OpenMed/multicare-articles huggingface dataset:
Abdominal wall hemorrhage after intravenous thrombolysis for acute ischemic stroke
Authors: Se-A An, Jinkwon Kim, Sang Heum Kim, Won Chan Kim
Journal: BMC Neurol (2013)
MeSH terms: Abdominal Wall / pathology, Fibrinolytic Agents / adverse effects, Hemorrhage / chemically induced, Heparin / adverse effects, Stroke / drug therapy, Case Reports, Administration, Intravenous / adverse effects, Aged, Brain Ischemia / complications, Coronary Angiography, Female, Hemorrhage / pathology, Humans, Stroke / etiology, Tomography, X-Ray Computed, Fibrinolytic Agents, Heparin

Background:
Thrombolysis is strongly recommended for patients with significant neurologic deficits secondary to acute ischemic stroke. Extracranial bleeding is a rare but major complication of thrombolysis.
Case presentation:
A 78-year-old woman presented with acute ischemic stroke caused by occlusion of the basilar artery. Clinical recovery was observed after successful recanalization by intravenous thrombolysis and intraarterial thrombectomy. However, the patient complained of sudden abdominal pain following the intervention and a newly developed abdominal wall mass was found. CT scan and selective angiography confirmed active bleeding from the left epigastric artery into the abdominal muscle layer and the bleeding was successfully managed by selective embolization of the bleeding artery.
Conclusions:
We report a rare case of abdominal wall hemorrhage after thrombolysis for acute ischemic stroke. The findings indicate that abdominal wall hemorrhage should be considered as a differential diagnosis in the presence of abdominal discomfort after thrombolysis for acute ischemic stroke.
3-dimensional physiologic postural range of the mandible: a computerized-assisted technique-a case study
Authors: Todd Shewman
Journal: Case Rep Med (2013)

Previous studies demonstrated that while the mandible assumes its resting position in space, antagonistic muscles should assume minimal muscle activity within a spatial range. This zone of mandibular rest has been mapped using physiologic parameters of muscle activity and incisal spatial kinematics. This case study expands on previous research by monitoring incisal and posterior jaw position and includes lateral pterygoid muscle activity, thus allowing for determining the spatial range including additional relevant coordinates and muscle activity. Four positions were evaluated: a maximum physiologic open position, a maximum physiologic closed position, physiologic rest position, and maximum physiologic protrusion position. Within the physiologic zone of rest formed by these 4 positions, the vertical and anterior borders of the envelope of function may be documented for the incisal and posterior mandible in true 3-dimensional fashion to assist the clinician in determining a physiologic interocclusal freeway space and vertical dimension of occlusion. Advantages and limitations are discussed.
Diffuse Adenomatosis and Hepatocellular Carcinoma Treated with Liver Transplantation in an Adolescent Female with Kabuki Syndrome with a Novel KMT2D Gene Mutation
Authors: Leander D Timothy, Heidi D Lehrke, Vishal S Chandan, Amy B Kolbe, Katryn N Furuya
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Kabuki syndrome (KS) is a rare disorder primarily associated with mutations in the KMT2D and KDM6A genes. Several tumors have been reported with KS; however, there have been no reports of hepatocellular carcinoma (HCC) or hepatic adenomatosis. We present an adolescent girl with KS and a novel KMT2D mutation who developed diffuse adenomatosis, HCC, and subsequently underwent liver transplantation.
Safety and Efficacy of Anti-CD19-Chimeric Antigen Receptor T Cell Combined With Programmed Cell Death 1 Inhibitor Therapy in a Patient With Refractory Post-Transplant Lymphoproliferative Disease: Case Report and Literature Review
Authors: Gang Feng, Qing Li, Haibo Zhu, Yanyu Jiang, Jijun Yuan, Yingxin Fu, Qi Deng
Journal: Front Oncol (2021)
Keywords: t cells, chimeric antigen receptor, diffuse large b-cell lymphoma, post-transplant lymphoproliferative disease, programmed cell death 1
MeSH terms: Case Reports

Post-transplant lymphoproliferative disease (PTLD) often exhibits poor prognosis and high mortality, and there are no uniform guidelines for the treatment of this disease. Anti-CD19 chimeric antigen receptor (CAR) T cells show significant efficacy in treatment of relapse/refractory diffuse large B-cell lymphoma (DLBCL). Treatment using anti-CD19-CAR T-cell therapy in PTLD has been limited by immunosuppressants and has not been widely employed. In this study, a refractory post kidney transplant DLBCL patient with a high tumor burden was enrolled in a clinical trial of anti-CD19-CAR T-cell therapy. The tacrolimus dose was not decreased during combination chemotherapy, as the creatinine level of the patient increased. To improve the function of autologous T cells, combination therapy with anti-CD19-CAR T cells and programmed cell death 1 (PD-1) inhibitors was selected. After treatment with the combination therapy, the patient was diagnosed with grade 1 cytokine release syndrome and grade 3 immune effector cell-associated neurotoxicity syndrome. The amplification peak of anti-CD19-CAR T cells reached 9.01% on day 7. With PD-1 inhibitor maintenance therapy, his disease was maintained in partial remission for 18 weeks. However, his tumor suddenly increased in size, and he discontinued the treatment, including radiation therapy. The anti-CD19-CAR T cell and PD-1 inhibitors have a combined effect on PTLD, and this combination therapy needs to be further explored.
Mepolizumab and dupilumab as a replacement to systemic glucocorticoids for the treatment of Chronic Eosinophilic Pneumonia and Allergic Bronchopulmonary Aspergillosis - Case series, Almoosa specialist hospital
Authors: Safwat A M Eldaabossi, Amgad Awad, Neda'a Anshasi
Journal: Respir Med Case Rep (2021)
Keywords: allergic bronchopulmonary aspergillosis, asthma, eosinophilic pneumonia
MeSH terms: Case Reports

In this case series, we present four patients who had asthma and blood eosinophilia. Two patients were diagnosed with Chronic Eosinophilic Pneumonia (CEP) and the other two with Allergic Bronchopulmonary Aspergillosis (ABPA). Laboratory findings revealed profound peripheral eosinophilia with abnormal chest radiography (alveolar shadows, segmental atelectasis, and cystic changes). Initial improvement (clinical, laboratory, and radiological) occurred with traditional asthma therapy, including systemic corticosteroids. The patients did not tolerate corticosteroid therapy because of weight gain, uncontrolled diabetes, bone fractures, and psychological adverse effects. Mepolizumab (administered to two CEP cases and one ABPA case) and Dupilumab (administered to one ABPA case) were initiated as steroid-sparing agents, resulting in successful therapy without relapse or adverse effects. Mepolizumab, and Interleukin-5 (IL-5) antagonist, targets diseases mediated by eosinophil activity and proliferation. Dupilumab blocks the Interleukin-4/Interleukin-13 pathway and suppresses Type 2 inflammation, including Immunoglobulin E (IgE). Dupilumab resulted in up to 70% drop in total IgE levels from baseline and reduced eosinophil-mediated lung inflammation, despite the presence of normal or increased blood eosinophil counts.
Case Report: Associated Ocular Adverse Reactions With Inactivated COVID-19 Vaccine in China
Authors: Kunpeng Pang, Lijie Pan, Hui Guo, Xinyi Wu
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19, keratitis, ocular adverse event, uveitis, vaccine
MeSH terms: Case Reports

The vaccine is still the best clinical measure for effective prevention and control of coronavirus disease 2019 (COVID-19). The vaccine-associated ocular adverse reactions should be noted in detail among the medical community. We reported twelve eyes of 9 patients presented at the Department of Ophthalmology, Qilu Hospital of Shandong University from March to August 2021 with ocular complaints following COVID-19 vaccination. The main inclusion criterion was the development of ocular symptoms within 14 days after receiving a dose of an inactivated COVID-19 vaccine. The mean (SD) age was 44.7 ± 16.5 years (range, 19-78 years), among which seven (77.8%) cases were women. The mean time of ocular adverse events was 7.1 days (range, 1-14 days) after receiving the inactivated COVID-19 vaccine. One patient was diagnosed with choroiditis, 1 with uveitis, 4 with keratitis, 1 with scleritis, 1 with acute retinal necrosis, and 1 with iridocyclitis. Although the causal relationship between vaccines and ocular adverse events cannot be established from this case series report, physicians should pay attention to the ocular adverse reactions following the COVID-19 vaccine administration.
Anti-Ri antibodies associated with short-term memory deficits and a mature cystic teratoma of the ovary
Authors: Oluwole Fadare, Hassan J Hart
Journal: Int Semin Surg Oncol (2004)

BACKGROUND: The IgG autoantibody ANNA-2 (anti-Ri) is a type 2 antineuronal antibody that has been found to bind to highly conserved and widely distributed adult brain proteins encoded by the Nova-1 and Nova-2 genes. Anti-Ri antibodies are typically detected in the serum and cerebrospinal fluids of patients with neurological disorders such as opsoclonus/myoclonus and cerebellar ataxia and in association with gynecologic and breast malignancies. CASE PRESENTATION: This report describes an unusual example of a 33-year-old female patient who developed short-term memory deficits over a 3-month period. An extensive neurological work-up, including a panel of paraneoplastic markers was negative with the exception of a high titer serum Anti-Ri (1:15,3600). A large left ovarian mass was palpated, surgically resected and eventually diagnosed as a mature cystic teratoma. Post-operatively, memory deficits had disappeared within 1 month and serum Anti-Ri titers had decreased significantly to 1:256. An extensive diagnostic work-up for other malignancies was negative. CONCLUSION: Although, Anti-Ri antibodies are typically associated with malignancies, this case illustrates the potential association between benign tumors and this autoantibody.
Primary Dural Spinal Lymphoma Presentation of a Rare Spinal Tumor Case
Authors: Dilber Ayçiçek Çeçen, Necati Tatarlı, Hikmet Turan Süslü, Selçuk Özdoğan, Nagehan Özdemir Barışık
Journal: Case Rep Surg (2015)

Background. Primary spinal dural lymphomas (PSDL) are tumors with characteristic histopathology of a lymphoma, which are completely in the spinal epidural space without any other systemic involvement. Extranodal primary lymphoma involving nervous system prefers thalamus/basal ganglia, periventricular region, cerebellum, eyes, meninges/dura, and cranial nerves or spinal cord. Rare spinal localization with acute spinal cord compression is worth attention. Case Presentation. A 48-year-old male presented with a several-month-long history of upper back pain. Lately, he had numbness and weakness at both lower extremities and was unable to walk for one week. A spinal MRI showed a thoracic lesion with cord compression at T2-T4 levels. The patient underwent surgical decompression, with his final histopathology showing diffuse large B-cell lymphoma. Systemic work-up was negative for nodal disease. Following surgery, he received radiotherapy combined with chemotherapy. He experienced a good outcome after four years. Conclusion. The upper thoracic cord is a rare location for primary spinal lesions/metastases, both of which prefer the lower thoracic and upper lumbar regions. In cases of progressive paraparesis, there should be immediate surgical intervention in the case of denovo disease, followed by combined radiotherapy and chemotherapy procedures.
An unusual case of bilateral anterior uveitis related to moxifloxacin: the first report in Latin America
Authors: Carlos M Rangel, M Margarita Parra, Gabriel Frederick, Alejandro Tello, Clara L Varón
Journal: GMS Ophthalmol Cases (2017)
Keywords: adverse effect, pigment dispersion syndrome, quinolones, uveitis
MeSH terms: Case Reports

Objective: To report a case of bilateral anterior uveitis secondary to oral moxifloxacin. Methods: Case report. Results: A 54-year-old female presented bilateral anterior uveitis following a 10-day course of oral moxifloxacin. She developed a bilateral anterior uveitis associated with pigment dispersion syndrome and iris transillumination. Conclusions: Drug-induced uveitis is one of the causes of anterior uveitis. Uveitis related to fluoroquinolones is a rare entity, there are few cases reported in the literature, this is the first case reported in Latin America.
Treatment of Large and Complicated Scalp Defects with Free Flap Transfer
Authors: Fanfan Chen, Hongbin Ju, Anfei Huang, Yongjun Yi, Yongfu Cao, Wei Xie, Xinliang Wang, Guo Fu
Journal: Biomed Res Int (2020)
MeSH terms: Free Tissue Flaps, Head and Neck Neoplasms / pathology, Head and Neck Neoplasms / surgery, Scalp / pathology, Scalp / surgery, Skin Neoplasms / pathology, Skin Neoplasms / surgery, Case Reports, Adult, Aged, Female, Humans, Male, Middle Aged

Background:
Large scalp defects, especially those complicated by calvarial defects, titanium mesh exposure, or cerebrospinal fluid (CSF) leak, pose a challenge for the neurosurgeon and plastic surgeon. Here, we describe our experience of reconstructing the complex scalp defect with free flap transfer.
Methods:
From October 2012 to September 2017, 8 patients underwent free flap transfer for the reconstruction of the scalp or complicated scalp and calvarial defects. Five patients presented with scalp tumor and the other 3 patients with scalp necrosis or ulceration (2 patients with titanium plate exposure). Seven anterolateral thigh flaps and one radial forearm flap were harvested and employed. The clinical data, including defect characteristics, flap type, complications, and outcomes, were recorded and analyzed.
Results:
Five patients were pathologically diagnosed with malignant tumor, and 3 of them were given further radiotherapy. For the 2 patients with exposure of titanium plate, no titanium plate was removed. For the patient with scalp necrosis after decompressive craniectomy accompanied by CSF leakage, the CSF leak was stopped after reconstruction. The size of the flaps ranged from 3 to 14 cm in width and 4 to 18 cm in length. No flap failure occurred in these cases. From follow-up to the present, no ulceration or necrosis occurred.
Conclusions:
Free flap transfer is an ideal method for the reconstruction of large, complicated scalp defects with a one-stage operation. The anterolateral thigh flap is favored because of its durability, adjustability, water tightness, and infection prevention.
Acute-onset chronic inflammatory demyelinating polyneuropathy complicating SARS-CoV-2 infection and Ad26.COV2.S vaccination: report of two cases
Authors: Aggeliki Fotiadou, Dimitrios Tsiptsios, Stella Karatzetzou, Sofia Kitmeridou, Ioannis Iliopoulos
Journal: Egypt J Neurol Psychiatr Neurosurg (2022)
Keywords: covid-19, chronic inflammatory demyelinating polyneuropathy, guillain–barre syndrome, sars-cov-2
MeSH terms: Case Reports

Background:
The spectrum of reported neurological sequelae associated with SARS-CoV-2 is continuously expanding, immune mediated neuropathies like Guillain-Barre syndrome (GBS) and exacerbations of preexisting chronic inflammatory demyelinating polyneuropathy (CIDP) being among them. However, respective cases of acute onset CIDP (A-CIDP) are rare.
Case presentation:
We hereby report two cases of A-CIDP after COVID-19 infection and Ad26.COV2.S vaccination that presented with flaccid paraparesis and acroparesthesias (Case presentation 1; female, 52) and facial diplegia accompanied by acroparesthesias (Case presentation 2; male, 62), respectively. In both instances clinical, neurophysiological and CSF findings were indicative of acute inflammatory demyelinating polyneuropathy, thus both patients were initially treated with intravenous immunoglobulins resulting in clinical improvement. Nevertheless, the first patient relapsed 5 weeks after the initial episode, thus was diagnosed with GBS with treatment related fluctuations (GBS-TRF) and treated successfully with seven plasma exchange (PLEX) sessions. However, 11 weeks from symptom onset she relapsed again. Taking into account that the second relapse occurred more than 8 weeks after the first episode, the potential diagnosis of A-CIDP was reached and oral dexamethasone 40 mg/d for 4 consecutive days every 4 weeks was administered. With regards to the second patient, he relapsed > 8 weeks after the initial episode, thus was also diagnosed with A-CIDP and treated with 7 PLEX sessions followed by similar to the aforementioned corticosteroid therapy. On 2 month follow-up both patients exhibited remarkable clinical improvement.
Conclusions:
Close surveillance of patients presenting with immune neuropathies in the context of SARS-CoV-2 infection or immunization is crucial for timely implementation of appropriate treatment. Prompt A-CIDP distinction from GBS-TRF is of paramount importance as treatment approach and prognosis between these two entities differ.
Supplementary information:
The online version contains supplementary material available at 10.1186/s41983-022-00515-4.
Congenital vaginal obstruction in a female with Cornelia de Lange syndrome: A case report
Authors: Yiding Shen, Dongyan Zhao, Long Sun, Xiuzhen Yang, Xiang Yan
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: cornelia de lange syndrome (cdls), case report, urinary tract infection (uti), vaginal obstruction, vesicoureteral reflux (vur)
MeSH terms: De Lange Syndrome / complications, De Lange Syndrome / diagnosis, De Lange Syndrome / genetics, Case Reports, Research Support, Non-U.S. Gov't, Cell Cycle Proteins / genetics, Child, Preschool, Female, Humans, Cell Cycle Proteins, NIPBL protein, human

Cornelia de Lange syndrome (CdLS) is a rare genetic disease involving multiorgan systems that varies in clinical manifestations. Female genital abnormalities in patients with CdLS are rarely reported, and current guidelines for CdLS contain little information related to female genital abnormalities. We report a case of classic CdLS with an NIPBL gene pathogenic variant in a 4.5-year-old girl who experienced recurrent urinary tract infections (UTIs) with vesical tenesmus. Urogenital physical and imaging examinations revealed external vaginal orifice obstruction and bilateral vesicoureteral reflux (VUR). Vaginal diaphragm-like tissue resection and vaginal orifice plasty were performed on this patient. The symptoms of urination disorders and recurrent UTIs, as well as VUR grading, improved after relieving the vaginal obstruction during the operation. For female CdLS patients, especially those with VUR, it is necessary to check for genital abnormalities and perform timely treatment, which is of great significance in improving urination disorder symptoms, reducing resistance during voiding, decreasing the occurrence of secondary VUR, and controlling recurrent UTIs.
Autoimmune thyroiditis associated with neuromyelitis optica (NMO)
Authors: Sreenivasa Rao Sudulagunta, Mahesh Babu Sodalagunta, Hadi Khorram, Mona Sepehrar, Jayadevappa Gonivada, Zahra Noroozpour, Nagendra Prasad
Journal: Ger Med Sci (2015)
Keywords: igg, autoimmune thyroiditis, neuromyelitis optica (nmo), optic neuritis, transverse myelitis
MeSH terms: Diagnostic Errors / adverse effects, Neuromyelitis Optica / complications, Thyroiditis, Autoimmune / complications, Case Reports, Delayed Diagnosis / adverse effects, Disease Progression, Female, Humans, Middle Aged, Neuromyelitis Optica / diagnosis, Thyroiditis, Autoimmune / diagnosis

Neuromyelitis optica (NMO or Devic's syndrome) is a rare relapsing demyelinating disease of the central nervous system (CNS) that mainly affects the spinal cord and optic nerves and shares many clinical and radiological features with multiple sclerosis. The association of NMO with other autoimmune diseases was reported, but very few reports described association with autoimmune thyroid disease. Early differentiation between NMO and multiple sclerosis is very important as the natural course and treatment regimens differ significantly. We report a case of a 50-year-old woman who was admitted initially with vomiting, hiccups and paraesthesias but was not diagnosed with NMO and presented with a severe progression of the disease. The patient was also diagnosed to have autoimmune thyroiditis with lymphocytic infiltration of the thyroid which progressed from hyperthyroidism to hypothyroidism. NMO diagnosis was established with seropositivity for NMO-IgG and MRI showing longitudinally extensive spinal cord lesions (3 or more spinal segments). In spite of treatment, the response was poor due to lack of early diagnosis and aggressive immunosuppressant therapy.
Bilateral primary hyperplastic persistent vitreous: report of two cases
Authors: Neha Singh, Siddharth Agrawal, Pallavi Mishra
Journal: GMS Ophthalmol Cases (2020)
Keywords: b-scan, phpv, peters’ anomaly, leucocoria
MeSH terms: Case Reports

Primary hyperplastic persistent vitreous (PHPV) or persistent fetal vasculature is a rare clinical entity that presents with leucocoria, microphthalmos, and cataract. It is mostly unilateral. Here we present a report of two cases of bilateral PHPV. One of the patients had associated Peters' anomaly. The entity closely mimics retinoblastoma and should be kept as a differential diagnosis of bilateral leucocoria. Examination under anesthesia, ultrasound B-scan, and aqueous lactate dehydrogenase levels helped us reach the diagnosis and differentiate it from the more serious entity retinoblastoma.
HIV infection and stroke in the Young in Abuja, Nigeria: a case series
Authors: Henry Chijioke Onyegbutulem, Dilli Dogo, Aminu Mai, Theresa Chioma Obidike, Chinazo Sandra Ogbu-Eze, Amina Shehu, Ene Ebele Chidiebere, Charles Ezeude
Journal: Pan Afr Med J (2022)
Keywords: hiv-positive, nigeria, stroke in the young
MeSH terms: HIV Infections / complications, HIV Infections / diagnosis, HIV Infections / epidemiology, Stroke / epidemiology, Stroke / etiology, Case Reports, Adolescent, Adult, Female, Hospitalization, Humans, Male, Nigeria / epidemiology, Risk Factors

Stroke is a major cause of disability and mortality among the Nigerian general population and thought to be commoner after the fifth decade of life and usually driven by conventional risk factors which are mainly cardio metabolic. However, with the youthful population in a city such as Abuja, stroke could be a mode of presentation of HIV in young people who are also more sexually active. Methods. This is a case series, reporting four cases of HIV positive young Nigerians with stroke. Patients´ data were retrieved from ward admissions records. The patients here had their socio-demographic data taken. They had presented with documented varied clinical features including those suggestive of stroke, after which they had HIV screening done which returned positive. One thousand four hundred and eighty-seven (1487) patients, were admitted in the medical ward, over a three-year period. Female to male ratio of 1:1 in the HIV-positive group, with an age range of 32 to 42 years and an average age of 37.5 years. Stroke constituted 5.7% of all admissions, with stroke in the young accounting for 1.2%. Of all stroke cases, stroke in the young constituted 21.43%, with those who were HIV positive accounting for 4.8%. Young people with stroke should be offered an HIV screening test.