OpenMed/multicare-articles huggingface dataset:
Case Report: Severe Edema and Marked Weight Gain Induced by Marginal Thiamine Deficiency in a Patient With Alcohol Dependency and Type 2 Diabetes Mellitus
Authors: Hitomi Tanaka, Takatoshi Anno, Haruka Takenouchi, Hideyuki Iwamoto, Hideaki Kaneto, Niro Okimoto, Koichi Tomoda
Journal: Front Nutr (2021)
Keywords: alcohol dependency, thiamine deficiency, type 2 diabetes mellitus, weight gain, whole body edema
MeSH terms: Case Reports

Background: Patients with alcohol use disorder (AUD) may develop peripheral edema due to alcohol-related liver, renal, or heart disease. Thiamine deficiency is reported to occur in AUD and type 2 diabetes mellitus (T2DM). Thiamine deficiency may also cause peripheral edema. Thiamine is essential for optimal glucose metabolism through its role as an essential co-factor for key enzymes in intermediary metabolism. Since glucose metabolism worsens under diabetic conditions, it seems that a relative shortage of thiamine may occur more easily in patients with diabetes mellitus. Case Presentation: A 59-year-old Japanese man was admitted to the hospital with severe peripheral edema. His background history included alcohol liver disease (ALD), chronic renal failure (CRF), and T2DM. His body mass index (BMI) at admission was 37.7 kg/m2 and this represented a 30 kg increase in body weight over 2 months. Laboratory investigations showed anemia, liver and renal injury, hyperglycemia, and marginal hypothyroidism. The plasma thiamine diphosphate concentration was 20 ng/mL (reference range: 24-66 ng/mL). Diet therapy of 1,600 kcal/day and intravenous fursultiamine hydrochloride therapy (50 mg/once a day, seven days) was commenced in combination with intravenous diuretics. After one week, the plasma thiamine concentration was 853 ng/mL, and the patient's body weight had reduced by 18 kg. Conclusions: Patients with T2DM and AUD may develop severe peripheral edema in the context of marginal thiamine deficiency. Fursultiamine hydrochloride (50 mg/once a day, seven days) restored normal plasma thiamine concentrations and may have contributed to the rapid resolution of severe peripheral edema in this case. Empirical treatment with thiamine should be considered in patients with severe peripheral edema in the context of AUD and T2DM.
Megestrol Acetate-Induced Symptomatic Hypogonadism in a Male Patient
Authors: Lubna Bashir Munshi, Yumiko Tsushima, Kwan Cheng, Maria Brito
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

The hypothalamic-pituitary-adrenal (HPA) axis and the hypothalamic-pituitary-gonadal (HPG) axis are very sensitive and can be affected by external factors like stress, starvation, and medication. Medication-induced suppression of these axes can cause adrenal insufficiency (AI) and hypogonadism. Exogenous glucocorticoid use is the most common cause of iatrogenic AI. Our aim is to bring attention to another broadly prescribed medication, megestrol acetate (MA), as the cause of suppression of both these axes. We report a case of symptomatic hypogonadism and asymptomatic AI in a male patient secondary to MA. The patient presented with decrease in testicular size and erectile dysfunction. His total testosterone and morning cortisol levels were low, but FH, LH, and TSH were normal. His pituitary MRI was unremarkable. Upon discontinuation of MA, the patient's testosterone and cortisol levels normalized and his symptoms resolved. Hypogonadism and AI are known adverse effects of MA, but symptomatic hypogonadism as the primary manifestation has only been reported once in previous literature. Prolonged hypogonadism can lead to sarcopenia, depression, and osteoporosis, while asymptomatic AI carries the risk of becoming overt AI. Thus, heightened awareness of the impact of MA on both these axes is necessary.
A rare presentation of in situ mantle cell lymphoma and follicular lymphoma: a case report and review of the literature
Authors: Josephine Taverna, Anju Nair, Seongseok Yun, Spencer Paulson, Jonathan H Schatz, Daniel Persky, Deborah Fuchs, Soham Puvvada
Journal: Case Rep Hematol (2014)

A 65-year-old gentleman presented with left groin swelling over the course of two months. Physical exam revealed nontender left inguinal adenopathy, and computed tomography scans detected multiple lymph nodes in the mesenteric, aortocaval, and right common iliac regions. An excisional lymph node biopsy was performed. Pathologic evaluation demonstrated follicular center site which stained positive for PAX5, CD20, CD10, Bcl-2, Bcl-6, and mantle zone cells. These findings demonstrated CCND1 and CD5 positivity, suggesting composite lymphoma comprising follicular lymphoma (FL) with in situ mantle cell lymphoma (MCLIS). FL is known as indolent non-Hodgkin lymphoma; however, the clinical significance of a coexisting MCLIS continues to be elusive, and optimal management of these patients remains largely unknown. This case illustrates the diagnostic and therapeutic challenges of composite lymphomas. This paper also discusses advances in molecular pathogenesis and lymphoma genomics which offer novel insights into these rare diseases.
Florid Cemento-Osseous Dysplasia-Associated Simple Bone Cyst Showing Marked Irregular Border and High Apparent Diffusion Coefficient Value
Authors: Ikuho Kojima, Takashi Nishioka, Maya Sakamoto, Yuko Sai, Yushi Ezoe, Masahiro Iikubo, Hiroyuki Kumamoto, Tetsu Takahashi
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

A simple bone cyst (SBC) is an intrabone cavity without epithelial lining, which occasionally occur with fibrous-osseous lesions. The imaging finding of the scalloped border and conserving the lamina dura, periodontal ligament spaces, or follicular spaces are considered radiographically pathognomonic of SBC. SBC has been reported to occur with fibrous-osseous lesions, including cemento-osseous dysplasia (COD). Computed tomography (CT) imaging findings are sparse, and there are no reports of magnetic resonance imaging (MRI) findings, including apparent diffusion coefficient (ADC) value calculated by diffusion-weighted MRI for the florid COD-associated SBC. We report a case of a 39-year-old woman who was referred to our hospital because a panoramic radiograph of her right mandible showed asymptomatic radiolucency in the apical molar area. CT images showed a low-density lesion in the periapical areas of the right mandible, which accompanied a well-defined, high-density lesion, and a mixed low/high-density lesion with an unusual marked irregular border in the left mandible. The MRI showed cyst-like extremely hyperintense signals on fat-suppressed T2-weighted images at the right mandibular low-density and the left mandibular mixed low/high-density areas. ADC map showed high values (over 2.5 × 10-3 mm2/s) at the cystic areas in the bilateral mandible. We performed incisional biopsies of the bilateral mandibular lesions and resections of the bilateral maxillary lesions. Surgical and histopathological findings established a diagnosis of florid COD in the bilateral mandible and maxilla, simultaneously complicated by multiple SBCs in the bilateral mandible. The ADC value of cystic component is useful for the diagnosis, if the COD-associated SBC exhibits solitary, nonspecific, or rare imaging findings.
Case report: Dancing in the dark: A critical single case study engaging a blind father in the rehabilitation journey of his visually impaired child
Authors: Livio Provenzi, Giada Pettenati, Antonella Luparia, Daria Paini, Giorgia Aprile, Federica Morelli, Eleonora Mascherpa, Luisa Vercellino, Serena Grumi, Sabrina Signorini
Journal: Front Psychol (2022)
Keywords: blind parent, dyadic regulation, parent-child interaction, state space grid, visually impaired children
MeSH terms: Case Reports

Background:
Face-to-face visual contact is a key component of the early parent-child interaction, therefore a visual impairment condition of the parent or the child represents a risk factor for dyadic patterns' development.
Aims:
The study presents a critical single case of a blind father and a 18-month-old visually impaired child. The study aims to explore changes in the relational functioning of this dyad during an early family-centered intervention.
Methods and procedures:
Ten parent-child sessions were videotaped and micro-analytically coded. Data were analyzed through a State Space Grid crossing child's social cues and types of father verbalizations.
Outcomes and results:
Findings showed a stable increase in the amount of child social cues over time. Moreover, the dyad exhibited progressive changes in dyadic regulation, stability, and organization. The return time to the "active interaction" region of interest decreased progressively. A reduction was observed also for the time spent by the dyad in the region "no vocal contact."
Conclusions and implications:
This critical single case highlighted the benefits of parental engagement in early interventions for the dyadic regulation in parent-child interaction.
Treatment of glioma patients with ketogenic diets: report of two cases treated with an IRB-approved energy-restricted ketogenic diet protocol and review of the literature
Authors: Kenneth Schwartz, Howard T Chang, Michele Nikolai, Joseph Pernicone, Sherman Rhee, Karl Olson, Peter C Kurniali, Norman G Hord, Mary Noel
Journal: Cancer Metab (2015)
Keywords: humans, ketogenic diet, primary brain neoplasm, treatment
MeSH terms: Case Reports

Background:
Based on the hypothesis that cancer cells may not be able to metabolize ketones as efficiently as normal brain cells, the ketogenic diet (KD) has been proposed as a complementary or alternative therapy for treatment of malignant gliomas.
Case presentation:
We report here our experience in treating two glioma patients with an IRB-approved energy-restricted ketogenic diet (ERKD) protocol as monotherapy and review the literature on KD therapy for human glioma patients. An ERKD protocol was used in this pilot clinical study. In addition to the two patients who enrolled in this study, we also reviewed findings from 30 other patients, including 5 patients from case reports, 19 patients from a clinical trial reported by Rieger and 6 patients described by Champ. A total of 32 glioma patients have been treated using several different KD protocols as adjunctive/complementary therapy. The two patients who enrolled in our ERKD pilot study were monitored with twice daily measurements of blood glucose and ketones and daily weights. However, both patients showed tumor progression while on the ERKD therapy. Immunohistochemistry reactions showed that their tumors had tissue expression of at least one of the two critical mitochondrial ketolytic enzymes (succinyl CoA: 3-oxoacid CoA transferase, beta-3-hydroxybutyrate dehydrogenase 1). The other 30 glioma patients in the literature were treated with several different KD protocols with varying responses. Prolonged remissions ranging from more than 5 years to 4 months were reported in the case reports. Only one of these patients was treated using KD as monotherapy. The best responses reported in the more recent patient series were stable disease for approximately 6 weeks. No major side effects due to KD have been reported in any of these patients.
Conclusions:
We conclude that 1. KD is safe and without major side effects; 2. ketosis can be induced using customary foods; 3. treatment with KD may be effective in controlling the progression of some gliomas; and 4. further studies are needed to determine factors that influence the effectiveness of KD, whether as a monotherapy, or as adjunctive or supplemental therapy in treating glioma patients.
Trial registration:
ClinicalTrials.gov# NCT01535911.
Acute Cervical Dystonia Induced by Clebopride
Authors: Jin Kyo Choi, Jin Yong Hong
Journal: Case Rep Neurol Med (2017)
MeSH terms: Case Reports

Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride should be aware of the adverse effects of this drug.
Genetic mutation of SLC6A20 (c.1072T > C) in a family with nephrolithiasis: A case report
Authors: Menglei Jv, Jing Zheng, Anni Yang, Wei Xie, Weiping Zhu
Journal: Open Med (Wars) (2023)
Keywords: slc6a20, gene variation, nephrolithiasis, whole exome sequencing
MeSH terms: Case Reports

Nephrolithiasis is a highly prevalent disease worldwide that is associated with significant suffering, renal failure, and cost for the healthcare system. A patient with nephrolithiasis was found to have SLC6A20 variation. SLC6A20 gene in human is located on chromosome 3p21.3, which is a member of SLC6 family of membrane transporters and the product of this gene expression is transporter protein of sub-amino acid transporter system. The previous studies have reported that the mutation of SLC6A20 may cause hyperglycinuria or iminoglycinuria which may lead to nephrolithiasis. The object was to investigate the relationship between nephrolithiasis and SLC6A20 through pedigree genetic analysis. To explore whether the SLC6A20 mutation can cause hereditary nephrolithiasis, and provide evidence for further research. The urine and blood were collected from the patients for compositional analysis. DNA sequencing was applied to analyze the gene mutation. Labial gland and kidney biopsy were conducted for pathological analysis. As a result we reported a rare family case of nephrolithiasis accompanied by primary Sjogren's syndrome and investigated it by examining the family members with whole exome gene sequencing technology and detecting 20 different amino acids and 132 kinds of organic acids in the urine with gas chromatography-mass spectrometry. We discovered that the proband and her mother had hyperglycinuria and the proband (Ⅱ2), her sister (Ⅱ3), and mother (Ⅰ1) were found to carry the SLC6A20 gene exon NM_020208.3 sequence c.1072T > C heterozygous mutation, and the other family members (Ⅰ2, Ⅱ1, Ⅱ4, Ⅲ1, Ⅲ2) did not carry the genetic mutation. As a conclusion, the heterozygous mutation of SLC6A20 (c.1072T > C) might be contributed to hyperglycinuria and the formation of nephrolithiasis.
Blurred vision due to choroidal metastasis as the first manifestation of lung cancer: a case report
Authors: Christos Asteriou, Dimitrios Konstantinou, Athanassios Kleontas, Dimitrios Paliouras, Georgios Samanidis, Fani Papadopoulou, Nikolaos Barbetakis
Journal: World J Surg Oncol (2010)
MeSH terms: Carcinoma, Squamous Cell / secondary, Choroid Neoplasms / secondary, Lung Neoplasms / pathology, Vision Disorders / etiology, Case Reports, Carcinoma, Squamous Cell / therapy, Choroid Neoplasms / therapy, Humans, Lung Neoplasms / therapy, Male, Middle Aged, Thoracic Surgery, Video-Assisted, Vision Disorders / pathology, Vision Disorders / therapy, Visual Acuity

Background:
Reduction in visual acuity combined with blurred vision is rarely the first sign of lung cancer and very few cases have been announced globally.
Case presentation:
A case of a 46-year-old man who admitted with blurred vision is presented. His medical history, apart from a mild gastritis under treatment was negative. Ocular examination revealed a decrease in visual acuity due to a choroidal tumor. Further image body scans demonstrated a right lung lesion with dissemination to other organs. Diagnosis of a non-small cell lung cancer established after a VATS biopsy carried out.
Conclusion:
Blurred vision due to choroidal metastasis as the primary symptom of lung cancer is very uncommon. A great index of suspicion is essential when a choroidal lesion appears.
Getting in touch: Communication in physical therapy practice and the multiple functions of language
Authors: Birgitte Ahlsen, Anne Birgitta Nilsen
Journal: Front Rehabil Sci (2022)
Keywords: case study, communication, language, non-verbal, patient—centered care, physical therapy, verbal

In physical therapy, communication that actively involves the patient is seen as the foundation of patient-centered treatment. Research on communication in physical therapy highlights how patients' opportunity to actively participate is often limited by the therapists' focus on biomedical facts and clinical tasks. Few studies have explored aspects of communication in clinical practice that may promote patients' active participation. The aim of this study is to shed light on verbal and nonverbal communication used by physical therapists to get in touch with patients and how this physical and linguistic touching may contribute to encouraging patients' participation. The selected case is from a qualitative observational case study of the first encounter between a female physical therapist and a male patient with chronic neck pain. Drawing on theories about communication and the metafunctions of language, the findings highlight how the therapist's use of unfinished sentences, repetitions of the patient's own words, touch, gaze and accepting interruptions from the patient promotes the patient's participation. Demonstrations of the use of linguistic communication theory in this study may contribute to enhancing physical therapists' self-awareness around communication and how to get in touch with patients, which is a fundamental element in patient-centered treatment.
Uterine collision tumor (PEComa and endometrioid carcinoma) in a tuberous sclerosis patient: a case report
Authors: Nektarios Koufopoulos, Ioannis S Pateras, Christos Koratzanis, Alina-Roxani Gouloumis, Argyro-Ioanna Ieronimaki, Alexandros Fotiou, Ioannis G Panayiotides, Nikolaos Vrachnis
Journal: Front Oncol (2023)
Keywords: case report, collision tumor, endometrioid carcinoma, tuberous sclerosis, uterine pecoma
MeSH terms: Case Reports

Perivascular epithelioid cell tumors are very rare mesenchymal neoplasms arising in various locations, such as the female genital tract, kidney, lung, prostate, bladder, pancreas, soft tissues, and bone. They possess a unique immunophenotype, co-expressing myogenic and melanocytic markers; molecular findings include mutations of tuberous sclerosis complex and translocations of transcription factor E3, a member of the microphthalmia transcription factor gene family. We herewith report a uterine collision tumor consisting of a perivascular epithelioid cell tumor and a moderately differentiated endometrial endometrioid carcinoma in a patient with genetically proven tuberous sclerosis; two leiomyomas were also found in contact with the tumor. Although two such cases one with a benign and another with a malignant perivascular epithelioid cell tumor have previously been reported, ours is, to our knowledge, the first reported in a tuberous sclerosis patient.
Ectopic Cecal Varices as a Cause of Lower Gastrointestinal Bleeding
Authors: Abdulrahman Qatomah, Sulaiman Almushir, Faisal Aljohani
Journal: Case Rep Gastrointest Med (2023)
MeSH terms: Case Reports

Ectopic varices account for 1%-5% of all variceal bleeding episodes in patients with portal hypertension. They can be found at any part of gastrointestinal tract including the small intestines, colon, or rectum. We report a case of a 59-year-old man who presented with bleeding per rectum 2 days after a routine colonoscopy, in which 2 lesions were biopsied. Gastroscopy was negative for bleeding, and he was not stable enough to undergo colonoscopy. CT angiography showed a large portosystemic shunt with multiple collaterals in the right lower quadrant. These findings were clues for a diagnosis of ectopic cecal varices.
Atezolizumab-Induced Autoimmune Diabetes in a Patient With Metastatic Lung Cancer
Authors: Jin Sothornwit, Anakapong Phunmanee, Chatlert Pongchaiyakul
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: atezolizumab, autoimmunity, checkpoint inhibitor, diabetes mellitus, immunotherapy
MeSH terms: Case Reports

Context: Immune checkpoint inhibitors (ICIs), now FDA-approved, are increasingly used as an effective treatment of various cancers. Autoimmune diabetes is a rare but life-threatening endocrine adverse event, which has been reported in patients treated with anti-programmed-cell death-1 (anti-PD-1) and anti-programmed-cell death-1 ligand (anti-PD-L1) therapies. Case description: We report a 52-year-old woman with advanced-stage non-small cell lung cancer who presented with diabetic ketoacidosis (DKA) at 24 weeks after atezolizumab initiation. She initially received oral antidiabetic medication from primary care hospital and experienced recurrent DKA 3 days later. Her plasma glucose on the day that she had recurrent DKA was 332 mg/dL (18.4 mmol/L), A1c was 7.9% (63 mmol/mol), fasting C-peptide was <0.03 nmol/L (0.1 ng/ml), fasting insulin level was <1 μIU/ml, anti-glutamic acid decarboxylase 65 (GADA) was 7.2 U/ml (normal, >5 U/ml), and human leukocyte antigen (HLA) class II typing was DR3-DQ2/DR14-DQ5. A diagnosis of autoimmune diabetes was made. After treatment for DKA, she recovered and received basal-bolus insulin treatment. Atezolizumab had been discontinued after the fifth cycle, prior to the development of DKA, due to progression of lung cancer. Conclusion: To date, there has been neither an effective way to detect if a patient is at high risk for autoimmune diabetes nor to prevent the complications associated with it. Regular glucose monitoring is the best method of early diabetes detection. In patients with new onset diabetes following treatment with ICIs, C-peptide levels and GADA should be screened, and insulin therapy should be prescribed to prevent hyperglycemic emergency while waiting for definite diagnosis.
[Agranulocytosis with tonsillitis associated with methimazole therapy]
Authors: Jorge T Zambrana, Fábio F T Zambrana, Firmino R S Neto, André L C Gonçalves, Fernanda F T Zambrana, Jorge Ushirohira
Journal: Braz J Otorhinolaryngol (2005)
MeSH terms: Agranulocytosis / chemically induced, Antithyroid Agents / adverse effects, Methimazole / adverse effects, Tonsillitis / chemically induced, Case Reports, English Abstract, Adult, Agranulocytosis / diagnosis, Diagnosis, Differential, Female, Humans, Hyperthyroidism / drug therapy, Leukopenia / diagnosis, Oropharynx, Tonsillitis / diagnosis, Antithyroid Agents, Methimazole

The treatment of hyperthyroidism with antithyroid drugs can cause a significant side effect in 0.2 to 0.3% of the cases: agranulocytosis. Infectious complications caused by this condition affect mainly the throat, and tonsillitis is one of its manifestations. The present study reported the case of a female patient, 33 years old, manifesting odynophagia and fever resistant to many antibiotics. The patient showed hyperthyroidism and had been using methimazole for two months. With the diagnoses of agranulocytic angina, the drug was withdrawn and treatment with ciprofloxacin, symptomatic drugs and granulocytic-colony stimulator, besides fluconazol was started. The patient developed satisfactorily, being discharged ten days after the beginning of the treatment. Fifteen days later, total thyroidectomy was carried out. The purpose of this report was to point out the importance of knowing the side effects of drugs to advise the patients about them and to warn physicians about the need for evaluating the patient as a whole, searching for other current diseases and drugs in use.