnea, palpitations, and edema. She had a raised jugular venous pressure, goiter, and exophthalmos. Laboratory tests showed pancytopenia, a raised alkaline phosphatase level, hyperbilirubinemia (mainly direct bilirubin), and hyperthyroidism [TSH: <0.01 mIU/L (reference values: 0.45-4.5), fT4: 54.69 pmol/L (reference values: 9.0-20.0), and fT3: >46.08 pmol/L (reference values: 2.6-5.7)]. Her thyroid uptake scan indicated GD. Echocardiography showed a high right ventricular systolic pressure: 60.16 mmHg. Lugol's iodine, propranolol, cholestyramine, and dexamethasone were initiated. Hematologic investigations uncovered no reason for the pancytopenia; therefore, carbimazole was started. Workup for hepatic impairment and pulmonary hypertension (PH) was negative. The patient became euthyroid after 3 months. Leukocyte and platelet counts and bilirubin levels normalized, and her hemoglobin and alkaline phosphatase levels and right ventricular systolic pressure (52.64 mmHg) improved. This is the first reported single case of GD with the following three rare manifestations: pancytopenia, cholestatic liver injury, and PH with right-sided heart failure. With antithyroid drugs treatment, pancytopenia should resolve with euthyroidism, but PH and liver injury may take several months to resolve.
Lymphomas in cartilage-hair hypoplasia - A case series of 16 patients reveals advanced stage DLBCL as the most common form
Authors: Hanna-Leena Kukkola, Pauliina Utriainen, Pasi Huttunen, Mervi Taskinen, Outi Mäkitie, Svetlana Vakkilainen
Journal: Front Immunol (2022)
Keywords: immunodeficiency, cancer, chemotherapy, chondrodysplasia, malignancy
MeSH terms: Hirschsprung Disease / epidemiology, Lymphoma, Large B-Cell, Diffuse, Osteochondrodysplasias / congenital, Osteochondrodysplasias / epidemiology, Primary Immunodeficiency Diseases, Research Support, Non-U.S. Gov't, Adolescent, Adult, Aged, Child, Female, Hair / abnormalities, Humans, Male, Middle Aged, Young Adult, Cartilage-hair hypoplasia

Background:
Patients with cartilage-hair hypoplasia (CHH) have an increased risk of malignancy, particularly non-Hodgkin lymphoma and basal cell carcinoma. The characteristics, clinical course, response to therapy and outcome of lymphomas in CHH remains unexplored.
Methods:
We assessed clinical features of lymphoma cases among Finnish patients with CHH. Data were collected from the Finnish Cancer Registry, hospital records, the National Medical Databases and Cause-of-Death Registry of Statistics Finland.
Results:
Among the 160 CHH patients, 16 (6 men, 10 women) were diagnosed with lymphoma during 1953-2016. Lymphoma was diagnosed in young adulthood (median age 26.4 years, range from 6.4 to 69.5 years), mostly in advanced stage. The most common lymphoma type was diffuse large cell B-cell lymphoma (DLBCL) (6/16, 38%). Eight patients received chemotherapy (8/16, 50%), and two of them survived. Standard lymphoma chemotherapy regimens were administered in the majority of cases. Altogether, eleven CHH patients died due to lymphomas (11/16, 69%). In almost all surviving lymphoma patients, the diagnosis was made either during routine follow-up or after evaluation for non-specific mild symptoms. Search for CHH-related clinical predictors demonstrated higher prevalence of recurrent respiratory infections, in particular otitis media, and Hirschsprung disease in patients with lymphoma. However, three patients had no clinical signs of immunodeficiency prior to lymphoma diagnosis.
Conclusion:
DLBCL is the most common type of lymphoma in CHH. The outcome is poor probably due to advanced stage of lymphoma at the time of diagnosis. Other CHH-related manifestations poorly predicted lymphoma development, implying that all CHH patients should be regularly screened for malignancy.
A case with concurrent duplication, triplication, and uniparental isodisomy at 1q42.12-qter supporting microhomology-mediated break-induced replication model for replicative rearrangements
Authors: Tomohiro Kohmoto, Nana Okamoto, Takuya Naruto, Chie Murata, Yuya Ouchi, Naoko Fujita, Hidehito Inagaki, Shigeko Satomura, Nobuhiko Okamoto, Masako Saito, Kiyoshi Masuda, Hiroki Kurahashi, Issei Imoto
Journal: Mol Cytogenet (2017)
Keywords: 1q, breakpoint junction sequence, chromosomal microarray, complex genomic rearrangement, dup-trp/inv-dup structure, microhomology-mediated break-induced replication model, template switching, uniparental isodisomy
MeSH terms: Case Reports

Background:
Complex genomic rearrangements (CGRs) consisting of interstitial triplications in conjunction with uniparental isodisomy (isoUPD) have rarely been reported in patients with multiple congenital anomalies (MCA)/intellectual disability (ID). One-ended DNA break repair coupled with microhomology-mediated break-induced replication (MMBIR) has been recently proposed as a possible mechanism giving rise to interstitial copy number gains and distal isoUPD, although only a few cases providing supportive evidence in human congenital diseases with MCA have been documented.
Case presentation:
Here, we report on the chromosomal microarray (CMA)-based identification of the first known case with concurrent interstitial duplication at 1q42.12-q42.2 and triplication at 1q42.2-q43 followed by isoUPD for the remainder of chromosome 1q (at 1q43-qter). In distal 1q duplication/triplication overlapping with 1q42.12-q43, variable clinical features have been reported, and our 25-year-old patient with MCA/ID presented with some of these frequently described features. Further analyses including the precise mapping of breakpoint junctions within the CGR in a sequence level suggested that the CGR found in association with isoUPD in our case is a triplication with flanking duplications, characterized as a triplication with a particularly long duplication-inverted triplication-duplication (DUP-TRP/INV-DUP) structure. Because microhomology was observed in both junctions between the triplicated region and the flanking duplicated regions, our case provides supportive evidence for recently proposed replication-based mechanisms, such as MMBIR, underlying the formation of CGRs + isoUPD implicated in chromosomal disorders.
Conclusions:
To the best of our knowledge, this is the first case of CGRs + isoUPD observed in 1q and having DUP-TRP/INV-DUP structure with a long proximal duplication, which supports MMBIR-based model for genomic rearrangements. Molecular cytogenetic analyses using CMA containing single-nucleotide polymorphism probes with further analyses of the breakpoint junctions are recommended in cases suspected of having complex chromosomal abnormalities based on discrepancies between clinical and conventional cytogenetic findings.
Reattachment of coronal tooth fragment: regaining back to normal
Authors: B Vishwanath, Umrana Faizudin, M Jayadev, Sushma Shravani
Journal: Case Rep Dent (2013)

Dental trauma is such a situation wherein the patient is affected both socially and psychologically. During their first dental visit, these patients with trauma are in pain and need emergency treatment. Such patients are quite apprehensive because of impaired functions, esthetics, and phonetics. The prime objective while handling such cases is successful pain management with immediate restoration of function, esthetics, and phonetics. The advances in adhesive dentistry have allowed dentists to use the patient's own fragment to restore the fractured tooth. Reattachment is such an ultraconservative technique which provides safe, fast, and esthetically pleasing results. This paper discusses fragment reattachment technique and presents a clinical case of complicated crown fracture.
Fatal CMV-Infection after Autologous Stem Cell Transplantation in Refractory Systemic Lupus Erythematosus
Authors: László Váróczy, Emese Kiss, Tünde Tarr, Margit Zeher, Gyula Szegedi, Arpád Illés
Journal: Case Rep Transplant (2012)
MeSH terms: Case Reports

High-dose chemotherapy followed by autologous stem cell transplantation can be a rescue for patients with severe refractory systemic lupus erythematosus (SLE). However, the procedure might have fatal complications including infections and bleeding. We report on a young female patient with SLE whose disease started in her early childhood. After many years, severe renal, neurological, and bone marrow involvement developed that did not respond to conventional therapy. She was selected for autologous stem cell transplantation. A successful peripheral stem cell apheresis was performed in March 2006. The nonselected graft was reinfused in August 2006 after a conditioning chemotherapy containing high-dose cyclophosphamide and antithymocyte globulin. Engraftment was detected within 11 days. On the 38th posttransplant day, severe cytomegalovirus (CMV) infection developed that included pneumonitis, hepatitis, and pancytopenia. The patient died in a week due to multiorgan failure. With her case, we want to call the attention to this rare, but lethal complication of the autologous transplantation.
Case Report: COVID-19 Vaccination Associated Fulminant Myocarditis
Authors: Guanglin Cui, Rui Li, Chunxia Zhao, Dao Wen Wang
Journal: Front Cardiovasc Med (2022)
Keywords: covid-19 vaccine, immunomodulatory therapy, myocarditis, myocyte necrosis, pathogenesis
MeSH terms: Case Reports

Herein, we describe a novel finding of fulminant myocarditis (FM) in two subjects the day after administration of the first dose of the currently available inactivated SARS-CoV-2 vaccine (Vero cell). Cardiac magnetic resonance imaging revealed extensive myocardial edema and necrosis. A pathologic evaluation of the endocardial biopsy tissues revealed inflammatory cell (lymphocytes) infiltration and interstitial edema, myocyte necrosis, and focal areas of fibrosis. A life-support-based comprehensive treatment regimen comprising mechanical circulatory support using intra-aortic balloon pulsation and immunomodulatory therapy-glucocorticoids and intravenous immunoglobulin-was used to treat the patients with FM; eventually, the patients recovered and were discharged. To our knowledge, these are the first two reported cases of FM, with no other identified cause or associated illness, after receiving the inactivated SARS-CoV-2 vaccine (Vero cell). These findings suggest a novel pathogenesis of myocarditis which mentions to pay more attention to this rare, but lethal complication of COVID-19 vaccination.
Two case reports of desensitization in patients with hypersensitivity to iron
Authors: Edgardo Chapman, Drixie Leal, Leidy Alvarez, Mónica Duarte, Elizabeth García
Journal: World Allergy Organ J (2017)
Keywords: hypersensitivity, intravenous iron allergy, iron deficiency anemia
MeSH terms: Case Reports

Background:
Iron deficiency anemia is a disease that can significantly compromise a patient's quality of life. Desensitization is a safe and effective treatment option for iron-deficient anemic patients who require intravenous iron despite their hypersensitivity to iron. This report describes a safe desensitization protocol for patients with iron hypersensitivity who require iron treatment for their clinical improvement.
Case presentation:
Two patients of 20 and 46-year-old diagnosed with secondary iron deficiency anemia hipermenorreas and a clinical history of fail treatment with oral iron, who presented a reaction of the anaphylactic type while they receive iron parenteral sucrose. Therefore, the patients were treated with the desensitization protocol applied for patients with hypersensitivity to iron.
Conclusion:
Iron deficiency anemia is a disease that can significantly compromise the quality of life of patients. The desensitization protocol for patients with hypersensitivity to iron is a safe and effective treatment option for patients with a history of allergy to intravenous iron. This case report shows the usefulness to use the desensitization protocol for patients with hypersensitivity to iron.
Necrotizing fasciitis caused by hypermucoviscous Klebsiella pneumoniae in a Filipino female in North America
Authors: Daniel Ng, Brad Frazee
Journal: West J Emerg Med (2015)
MeSH terms: Fasciitis, Necrotizing / diagnosis, Klebsiella Infections / diagnosis, Klebsiella pneumoniae / isolation & purification, Case Reports, Aged, California, Fasciitis, Necrotizing / microbiology, Fatal Outcome, Female, Humans, Klebsiella Infections / microbiology, Klebsiella pneumoniae / pathogenicity, Philippines / ethnology

Necrotizing fasciitis caused by Klebsiella pneumoniae has been described in Southeast Asia, but has only recently begun to emerge in North America. The hypermucoviscous strain of K. pneumoniae is a particularly virulent strain known to cause devastatingly invasive infections, including necrotizing fasciitis. Here we present the first known case of necrotizing fasciitis caused by hypermucoviscous K. pneumoniae in North America.
An irritable infant and the runaway redback: an instructive case
Authors: Thomas R Ward, James A Falconer, John A Craven
Journal: Case Rep Emerg Med (2011)
MeSH terms: Case Reports

The envenomation syndrome of Redback spider bites, lactrodectism, is distinctive. However diagnosis can be difficult due to an atypical presentation. We describe the case of a 1 year old boy with irritability, diaphoresis and reduced oral intake, in whom a diagnosis was made of redback spider bite. Successful resolution of symptoms was achieved following treatment with antivenom. The symptoms and management of redback spider bites is discussed.
Case report: Single-cell mapping of peripheral blood mononuclear cells from a patient with both Crohn's disease and isolated congenital asplenia
Authors: Dan Pu, Lu Liu, Na Wang, Dandan Wang, Zhe Zhang, Baisui Feng
Journal: Front Immunol (2022)
Keywords: crohn’s disease, cytof, pbmc, isolated congenital asplenia, spleen
MeSH terms: Crohn Disease / complications, Inflammatory Bowel Diseases, Case Reports, Research Support, Non-U.S. Gov't, Humans, Infant, Newborn, Intestines, Leukocytes, Leukocytes, Mononuclear

Crohn's disease (CD), as one of the principal form of inflammatory bowel disease (IBD), is characterized by the chronic and recurring inflammatory conditions in the intestine resulting from the over-activation of intestinal immunity. Hyposplenism is strongly associated with CD, while the effect of human spleen on the differentiation and development of immune cell subsets in CD patients remains unclear. Isolated congenital asplenia (ICA) is an extremely rare condition characterized by the absence of a spleen at birth without any other developmental defects. Here, we describe the first case of a patient with both ICA and CD, and follow the progression of CD from remission to active stage. Using cytometry by time of flight (CyTOF) analysis, we draw the first single-cell mapping of peripheral blood mononuclear cells (PBMC) from this unique patient, tracing back to the innate or adaptive immune cell subsets and cell surface markers affected by the spleen. Based on our analysis, it is speculated that the spleen contributes to maintaining immune homeostasis, alleviating intestinal inflammation and improving prognosis by influencing the differentiation and development of peripheral immune cell subsets and the expression of cell surface markers in patients with CD.
Brain metastases as primary manifestation of a melanocytic malignant peripheral nerve sheath tumor in a 60-year-old man
Authors: Johannes Tilgner, Klaus Müller, Nadir Ghanem, Johannes Lutterbach, Jan Vesper
Journal: BMC Neurol (2007)
MeSH terms: Brain Neoplasms / diagnostic imaging, Brain Neoplasms / secondary, Melanocytes / pathology, Nerve Sheath Neoplasms / diagnostic imaging, Nerve Sheath Neoplasms / secondary, Case Reports, Brain Neoplasms / pathology, Brain Neoplasms / surgery, Humans, Male, Middle Aged, Nerve Sheath Neoplasms / pathology, Nerve Sheath Neoplasms / surgery, Radiography

Background:
Malignant peripheral nerve sheath tumors are rare tumor entities that originate from peripheral nerve sheaths and have an unfavorable prognosis. Metastatic spread to the cerebral parenchyma is absolutely rare. This case report describes the clinical course in a 60-year-old man whose tumor came to medical attention because of a seizure.
Case presentation:
Magnetic resonance imaging demonstrated two intracerebral lesions. The symptomatic lesion was removed microneurosurgically and histology demonstrated a metastasis from a malignant peripheral nerve sheath tumor. Postoperatively, whole-brain irradiation was performed. The primary tumor was identified in the area of the sciatic nerve on the right. Follow-up 14 months after resection showed that there was no progression of the intracerebral lesions but an increase in size and number of distant metastases.
Conclusion:
There are no generally accepted guidelines for the treatment of malignant peripheral nerve sheath tumors with cerebral metastases. This case report presents and discusses one possible therapeutic approach. Due to the poor overall prognosis, the least invasive therapy should be chosen.