OpenMed/multicare-articles huggingface dataset:
Leiomyosarcoma of bone: a case report
Authors: Andreas Frings, Andreas Leithner, Bernadette Liegl-Atzwanger
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

The aim of this paper is to present clinicopathologic features and immunohistochemical findings of a primary leiomyosarcoma of bone occurring in the proximal femur of a 46-year-old Caucasian male patient. Each case report on this exceedingly rare entity contributes to the notion of this disease.
Transesophageal Echocardiogram: Still a Powerful Tool in the 21st Century for the Diagnosis of Aortic Dissection
Authors: Rui Flores, Joana Lopes, Vítor Hugo Pereira, Nuno Salomé
Journal: Cureus (2023)
Keywords: aortic disease, cardiac magnetic resonance (cmr), trans-esophageal echocardiogram, transthoracic echocardiogram, type b aortic dissection
MeSH terms: Case Reports

A 63-year-old woman with a history of previous anaphylactic reaction to iodate contrast presented with sudden back pain during exertion associated with elevated D-dimer levels. Transthoracic echocardiogram was unremarkable. She was unable to perform a computerized tomography for further evaluation of the aorta due to her allergic background. Transesophageal echocardiogram disclosed a type B aortic dissection. This case report recalls the importance of transesophageal echocardiography in the algorithm for diagnosing aortic dissection in scenarios where CT is not possible.
Post-COVID-19 fatal Aspergillus endocarditis: A case report
Authors: Narges Najafi, Azam Moslemi, Rahman Ghafari, Shadi Shayesteh Azar, Maryam Nabati, Leila Faeli, Maryam Salimi, Roghayeh Mirzakhani, Tahereh Shokohi
Journal: J Clin Lab Anal (2023)
Keywords: aspergillus fumigatus, covid-19, endocarditis, prosthetic heart valves
MeSH terms: COVID-19 / complications, Endocarditis / complications, Endocarditis / diagnostic imaging, Invasive Pulmonary Aspergillosis / complications, Case Reports, Aspergillus, Humans, Male, Middle Aged, Voriconazole / therapeutic use, Voriconazole

Background:
Aspergillus endocarditis (AE) is a rare fatal infection. The infection is often reported in patients with prosthetic heart valves, immunosuppressed, broad-spectrum antimicrobial use regimens, and drug abusers.
Methods:
Herein, we report a rare case of native mitral valve AE in a 63-year-old man, with a probable COVID-19-associated invasive pulmonary aspergillosis nine months ago treated with antifungals.
Results:
In the last admission, the lethargy, neurological deficit, and septic-embolic brain abscess in brain MRI led to suspicion of infective endocarditis. Transesophageal two-dimensional echocardiography and color Doppler flow velocity mapping showed a large highly mobile mass destroying leaflet and severe mitral regurgitation. The Surgical valve replacement is performed. The surgical valve replacement is performed. Direct microscopic examination and culture of the explanted and vegetative mass revealed Aspergillus section Fumiagati confirmed by molecular method. Despite the administration of voriconazole and transient improvement the patient expired.
Conclusion:
As AE is a late consequence of COVID-19-associated invasive pulmonary aspergillosis, therefore, long-term follow-up of invasive aspergillosis, and prompt diagnosis of surgical and systemic antifungal therapy treatment, are warranted to provide robust management.
Acute Urinary Retention in the Male Child from Urethral Calculi: A Report of Three Cases
Authors: L O Mbouché, G Ondobo Andzé, A S Nwaha Makon, D Nyanit Bob, E Njuma Tamufor, A L Amenglé, F F Mouafo Tambo, P Y Mure, J Zé Mikandé, F F Angwafo 3rd
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Urinary stones are uncommon in children. Urethral location of calculi can give rise to various clinical manifestations. We report three cases of urethral lithiasis presenting with acute urinary retention in children.
Does sports therapy affect momentary affective states? Feasibility of intensive longitudinal case studies in forensic psychiatry
Authors: Vanessa Reimer, Martina K Kanning
Journal: Front Psychiatry (2023)
Keywords: affective states, calmness, energetic arousal, forensic psychiatry, intensive longitudinal case studies, sports therapy, valence

Physical exercise interventions improve quality of life in people with mental disorders and improve abstinence and cravings in substance use disorders patients in both the short term and long term. In people with mental illness, physical exercise interventions significantly reduce psychiatric symptoms of schizophrenia and symptoms of anxiety. For forensic psychiatry, there is little empirical evidence supporting mental health-enhancing effects of physical exercise interventions. Interventional studies in forensic psychiatry deal mainly with three problems: heterogeneity of the individuals, a small sample size, and a low compliance rate. Intensive longitudinal case studies could be a suitable approach to address these methodological challenges in forensic psychiatry. This study uses an intensive longitudinal design to determine whether forensic psychiatric patients are content to complete several data assessments per day over the course of several weeks. The feasibility of this approach is operationalized by the compliance rate. Additionally, single-case studies examine the effects of sports therapy (ST) on momentary affective states (energetic arousal, valence, and calmness). The results of these case studies reveal one aspect of feasibility and offer insights into the effects of forensic psychiatric ST on the affective states among patients with different conditions. The patients' momentary affective states were recorded before (PRE), after (POST) and 1 h after (FoUp1h) ST by questionnaires. Ten individuals (Mage = 31.7, SD = 11.94; 60% male) participated in the study. A total of 130 questionnaires were completed. To perform the single-case studies, data of three patients were considered. Repeated-measures ANOVA was performed for the individual affective states to test for main effects of ST. Due to the results, ST has no significant effect on none of the three affect dimensions. However, effect sizes varied between small to medium (energetic arousal: η2 = 0.01, η2 = 0.07, η2 = 0.06; valence: η2 = 0.07; calmness: η2 = 0.02) in the three patients. Intensive longitudinal case studies are a possible approach to address heterogeneity and the low sample size. The low compliance rate in this study reveals that the study design needs to be optimized for future studies.
Citalopram associated with acute angle-closure glaucoma: case report
Authors: Robert Croos, Srinivasa Thirumalai, Sabit Hassan, Jane Da Roza Davis
Journal: BMC Ophthalmol (2005)
MeSH terms: Antidepressive Agents, Second-Generation / adverse effects, Citalopram / adverse effects, Glaucoma, Angle-Closure / chemically induced, Case Reports, Acute Disease, Drug Overdose, Female, Humans, Intraocular Pressure / drug effects, Middle Aged, Visual Acuity, Antidepressive Agents, Second-Generation, Citalopram

Background:
Acute angle-closure glaucoma is a rare complication in patients receiving anti-depressant treatment. In the following case, we report the development of acute angle closure glaucoma in a patient who overdosed on Citalopram, an antidepressant, and discuss the possible etiological mechanisms for the condition.
Case presentation:
We report a 54 year old, Caucasian lady, with depression and alcohol dependence syndrome, who developed acute angle-closure glaucoma after an overdose of Citalopram, along with alcohol. She was treated with medications and had bilateral Yag laser iridotomies to correct the glaucoma and has made complete recovery. In this case, the underlying cause for glaucoma appears to be related to the ingestion of Citalopram.
Conclusion:
The patho-physiological basis for acute angle closure glaucoma in relation to antidepressant medications remains unclear. The authors suggest Citalopram may have a direct action on the Iris or Ciliary body muscle through serotonergic or anti-cholinergic mechanisms or both. This case highlights the importance of the awareness of the underlying risks, which may predispose an individual to develop acute angle-closure glaucoma, and reminds the clinicians the significance of history taking and examination of the eye before and after starting anti-depressants. This area needs to be further researched.
Short-term efficacy of the IL6 receptor antibody tocilizumab in patients with HIV-associated multicentric Castleman disease: report of two cases
Authors: Azusa Nagao, Shoko Nakazawa, Hideji Hanabusa
Journal: J Hematol Oncol (2014)
MeSH terms: Antibodies, Monoclonal, Humanized / therapeutic use, Castleman Disease / drug therapy, HIV Infections / complications, Receptors, Interleukin-6 / antagonists & inhibitors, Case Reports, Adult, Antibodies, Monoclonal, Humanized / immunology, Castleman Disease / complications, Castleman Disease / metabolism, Humans, Male, Middle Aged, Receptors, Interleukin-6 / immunology, Receptors, Interleukin-6 / metabolism, Recurrence, Time Factors, Treatment Outcome, Antibodies, Monoclonal, Humanized, Receptors, Interleukin-6, tocilizumab, Multi-centric Castleman's Disease

Multicentric Castleman disease (MCD) is a lymphoproliferative disorder caused by human herpesvirus 8 (HHV8) infection HIV associated MCD (HIV-MCD) presents with various clinical symptoms. Many HIV-negative MCD patients are often treated with anti-human interleukin-6 (IL6) receptor monoclonal antibodies (tocilizumab), and successful results have been reported. IL-6 plays an important role in the development of both HIV-positive and HIV-negative MCD; however, the efficacy of tocilizumab in HIV-MCD patients is unknown. We herein report the clinical and biologic courses of two HIV-MCD patients treated with tocilizumab. In both cases, a significant and rapid clinical improvement was observed after the first infusion. However, the treatment efficacy was not maintained for a long period, and relapse occurred at 15 and 22 weeks, respectively. Both patients received rituximab and subsequently achieved complete clinical remission. Our report, in addition to data presented in the literature, suggests that tocilizumab could be an initial treatment option in patients with HIV-MCD.
Case report: Regression of Glioblastoma after flavivirus infection
Authors: Patricia P Garcez, André Guasti, Nina Ventura, Luiza Mendonça Higa, Felipe Andreiuolo, Gabriella Pinheiro A de Freitas, Liane de Jesus Ribeiro, Richard Araújo Maia, Sheila Maria Barbosa de Lima, Adriana de Souza Azevedo, Waleska Dias Schwarcz, Elena Cristina Caride, Leila Chimelli, Luiz Gustavo Dubois, Orlando da Costa Ferreira Júnior, Amilcar Tanuri, Vivaldo Moura-Neto, Paulo Niemeyer
Journal: Front Med (Lausanne) (2023)
Keywords: denv, zikv, flavivirus, glioblastoma, immunovirotherapy, oncolytic virus
MeSH terms: Case Reports

Glioblastoma is the most frequent and aggressive primary brain cancer. In preclinical studies, Zika virus, a flavivirus that triggers the death of glioblastoma stem-like cells. However, the flavivirus oncolytic activity has not been demonstrated in human patients. Here we report a glioblastoma patient who received the standard of care therapy, including surgical resection, radiotherapy and temozolomide. However, shortly after the tumor mass resection, the patient was clinically diagnosed with a typical arbovirus-like infection, during a Zika virus outbreak in Brazil. Following the infection resolution, the glioblastoma regressed, and no recurrence was observed. This clinical response continues 6 years after the glioblastoma initial diagnosis.
Multiparametric 18F-FDG PET/MR follow-up in a patient with autoimmune pancreatitis
Authors: Isabel Rauscher, Matthias Eiber, Hana Algül, Jens T Siveke, Gregor Weirich, Anna M Schlitter, Ambros J Beer
Journal: Eur J Hybrid Imaging (2017)

Background:
Positron emission tomography/magnetic resonance imaging (PET/MR) is a new multimodal imaging technique, which might improve the diagnostic performance not only in oncological patients but also in patients with non-neoplastic inflammatory lesions as routinely used 18F-FDG is not a cancer specific agent.
Case presentation:
Multiparametric 18F-FDG PET/MR in a woman with pain in the upper abdomen and inconclusive laboratory and clinical data presenting with moderately increased, diffuse 18F-FDG uptake with delayed contrast enhancement, diffusion-restriction and focal enlargement in the pancreatic body being suggestive for autoimmune pancreatitis (AIP). Follow-up 18F-FDG PET/MR after initiation of steroid therapy confirmed complete resolution of imaging abnormalities.
Conclusion:

18F-FDG PET/MR might be valuable in the management of AIP providing complementary data regarding accurate diagnosis and monitoring therapy response to avoid unnecessary surgery.
Urachal Adenocarcinoma: A Case Report with Key Imaging Findings and Radiologic-Pathologic Correlation
Authors: Willian Schmitt, Marta Baptista, Marco Ferreira, António Gomes, Ana Germano
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Urachal pathologies are rare and can mimic numerous abdominal and pelvic diseases. Differential diagnosis of urachal anomalies can be narrowed down by proper assessment of lesion location, morphology, imaging findings, patient demographics, and clinical history. We report a case of a 60-year-old male, with a history of unintentional weight loss without associated symptoms, who was diagnosed with locally invasive urachal adenocarcinoma. With this article, we pretend to emphasize urachal adenocarcinoma clinical features along with its key imaging findings with radiologic-pathologic correlation.
Treatment of Hypochondriasis in Two Schizophrenia Patients Using Clozapine
Authors: Antonio Tundo, Luca Proietti, Rocco de Filippis
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

Hypochondriasis (HYPO), an obsessive-compulsive spectrum disorder, is frequent in patients with schizophrenia (SCH) (20%), especially among those treated with clozapine (36.7%). Treatment options for OCS/OCD in patients under clozapine (CLZ) include combining clozapine with amisulpride/aripiprazole or a mood stabilizer, augmenting clozapine with a serotoninergic reuptake inhibitor, adding cognitive behavioural therapy, and gradually reducing dosage. No treatments have been proposed for HYPO in patients using clozapine so we examine these options in 2 cases and report the results. Among treatments delivered, only dosage reduction adequately worked. We recommend caution when thinking about escalating treatment and suggest trying it only when alternative interventions were not successful and weighing risk and benefits of this therapeutic strategy. Further research is needed to confirm the hypothesis that CLZ treatment induces hypochondriac symptoms, to investigate the prevalence of the phenomenon, and, mostly, to identify possible treatment strategies.
Case Report: Concomitant Diagnosis of Plasma Cell Leukemia in Patient With JAK2 Positive Myeloproliferative Neoplasm
Authors: Christine J Kurian, Colin Thomas, Sarah Houtmann, Thomas Klumpp, Adam Finn Binder
Journal: Front Oncol (2020)
Keywords: jak2 mutation, case report, essential thrombocytosis, myeloproliferative neoplasm, plasma cell leukemia
MeSH terms: Case Reports

Plasma cell dyscrasias and myeloproliferative neoplasms (MPN) are hematologic malignancies arising from two distinct hematopoietic cell lineages. They rarely occur concomitantly. Here, we report a case of a patient with a recent diagnosis of a JAK2 V617F positive MPN who presented with a new diagnosis of plasma cell leukemia. The patient had presented to the hospital with a leukocytosis predominantly comprised of plasma cells, followed by work-up involving peripheral blood flow cytometry, FISH analysis, and bone-marrow biopsy. FISH analysis was suggestive of a common progenitor cell for these distinct hematologic malignancies. To our knowledge, this case represents the second reported instance of a concomitant JAK2 positive MPN with primary plasma cell leukemia.
Choledochal cyst as a diagnostic pitfall: a case report
Authors: Uta Waidner, Doris Henne-Bruns, Klaus Buttenschoen
Journal: J Med Case Rep (2008)

Introduction:
Choledochal cysts are rare congenital anomalies. Their diagnosis is difficult, particulary in adults.
Case presentation:
This case report demonstrates the diagnostic and therapeutic pitfalls.
Conclusion:
To prevent cost-intensive and potentially life-threating complications, a choledochal cyst must be considered in the differential diagnosis whenever the rather common diagnosis of a hepatic cyst is considered.
Multifocal aggressive squamous cell carcinomas induced by prolonged voriconazole therapy: a case report
Authors: C Morice, A Acher, N Soufir, M Michel, F Comoz, D Leroy, L Verneuil
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Voriconazole is a treatment for severe fungal infections. Prolonged voriconazole therapy may induce skin reactions, with 1% of severe photosensitivity accidents. Recently the imputability of voriconazole in skin carcinogenesis has been suggested. This report concerns a 55-year-old man suffering from pulmonary aspergillosis who presented a phototoxic reaction a few months after introduction of voriconazole, followed by multiple squamous cell carcinomas of sun-exposed skin areas. After voriconazole discontinuation, no new carcinoma was observed. The detection of EBV and HPV in skin lesions was negative. Exploration of gene mutations involved in skin carcinogenesis showed two variants of the MICR gene. The occurrence of multiple, recurrent, aggressive squamous cell carcinomas is rare with voriconazole, but its imputability is strongly suggested. A plausible hypothesis is that several factors including voriconazole uptake, immunosuppression, and genetic background could explain the phenotype of fast-developing skin carcinomas. Voriconazole therapy should be accompanied by stringent photoprotection and skin monitoring.
Case report: Two clusters of Creutzfeldt-Jakob disease cases within 1 year in West Michigan
Authors: Ling Ling Rong, Nicholas J Lannen, Evan C Tank, Jessica L Feistel, Christopher J Therasse, Anvita Potluri, Muhib Khan, Jiangyong Min
Journal: Front Neurol (2023)
Keywords: creutzfeldt-jacob disease, west michigan, cluster, prion, rapidly progressive dementia, real-time quaking-induced conversion
MeSH terms: Case Reports

Background:
Creutzfeldt-Jakob disease (CJD) is a rare, rapidly progressive, and uniformly fatal neurodegenerative disease. The reported incidence of CJD is 1 to 2 per million people worldwide annually, with fewer than 1,000 cases in the United States per year. In this study, we report a unique case series on temporo-spatial clusters of CJD cases in West Michigan.
Methods:
A total of five CJD cases consisting of two temporal clusters were seen from July 2021 to June 2022 at Corewell Health West hospitals. All patients had brain MRI, EEG, and CSF tests. Four patients underwent autopsies.
Results:
All patients' MRIs showed characteristic CJD patterns. Four patients had positive CJD panels in CSF. One patient had typical CJD EEG findings. Four patients were confirmed as sporadic CJD by autopsy. All patients died within 3 months after CJD was suspected.
Discussion:
All patients lived within a 90-mile radius of Grand Rapids, MI, and two lived in the same county. West Michigan has a population of 1.6 million people, and the four counties where five patients lived have a combined population of 395,104, indicating CJD's new case rate of 3.1 and 12.5 per million people, respectively. Corewell Health is one of the three major healthcare systems in West Michigan. The actual incidence of CJD in West Michigan is likely even higher. This dense temporal and spatial cluster of CJD cases poses a serious public health challenge and warrants urgent investigation.
Severe Eosinophilia in Myelodysplastic Syndrome With a Defined and Rare Cytogenetic Abnormality
Authors: Shinya Rai, J Luis Espinoza, Yasuyoshi Morita, Hirokazu Tanaka, Itaru Matsumura
Journal: Front Immunol (2019)
Keywords: cytogenetic (cg) analyses, eosinophilia, eosinophilic pneumonia, membranoproliferative glomerulonephritis (mpgn), myelodisdplastic/myeloproliferative disorders, myelofibrosis
MeSH terms: Chromosome Aberrations, Eosinophilia / diagnosis, Eosinophilia / etiology, Myelodysplastic Syndromes / complications, Myelodysplastic Syndromes / genetics, Case Reports, Research Support, Non-U.S. Gov't, Aged, Biomarkers, Biopsy, Bone Marrow / pathology, Cytogenetic Analysis, Disease Susceptibility, Eosinophils / pathology, Humans, Karyotype, Leukocyte Count, Male, Myelodysplastic Syndromes / diagnosis, Phenotype, Severity of Illness Index, Tomography, X-Ray Computed, Biomarkers

Myelodysplastic syndromes (MDS) are a heterogeneous group clonal disorders of hematopoietic stem cells (HSC) characterized by ineffective hematopoiesis that lead to variable grades of impaired blood cell production. Chromosomal aberrations are often detected in MDS patients and thus cytogenetic analysis is useful for the diagnosis of these disorders. Common recurring chromosomal defects, such as the -5/5q- and -7/7q- are relatively well characterized cytogenetic abnormalities in MDS, however, the biological significance of uncommon cytogenetic alterations is unknown. We report here, two cases of peripheral blood and bone marrow hypereosinophilia in patients with MDS harboring the unbalanced translocation der(1;7)(q10;p10), a poorly characterized cytogenetic abnormality that is found in certain myeloid malignancies, including MDS. The patients reported here presented hypereosinophilia that was refractory to steroids and cytotoxic therapy, leading to severe target tissue damage that ultimately resulted in fatal end-organ failure. Potential roles of the der(1;7)(q10;p10) aberrations in the pathogenesis of aggressive eosinophilia and disease prognosis are discussed here.
Acute Gastroenteritis Induced Adrenal Crisis in a patient with Congenital Adrenal Hyperplasia: A Case Report
Authors: Nibedita Chapagain, Aayam Adhikari, Nishob Adhikari, Santosh Paudel, Deependra Mandal
Journal: JNMA J Nepal Med Assoc (2023)
Keywords: adrenal insufficiency, gastroenteritis, glucocorticoids
MeSH terms: Adrenal Hyperplasia, Congenital / complications, Adrenal Hyperplasia, Congenital / diagnosis, Adrenal Insufficiency / complications, Adrenal Insufficiency / etiology, Gastroenteritis / complications, Gastroenteritis / diagnosis, Case Reports, Acute Disease, Glucocorticoids / therapeutic use, Humans, Male, Prednisolone / therapeutic use, Glucocorticoids, Prednisolone

Congenital Adrenal Hyperplasia is a group of autosomal recessive diseases due to deficiencies of enzymes involved in steroidogenesis. If not diagnosed and treated adequately, Congenital Adrenal Hyperplasia can lead to an acute adrenal crisis with hemodynamic collapse. Acute stressors and steroid insufficiency precipitate an adrenal crisis. The major clinical features are hypotension and volume depletion. Nonspecific symptoms such as fatigue, lack of energy, anorexia, nausea, vomiting, and abdominal pain are common. We report a case of a 3-year male previously diagnosed with congenital adrenal hyperplasia in adrenal crisis secondary to medicine noncompliance and gastroenteritis. The diagnosis was based on the clinical history and biochemical investigations. After initial resuscitation was managed; lifelong oral prednisolone and fludrocortisone were prescribed.
Keywords:
adrenal insufficiency; gastroenteritis; glucocorticoids.