OpenMed/multicare-articles huggingface dataset:
Treatment of children and adolescents with avoidant/restrictive food intake disorder: a case series examining the feasibility of family therapy and adjunctive treatments
Authors: Wendy Spettigue, Mark L Norris, Alexandre Santos, Nicole Obeid
Journal: J Eat Disord (2018)
Keywords: avoidant/restrictive food intake disorder, case series, family therapy, pharmacotherapy
MeSH terms: Case Reports

Background:
To date, little research has examined the effectiveness of either modified Family-Based Therapy or psychopharmacological treatments for patients diagnosed with avoidant/restrictive food intake disorder (ARFID), and there is little evidence to guide clinicians treating children and adolescents with ARFID. This case series describes the clinical presentations, treatments and outcomes of six patient diagnosed with ARFID who were treated sequentially by a child psychiatrist and adolescent medicine physician in a hospital-based eating disorder program.
Case presentations:
Five out of six cases were female and median age of patients at assessment was 12.9 (SD = 1.13) years. On average, patients' percentage of treatment goal weight was 80.5% at initial assessment (SD = 8.56) and 81.9% (SD = 7.08) when family therapy began. Cases 1, 2 and 3 were admitted to a specialized inpatient unit at assessment due to medical instability (2) or failed outpatient treatment (1), and all six cases presented with severe co-morbid anxiety. All patients were treated using a combination of medical monitoring, family therapy, medication (including olanzapine, fluoxetine and in two cases cyproheptadine), and cognitive behavioural therapy. At treatment termination, all six patients had achieved their goal weight.
Conclusion:
These cases illustrate the complex ways in which young patients with ARFID can present, the illness' effect on development and mental health, and the positive outcomes associated with weight gain and concurrent treatment for co-morbid anxiety disorders.
Tuberous Sclerosis Complex With Multiple Organ Tumors: Case Report and Literature Review
Authors: Xinhe Zhang, Xinping Zhong, Xuyong Lin, Xuedan Li, Haoyu Tian, Bing Chang, Ying Wang, Jing Tong, Ningning Wang, Dan Li, Xiuli Jin, Die Huang, Yanmeng Wang, Huipeng Cui, Lin Guan, Yiling Li
Journal: Front Oncol (2022)
Keywords: liver perivascular epithelioid tumors, pancreatic neuroendocrine neoplasms, renal angiomyolipoma, splenic hamartoma, tuberous sclerosis complex
MeSH terms: Review

Pancreatic neuroendocrine neoplasms (PNEN) are tumors that originate from neuroendocrine cells. Only about 1% patients are related to mutation of tuberous sclerosis complex gene. Here, we reported a rare case with involvement of multiple organs and space-occupying lesions. Initially, the patient was thought to have metastasis of a pancreatic tumor. However, the patient was diagnosed as pancreatic neuroendocrine tumors, liver perivascular epithelioid tumors, splenic hamartoma, and renal angiomyolipoma by pathological examination after surgery. We performed genetic mutation detection to identify that tuberous sclerosis complex 2 gene presented with a heterozygous variant. Tuberous sclerosis often presents with widespread tumors, but it is less common to present with pancreatic neuroendocrine tumors and liver perivascular tumors as highlighted in the case. So we analyzed the relationship between TSC gene mutations and related tumors. And we also reviewed the current molecular mechanisms and treatments for tuberous sclerosis complex.
Case report: PSMA PET/CT addresses the correct diagnosis in a patient with metastatic prostate cancer despite negative core biopsies and mpMRI. A diagnostic challenge
Authors: Luigia Vetrone, Giulia Cuzzani, Riccardo Mei, Lucia Zanoni, Alessandro Bertaccini, Lorenzo Bianchi, Paolo Castellucci, Caterina Gaudiano, Alberta Cappelli, Francesca Giunchi, Stefano Fanti
Journal: Front Oncol (2023)
Keywords: [68ga]ga-psma-pet/ct, metastatic lymph node, mini-invasive biopsy, prostate cancer, staging
MeSH terms: Case Reports

This is a case of [68 Ga]Ga-Prostate-specific membrane antigen (PSMA)-11 PET/CT in a 73-years old patient presenting high Prostate Specific Antigen (PSA) levels despite both multi-parametric magnetic resonance imaging (mpMRI) and 12-core saturation biopsy negative for prostate cancer (Pca). This is a highly interesting case because, despite the advanced metastatic spread at initial presentation as showed by [68Ga]Ga-PSMA-PET/CT, the primary Pca was detected by none of the diagnostic techniques (12 random sample biopsy, mpMRI, PSMA PET/CT). However, [68Ga]Ga-PSMA-PET/CT showed a suspicious axillary lesion suitable for biopsy, which finally resulted as Pca metastasis. This case report is therefore a brilliant example of how [68Ga]Ga-PSMA-PET/CT optimized patient's management.
Posterior Reversible Encephalopathy Syndrome Secondary to CSF Leak and Intracranial Hypotension: A Case Report and Literature Review
Authors: Tariq Hammad, Alison DeDent, Rami Algahtani, Yaseen Alastal, Lawrence Elmer, Azedine Medhkour, Fadi Safi, Ragheb Assaly
Journal: Case Rep Neurol Med (2015)

Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical neuroradiological condition characterized by insidious onset of neurological symptoms associated with radiological findings indicating posterior leukoencephalopathy. PRES secondary to cerebrospinal fluid (CSF) leak leading to intracranial hypotension is not well recognized etiology of this condition. Herein, we report a case of PRES that occurred in the setting of CSF leak due to inadvertent dural puncture. Patient underwent suturing of the dural defect. Subsequently, his symptoms resolved and a repeated brain MRI showed resolution of brain lesions. The pathophysiology and mechanistic model for developing PRES in the setting of intracranial hypotension were discussed. We further highlighted the importance of tight blood pressure control in patients with CSF leak and suspected intracranial hypotension because they are more vulnerable to develop PRES with normal or slightly elevated bleed pressure values.
Concealed enterovesical fistula associated with forgotten intra-abdominal haemostat and intravesical towel
Authors: Ademola Alabi Popoola, J O Bello, G G Ezeoke, K T Adeshina, A Fadimu
Journal: Case Rep Urol (2014)

Introduction. Enterovesical fistula is rare and is often caused by bowel inflammatory diseases and tumours in the urinary bladder or the intestine with local infiltration of bowel or bladder, respectively. The fistula usually presents with lower urinary tract symptoms, pneumaturia, and faecaluria or with food particles in the urine. Intra-abdominal retained surgical foreign bodies have also been reported as causes. Case Presentation. A case of atypical presentation in a woman with enterovesical fistula following abdominal hysterectomy. Investigations confirmed the presence of surgical towel in the urinary bladder and a pair of artery forceps in the abdomen. The towel was removed at cystoscopy after which she presented with food particles in the urine. She later had laparatomy to remove the haemostat and to repair the fistula. Discussion. A typical presentation of enterovesical fistula delayed the diagnosis and treatment in this patient. Conclusion. Managing patients with recurrent urinary tract infection after abdominal operation should include appropriate imaging of the abdomen with emphasis on pelvic organs. Also, surgical operation should always be given the best shot the first time and strict operation room standards and guidelines should always be followed.
Resolution of acute hydrocephalus and migration of neurocysticercosis cyst with external ventricular drainage
Authors: Abhineet Chowdhary, Taylor J Abel, Patrik Gabikian, Gavin W Britz
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Neurocysticercosis is endemic in the developing world, but is becoming more common in the US due to immigration. A 24-year-old man presented with acute hydrocephalus and headaches, nausea, and vomiting. Head CT revealed a 3rd ventricular cyst and immunological studies were suggestive of neurocysticercosis. EVD placement resulted in migration of the cyst interiorly and superiorly with return of normal CSF flow by MRI and resolution of symptoms. Review of this condition is important given increasing incidence in the United States.
SIMPLE Technique of Laparoscopic Nephrectomy for Ectopic Nonfunctioning Pelvic Kidney Secondary to Pelviureteric Junction Obstruction: A Feasible and Safe Technique
Authors: Santosh Kumar, Kalpesh Mahesh Parmar, Sriharsha Shankaregowda Ajjoor, Nitin Garg, Kumar Jayant, Shrawan Kumar Singh
Journal: Case Rep Urol (2014)

Ectopic kidneys are rare developmental anomalies. Anomalous blood supply of the pelvic ectopic kidneys poses a problem for a minimally invasive surgery. Although laparoscopic nephrectomies have been described for symptomatic nonfunctioning pelvic ectopic kidney, this is the first case report that highlights the safety and feasibility of SIMPLE technique of laparoscopic nephrectomy in a pelvic kidney.
Disseminated Juvenile Xanthogranuloma and Hemophagocytic Lymphohistiocytosis Developed During Treatment of Acute Lymphoblastic Leukemia: Case Report
Authors: Katarzyna Pawińska-Wa Sikowska, Magdalena Cwiklinska, Elzbieta Wyrobek, Walentyna Balwierz, Karolina Bukowska-Strakova, Agnieszka Dluzniewska, Jolanta Gozdzik, Grazyna Drabik, Monika Rygielska, Konrad Stepien, Szymon Skoczen
Journal: Front Oncol (2020)
Keywords: acute lymphoblastic leukemia, case report, hemophagocytic lymphohistiocytosis, juvenile xanthogranuloma, non-langerhans cell histiocytosis
MeSH terms: Case Reports

The association between acute lymphoblastic leukemia (ALL), non-Langerhans cell histiocytosis (non-LCH), and hemophagocytic lymphohistiocytosis (HLH), to the best of our knowledge, has not been published to date. Juvenile xanthogranuloma (JXG), as a type of non-LCH, is usually a benign disease limited to the skin. Systemic involvement is rarely reported. The present case report describes a 15-year-old boy diagnosed with disseminated JXG involving skin and bone marrow concurrent with severe symptoms of HLH during ALL therapy. Examination of immunoglobulin heavy chain genes in B-cell precursor leukemic blasts and histiocytes in the skin and bone marrow revealed identical rearrangements, confirming clonal relationship between both diseases. Implementation of corticosteroids, vinblastine, etoposide, cyclosporine, and tocilizumab resulted in partial skin lesion resolution with no improvement of bone marrow function; therefore, hematopoietic stem cell transplantation (HSCT) was eventually performed. The patient's hematological and general status has improved gradually; however, remarkable recovery of skin lesions was observed after empirical antitubercular therapy. Mycobacterium spp. infection should be considered as a possible secondary HLH trigger. Triple association of ALL, non-LCH, and HLH highlights heterogeneity of histiocytic disorders and possible common origin of dendritic and lymphoid cells.
Case Report: Clinical Analysis of Fulminant Mycoplasma pneumoniae Pneumonia in Children
Authors: Tongqiang Zhang, Chunjiao Han, Wei Guo, Jing Ning, Chunquan Cai, Yongsheng Xu
Journal: Front Pediatr (2021)
Keywords: children, clinical diagnosis, fiberoptic bronchoscopy, fulminant mycoplasma pneumoniae pneumonia, treatment
MeSH terms: Case Reports

Fulminant Mycoplasma pneumoniae pneumonia (FMPP) accounts for 0.5-2% of all MPP cases, which is considered as MPP combined with severe complications such as hypoxemia, acute respiratory distress syndrome, or acute respiratory failure. It primarily affects young adults with no underlying disease. Although some studies have proved the severity of FMPP, the details about clinical diagnosis and treatment of FMPP in children have been rarely reported. In this case study, we described three cases who suffered from FMPP. These children not only developed acute lung injury and multiple organ involvement within 7 days of treatment, but were also found plastic bronchitis by bronchoscopy. Finally, all the patients were treated successfully with azithromycin, glucocorticoid, and bronchoscopy lavage. We conclude that this case study would contribute to raise awareness with respect to FMPP, which may occur at a younger age with faster disease progression and common extrapulmonary manifestations. It also reinforces the importance of early identification and prompt intervention to save life of children and reduces sequelae. Further studies are needed about mechanism of FMPP.
Eculizumab for acute relapse of neuromyelitis optica spectrum disorder: Case report
Authors: Sophie Chatterton, John Douglas Edward Parratt, Karl Ng
Journal: Front Neurol (2022)
Keywords: case report, demyelination, humanized antibody, neuroimmunology, neuromyelitis optica (nmo)
MeSH terms: Case Reports

Introduction:
Eculizumab has been shown to be an effective and typically well-tolerated medication in the treatment of neuromyelitis optica spectrum disorder (NMOSD) in maintaining disease remission in patients who are aquaporin-4 water channel autoantibody (AQP4-IgG) seropositive. The efficacy of eculizumab in an acute relapse of NMOSD however is still under review.
Case:
We describe a 46 year-old female who presented with acute left monocular vision loss on a background of bilateral optic neuritis treated 15 years prior as suspected NMOSD. She had very poor vision from the right eye (6/60). On presentation she was not on any long-term immunosuppressive agents. Her serum was positive for AQP4-IgG and MRI brain and spine demonstrated areas of demyelination in the corpus callosum and thoracic spine. She was treated with high dose intravenous methylprednisolone and underwent plasmapheresis for five consecutive days, but continued to clinically deteriorate with ongoing blindness in her left eye (light perception only). She was subsequently administered eculizumab with weaning oral corticosteroids. Clinically her vision improved to counting fingers and she remains on maintenance eculizumab infusions in the community. At 3 months, there is a steady improvement but still significant loss of central vision from that eye.
Conclusion:
The utility of eculizumab in NMOSD may assist with treating acute episodes. This theoretically accords with the mode of action in inhibiting conversion of C5-C5a/b, perhaps arresting the acute inflammatory process in this disease. Given that disease burden and mortality in NMOSD is almost entirely related to relapses, increased use of eculizumab acutely could potentially aid recovery from an attack in very severe attacks, and therefore minimize immediate stepwise accrual of disability.
Agenesis of the piriformis muscle: A case report with review of literature
Authors: Pankaj Nepal, Syed I Alam, Sadia Sajid, Syeda S Intakhab, Vijayanadh Ojili
Journal: SA J Radiol (2020)
Keywords: mri, agenesis, lower back pain, orthopaedics, piriformis muscle
MeSH terms: Case Reports

Agenesis of the piriformis muscle is an extremely rare occurrence. Knowledge about this anatomic variant is important because of its close proximity with the sciatic nerve and sacral plexus. The piriformis muscle also serves as an important anatomic landmark for image-guided intervention and hip surgery. We report a case of piriformis muscle agenesis in a 28-year-old woman, incidentally detected on magnetic resonance imaging of the lumbosacral spine and pelvis, performed for low back pain.
SHOX Duplication and Tall Stature in a Patient with Xq Deletion and Vascular Disease
Authors: J M Ramirez, F A Rodríguez, M I Echeverría, A L Vargas, A E Calderón, R M Miatello, N F Renna
Journal: Case Rep Genet (2019)
MeSH terms: Case Reports

The anomalies of X chromosome are classified as numerical or structural. Concomitant structural anomalies in this chromosome that associate partial loss of its long arm with duplications in its short arm are uncommon. Only a few cases have been published and in most of them the reported patients present ovarian dysfunction, tall stature, and overdosage of the SHOX gene with locus Xp22.33. Considering these reports, we evaluated the case of a woman with a deletion in the long arm of the X chromosome, premature ovarian failure, tall stature, and multiple arterial vascular disease. With the aim to find a relationship between karyotype and phenotype, we explored associated anomalies in Xp and certified the overdosage of the SHOX gene in this case by MLPA. Also, taking into account the fact that the gene locus of the angiotensin-converting enzyme type 2 (ACE2) is located in Xp, our goal was to investigate the influence of this gene in the development of cardiovascular disease. The detection of the gene product of ACE2 by ELISA was undetectable. We have proposed that cytogenetic anomalies in X chromosome could contribute to decrease this protein synthesis in this gender.
A case report of surgical resection treatment for complete remission after chemotherapy for advanced pancreatic cancer
Authors: Zhongyan Zhang, Hongfeng Lin, Hehe Li, Xin Wang
Journal: Front Oncol (2023)
Keywords: advanced pancreatic cancer, case report, chemotherapy, gemcitabine, nab-paclitaxel (nab-p), surgical resection
MeSH terms: Case Reports

Pancreatic cancer is a common type of cancer that is treated using surgery or chemotherapy. However, for patients who cannot have surgery, the treatment options are limited and have a low success rate. We report a case of a patient with locally advanced pancreatic cancer who was unable to have surgery due to a tumor that had invaded the coeliac axis and portal vein. However, after receiving chemotherapy with gemcitabine plus nab-paclitaxel(GEM-NabP), the patient achieved complete remission, and a PET-CT scan confirmed that the tumor had disappeared. Eventually, the patient underwent radical surgery with distal pancreatectomy with splenectomy, and the treatment was successful. This case is rare, and there are few reports of complete remission after chemotherapy for pancreatic cancer. This article reviews the relevant literature and guides future clinical practice.
The Slower, the Better: Wide Complex Tachycardia Triggered by Flecainide in an Elderly Female
Authors: Ebubechukwu Ezeh, Maddie Perdoncin, Morgan K Moroi, Mohammad Amro, Mohammed Ruzieh, Paul I Okhumale
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Class IC antiarrhythmics are generally considered a safe means of treating many common arrhythmias such as atrial fibrillation (a-fib), atrial flutter (a-flutter), and paroxysmal supraventricular tachycardia (PSVT). Essentially, flecainide works by binding and blocking sodium channels more effectively at higher heart rates. However, this class of drugs is known to exhibit use dependence which could predispose patients to the development of malignant arrhythmias during episodes of tachycardia. In this case, we present a patient who was being treated with flecainide for a-fib who ultimately developed a wide complex tachycardia after her metoprolol was held.
Artery of Percheron in the Differential Diagnosis of Acute Altered Mental Status
Authors: Maria Isabel Pérez Pan Art, Beatriz Sierra Bergua
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Bilateral thalamic infarction is a rare entity (it occurs in 0.6% of ischemic strokes) and can be confused with other vascular etiologies such as basilar syndrome and deep cerebral venous thrombosis, as well as neoplasms, infections, or toxins. It is typically characterized by the triad of altered mental status, vertical gaze paralysis, and memory impairment, although their symptoms can be highly variable. We describe the case of a young man who came to the emergency department presenting diplopia, speech alteration, and decreased level of consciousness with frequent fluctuations. Baseline computerized tomography was normal, and because of the clinical findings, thrombolysis was performed. Subsequently made magnetic resonance showed a bilateral acute thalamic infarction caused by an obstruction of the Percheron artery. Although Percheron syndrome has been previously described in medical journals, our case is an unusual case in which we could perform an acute intravenous thrombolytic treatment. Besides, it is important for emergency physicians to enclose the Percheron syndrome in the differential diagnosis of coma in young people so that emergent treatments such as thrombolysis can be employed.
Adrenal Incidentaloma: Challenges in Diagnosing Adrenal Myelolipoma
Authors: Sreedhar Adapa, Srikanth Naramala, Vijay Gayam, Frank Gavini, Hemant Dhingra, Florette Kimberly Gray Hazard, Narothama Reddy Aeddula, Venu Madhav Konala
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: adrenal incidentaloma, adrenal myelolipomas
MeSH terms: Adrenal Gland Neoplasms / diagnosis, Myelolipoma / diagnosis, Case Reports, Adrenal Gland Neoplasms / complications, Adrenal Gland Neoplasms / diagnostic imaging, Adrenal Glands / diagnostic imaging, Adult, Humans, Hypertension / etiology, Incidental Findings, Male, Myelolipoma / complications, Myelolipoma / diagnostic imaging, Renal Insufficiency / etiology, Tomography, X-Ray Computed, Adrenal incidentaloma

Adrenal myelolipomas (AMLs) are rare benign adrenal tumors, containing adipose and hematopoietic tissue, a result of reticuloendothelial cell metaplasia. Incidence on autopsy has been reported from 0.08% to 0.4%. AMLs are generally considered nonsecretory. The functional aspect of adrenal incidentaloma should be evaluated. In this article, we report a case of a 40-year-old male, who presented with uncontrolled hypertension and renal failure, with imaging revealing an adrenal incidentaloma. He was started on dialysis for acute fluid overload, and workup for pheochromocytoma revealed an elevated serum norepinephrine level of 1181 pg/mL. Free metanephrine and normetanephrine levels were low when checked pre- and post-dialysis. Complete resection of the encapsulated right adrenal mass was performed. Pathology of the adrenal tumor demonstrates an 11.5 × 9.5 × 7.5 cm well-circumscribed, partially encapsulated proliferation of mature adipose tissue with admixed hemopoietic elements consistent with myelolipoma weighing 29.3 g. This case highlights the inclusion of a full metabolic workup for all adrenal incidentalomas, including AML.
Banana in a Condom: An Unusual Cause of Small Bowel Obstruction
Authors: Rosarie A Tudas, Karan Rao, Luis J Garcia, Yashant Aswani
Journal: Cureus (2023)
Keywords: condom ileus, foreign body ingestion in adults, ingested large foreign body, small-bowel obstruction, swallowed foreign body
MeSH terms: Case Reports

An otherwise healthy, 34-year-old man presented to the emergency department with abdominal pain, nausea, and vomiting, which began a day after he ingested a banana-stuffed condom. A contrast-enhanced computed tomography (CT) abdomen and pelvis revealed a dilated small bowel with a transition point, findings consistent with small bowel obstruction. Abdominopelvic ascites was also noted on imaging, which was concerning for bowel distress. He was taken to the operating room for an exploratory laparotomy, which revealed a high-grade obstruction by a foreign body, a banana stuffed in a condom, in the mid-jejunum. An enterotomy was performed to relieve the obstruction. The postoperative course was uneventful, and he was discharged three days later.