OpenMed/multicare-articles huggingface dataset:
The Spectrum of Autoimmune Thyroid Disease in the Short to Medium Term Following Interferon-alpha Therapy for Chronic Hepatitis C
Authors: Huy A Tran, Glenn E M Reeves
Journal: Int J Endocrinol (2009)
MeSH terms: Case Reports

Autoimmune thyroid diseases are common manifestations of hepatitis C infection, exacerbated by interferon-based treatment. However, the occurrence and pattern of thyroid disease in the short/medium term following the completion of IFN-based therapy is relatively unknown and there are very few previous reports regarding the specific spectrum of autoimmune thyroid disease that may follow such therapy. We hereby report 3 cases which demonstrate the range of thyroid diseases that may occur following interferon therapy. The hypothesis advanced is that in the pathogenesis of these conditions there must be both triggering and sustaining mechanisms as thyroid diseases occur well outside the immediate effect window of pegylated interferon. This paper suggests the need to continue thyroid surveillance in IFN-treated HCV patients following the completion of therapy, perhaps for the first 6 months.
Spontaneous regression of bone metastasis from renal cell carcinoma; a case report
Authors: Takahiro Nakajima, Makoto Suzuki, Soichiro Ando, Tomohiko Iida, Akinobu Araki, Takehiko Fujisawa, Hideki Kimura
Journal: BMC Cancer (2006)
MeSH terms: Bone Neoplasms / secondary, Carcinoma, Renal Cell / pathology, Case Reports, Aged, Biopsy, Needle, Bone Neoplasms / pathology, Carcinoma, Renal Cell / surgery, Hemorrhage, Humans, Male, Necrosis, Nephrectomy, Remission, Spontaneous, Tomography, X-Ray Computed

Background:
Spontaneous regression of metastatic renal cell carcinoma is rarely observed.
Case presentation:
Metastatic renal cell carcinoma was identified in a 70-year-old male using computed tomography-guided percutaneous needle biopsy. Two months after the diagnosis, a partial resection of the sternal bone was performed. Pathological examination revealed granulated tissue with bleeding and necrosis but no carcinogenic cells.
Conclusion:
We report a pathologically identified case in which a sternal bone metastasis that was noticed two years after radical nephrectomy regressed completely and spontaneously.
Chagas Cardiomyopathy Presenting as Symptomatic Bradycardia: An Underappreciated Emerging Public Health Problem in the United States
Authors: Richard Jesse Durrance, Tofura Ullah, Zulekha Atif, William Frumkin, Kaushik Doshi
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Chagas cardiomyopathy (CCM) is traditionally considered a disease restricted to areas of endemicity. However, an estimated 300,000 people living in the United States today have CCM, of which its majority is undiagnosed. We present a case of CCM acquired in an endemic area and detected in its early stage. A 42-year-old El Salvadoran woman presented with recurrent chest pain and syncopal episodes. Significant family history includes a sister in El Salvador who also began suffering similar episodes. Physical exam and ancillary studies were only remarkable for sinus bradycardia. The patient was diagnosed with symptomatic sinus bradycardia and a pacemaker was placed. During her hospital course, Chagas serology was ordered given the epidemiological context from which she came. With no other identifiable cause, CCM was the suspected etiology. This case highlights the underrecognized presence of Chagas in the United States and the economic and public health importance of its consideration in the etiological differential diagnosis of electrocardiographic changes among Latin American immigrants. While the United States is not considered an endemic area for Chagas disease, the influx of Latin American immigrants has created a new challenge to identify at-risk populations, diagnose suspected cases, and provide adequate treatment for this disease.
Graft versus host disease and microchimerism in a JAK3 deficient patient
Authors: Zahra Shahbazi, Nima Parvaneh, Shirin Shahbazi, Hamzeh Rahimi, Mohammad Hamid, Davoud Shahbazi, Samaneh Delavari, Hassan Abolhassani, Asghar Aghamohammadi, Reza Mahdian
Journal: Allergy Asthma Clin Immunol (2019)
Keywords: graft versus host disease, jak3 deficiency, microchimerism, severe combined immunodeficiency, short tandem repeat
MeSH terms: Case Reports

Background:
The lymphohematopoietic cells originating from feto-maternal trafficking during pregnancy may cause microchimerism and lead to materno-fetal graft versus host disease (GVHD) in severe combined immunodeficiency (SCID) patients. However, definitive diagnosis between GVHD and Omenn's syndrome is often difficult based on clinical and immunological phenotypes particularly in the patients with hypomorphic mutations.
Case presentation:
A 3-year-old girl with a history of erythroderma and immunodeficiency was studied. The whole exome sequencing method was used to find the disease-causing variants, and T-A cloning and Quantitative Florescence Polymerase Chain Reaction (QF-PCR) methods were utilized to detect the presence of mosaicism or microchimerism. We identified a homozygous missense Janus Kinase 3 mutation (JAK3, c.2324G>A, p.R775H) as a new disease-causing variant in the patient, and the presence of microchimerism with maternal origin was proven as an underlying cause of her clinical presentation.
Conclusion:
The findings highlighted the importance of appropriate diagnostic approach in GVHD cases with hypomorphic JAK3 mutations. When analyzing the results of the next generation sequencing, the possibility of microchimerism should be considered based on the context of the disease.
Fulminant Hepatic Failure in the Course of an Outpatient Anesthetic Procedure: Sevoflurane among Other High-Risk Factors
Authors: Céline Cheron, Perrine Hoet, Nathalie Renard, Geoffroy Vanderweerden, Cristina Miscu, Mina Komuta, Pierre-François Laterre, Philippe Hantson
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

A 20-year-old man underwent an outpatient general anesthetic procedure with sevoflurane for the correction of a bilateral gynecomastia. The patient had been first exposed to sevoflurane two years before, without any complication. He presented an overweight with a body mass index (BMI) of 31.4 kg/m2 and had an episode of "binge" drinking a few days before anesthesia. He became icteric from postoperative day 9, and after the worsening of liver function tests, the liver biopsy revealed centrilobular necrosis. The patient became encephalopathic and required urgent liver transplantation on postoperative day 30. The possibility of a sevoflurane-related fulminant hepatic failure is discussed.
A Rare Case of Extramedullary T/Myeloid Mixed Phenotype Acute Leukemia with t(1;5)(q23;q33)
Authors: Ahmad Monabati, Akbar Safaei, Sadat Nouri, Moeinadin Safavi, Freidoon Solhjoo
Journal: Case Rep Pathol (2016)
MeSH terms: Case Reports

Mixed phenotype acute leukemia (MPAL) is a rare neoplasm which accounts for 2-5% of all leukemias and it is classified under heading of acute leukemia of ambiguous lineage in 2008 WHO classification. This patient was a 61-year-old man who presented with malaise and weakness. In physical examination there was cervical and axillary lymphadenopathy. Paraclinical evaluation revealed anemia (Hb = 10.3 g/dL, MCV = 108 fl). Histologic sections of the axillary lymph node revealed leukemic involvement with two discrete populations of cells in immunohistochemistry. One population was immunoreactive for MPO and the other showed immunostaining for CD3, CD99, and tdt. Differential count of bone marrow cells in marrow aspirate had 6% blast. Karyotype study on bone marrow culture depicted an interesting finding which was t(1;5)(q23;q33). An extensive search on literature was done for the same genetic change. A similar translocation has been mentioned in literature for other hematologic malignancies but not for same neoplasm; anyhow this translocation was an imbalanced one and led to der(5)t(1;5)(q12-25;q13-q35).
Deep sequencing reveals persistence of cell-associated mumps vaccine virus in chronic encephalitis
Authors: Sofia Morfopoulou, Edward T Mee, Sarah M Connaughton, Julianne R Brown, Kimberly Gilmour, W K 'Kling' Chong, W Paul Duprex, Deborah Ferguson, Mike Hubank, Ciaran Hutchinson, Marios Kaliakatsos, Stephen McQuaid, Simon Paine, Vincent Plagnol, Christopher Ruis, Alex Virasami, Hong Zhan, Thomas S Jacques, Silke Schepelmann, Waseem Qasim, Judith Breuer
Journal: Acta Neuropathol (2017)
MeSH terms: Brain / virology, Encephalitis, Viral / virology, Mumps Vaccine / adverse effects, Mumps virus / isolation & purification, Case Reports, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural, Biopsy, Brain / diagnostic imaging, Brain / pathology, Chronic Disease, Encephalitis, Viral / complications, Encephalitis, Viral / diagnostic imaging, Encephalitis, Viral / therapy, Fatal Outcome, High-Throughput Nucleotide Sequencing, Humans, Infant, Male, Mumps virus / genetics, Severe Combined Immunodeficiency / complications, Severe Combined Immunodeficiency / diagnostic imaging, Severe Combined Immunodeficiency / therapy, Mumps Vaccine

Routine childhood vaccination against measles, mumps and rubella has virtually abolished virus-related morbidity and mortality. Notwithstanding this, we describe here devastating neurological complications associated with the detection of live-attenuated mumps virus Jeryl Lynn (MuVJL5) in the brain of a child who had undergone successful allogeneic transplantation for severe combined immunodeficiency (SCID). This is the first confirmed report of MuVJL5 associated with chronic encephalitis and highlights the need to exclude immunodeficient individuals from immunisation with live-attenuated vaccines. The diagnosis was only possible by deep sequencing of the brain biopsy. Sequence comparison of the vaccine batch to the MuVJL5 isolated from brain identified biased hypermutation, particularly in the matrix gene, similar to those found in measles from cases of SSPE. The findings provide unique insights into the pathogenesis of paramyxovirus brain infections.
Complex Perineal Trauma with Anorectal Avulsion
Authors: Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran
Journal: Case Rep Surg (2016)

Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed. After 12 hours in the Intensive Care Unit, the abdominal ultrasonography revealed free peritoneal fluid. We decided emergency laparotomy, and massive hemoperitoneum due to intraperitoneal rupture of pelvic hematoma was confirmed. Pelvic packing controlled the ongoing diffuse bleeding. After 48 hours, the relaparotomy with packs removal and loop sigmoid colostomy was performed. The postoperative course was progressive favorable, with discharge after 70 days and colostomy closure after four months, with no long-term complications. Conclusions. Severe perineal injuries are associated with significant morbidity and mortality. Their management in high volume centers, with experience in colorectal and trauma surgery, allocating significant human and material resources, decreases the early mortality and long-term complications, offering the best quality of life for patients.
Case report: treatment of severe subcutaneous emphysema with a negative pressure wound therapy dressing
Authors: Christopher M Sciortino, Gerhard S Mundinger, David P Kuwayama, Stephen C Yang, Marc S Sussman
Journal: Eplasty (2009)

Objective:
This article describes a patient who developed severe subcutaneous emphysema and a persistent air leak after several attempts at needle thoracostomy for what was thought to be a tension pneumothorax. Subcutaneous emphysema was effectively treated with a topical negative pressure wound therapy dressing applied to a typical subfacial "blowhole" incision. This article aims to describe and contextualize the use of negative pressure wound therapy within the existing treatment options for subcutaneous emphysema.
Methods:
A case report of the clinical course and technique was drafted, and the relevant literature in PubMed was reviewed.
Results:
The level of subcutaneous emphysema decreased significantly within 48 hours of negative pressure wound therapy as confirmed with physical examination and computed tomography scans. Negative pressure wound therapy for subcutaneous emphysema has not been previously described in the literature.
Conclusions:
Negative pressure wound therapy applied over subfascial incisions is a novel technique that effectively and rapidly controlled massive subcutaneous emphysema and persistent air leak. This technique may be efficacious in other cases of subcutaneous emphysema.
Case Report: Severe hypernatremia from psychogenic adipsia
Authors: Sarah Manning, Rehan Shaffie, Shitij Arora
Journal: F1000Res (2017)
Keywords: adipsia, altered mental status, hypernatremia, infection, osmolality, osmotic demyelination, paranoia, stroke

Hypernatremia is a common emergency room presentation and carries high mortality. We describe a case of a 56-year-old male patient with who presents with refusal to drink water for several weeks leading to the admission. He was diagnosed with psychogenic adipsia and was treated successfully with fluids, mirtazapine and clonazepam.
A rare presentation of soft tissue chondroma: A case report
Authors: Fahmi H Kakamad, Abdulwahid M Salih, Marwan N Hassan, Shvan H Mohammed, Ari M Abdullah
Journal: Int J Surg Case Rep (2020)
Keywords: benign, extraskeletal chondroma, soft tissue chondroma
MeSH terms: Case Reports

Introduction:
Extraskeletal chondroma (ESC) is a benign, slow-growing cartilaginous tumor arising from tenosynovial sheaths. The aim of this article is to report and discuss a case of ESC affecting upper thigh.
Case report:
A 41-year-old male presented with a swelling in the medial aspect of the left thigh. On clinical examination, there was a 10 × 15 cm non-tender, hard, ill-defined mass in the medial aspect of the left upper thigh. Ultrasound showed a large well defined thick wall mass, located inside gracillis or adductor muscles. Magnetic resonance imaging showed a large well defined mass involving the adductor compartment of the upper thigh. The patient underwent wide local excision under spinal anesthesia. The histopathological examination of the specimen revealed binucleated chondrocytes with dots of calcification confirming ESC.
Discussion:
There are many theories trying to explain the origin of ESC, as some authors think that it originates from the pluripotent cells of the tenosynovium, while others state that it may be derived from metaplasia of the tendon sheath. In this case, the lesion was completely surrounded by muscle fibers away from the nearby tendons.
Conclusion:
Extraskeletal chondroma is a rare benign lesion, although mostly affect the upper extremities, it can be found anywhere in the body, histopathological examination of the specimen is the diagnostic method of choice.
Pulmonary Artery and Pulmonic Valve Vegetations in a Young Pregnant Filipino with Patent Ductus Arteriosus
Authors: Valerie R Ramiro, Jezreel L Taquiso, Stephanie Martha O Obillos, Charlene F Agustin, Jose Donato A Magno, Eric Oliver D Sison
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Background:
Infective endocarditis (IE) involving the pulmonic valve and/or the pulmonary artery is rare. An unrepaired patent ductus arteriosus (PDA) is a risk factor for IE. A previous IE is also a risk factor that predisposes to IE recurrence. Discriminating between IE recurrence and a persistence of a vegetation from a previously treated IE can be difficult. We present the case of a 19-year-old primigravid with an unrepaired PDA and a history of IE treated 7 years prior, with positive blood cultures and vegetations on the pulmonic valve and pulmonary artery seen on transthoracic echocardiogram (TTE).
Methods and results:
On TTE, a small-sized PDA with a Qp : Qs of 1.18 and vegetations on the pulmonic valve and pulmonary artery were documented. Despite the paucity of symptoms, she was empirically treated as culture-negative IE and given 2 weeks of ceftriaxone. Repeat TTE done after 2 weeks only showed a slight decrease in the vegetation size. Due to the paucity of symptoms of infection, lack of growth of the vegetation, and absence of embolic events, the vegetations were deemed to be persistent remnants from the previous IE rather than a recurrent IE. She was advised surgical PDA closure and harvest of vegetations after delivery, but the patient did not consent. The rest of her perinatal course was uneventful.
Conclusion:
Persistence of vegetations despite successful medical treatment occurs in some cases and has not been reported to be associated with increased morbidity. Therefore, a follow-up of IE after treatment should be guided by the clinical course and response to therapy as well as the echocardiographic morphology of vegetations over time.
Acquired thrombotic thrombocytopenic purpura after AstraZeneca vaccine: A case report
Authors: Fatemeh Yaghoubi, Davood Dalil
Journal: Caspian J Intern Med (2022)
Keywords: astrazeneca, covid-19, ttp, thrombocytopenia, vaccines
MeSH terms: Case Reports

Background:
Rare cases of acquired thrombotic thrombocytopenic purpura (aTTP) have been reported since the administration of the COVID-19 vaccination. Based on our information, the present study provides the first case report of aTTP developed after the COVID-19 vaccination in Iran.
Case presentation:
A 22-year-old Iranian woman presented with symptoms of ataxia, dysphasia, paresthesia, and acute numbness of her left upper limb four weeks after the AstraZeneca COVID-19 vaccination. Laboratory data suggested hemolytic anemia and thrombocytopenia. Also, schistocytes were noted on her peripheral blood smear. Acquired thrombotic thrombocytopenic purpura (aTTP) was diagnosed in accordance with clinical manifestations along with initial blood test results and was confirmed later through findings of ADAMTS-13 low level activity and the ADAMTS-13 positive inhibitor. She underwent 22 sessions of plasma exchange, receiving corticosteroid and rituximab. Finally, the treatment was successful.
Conclusion:
Despite the presence of rare complications such as aTTP, vaccination is one of the best ways to prevent COVID-19 disease. The present case report describes the potential, but unproven, role of the AstraZeneca COVID-19 vaccine in aTTP pathogenesis. Vaccine-associated aTTP can be successfully treated with plasma exchange, corticosteroids, and rituximab.
Acral cutaneous neural angiomatous hamartoma: a variant of palmar cutaneous hamartoma?
Authors: Nebojsa Arsenovic, Anuradha Sheth
Journal: Case Rep Dermatol Med (2012)

Hamartomas are benign malformations composed of tissue elements normally found at that site, but which are growing in a disorganized fashion. Cutaneous hamartomas containing only neural and/or neurovascular elements are very rare, with very few case reports in the literature. Herein we describe a case of congenital neural angiomatous hamartoma of the skin.
A rare case of basilar artery dissection
Authors: Sahibjot Bhatia, Nimrit Gahoonia, Jeffrey Stenger, Forshing Lui
Journal: AIMS Neurosci (2023)
Keywords: anticoagulation, antiplatelet, basilar artery dissection, exercise-related headache, headache
MeSH terms: Case Reports

This case describes a 30-year-old Hispanic male who presented with a significant headache that started after a period of weightlifting and squatting. The patient was diagnosed with a basilar artery dissection. His only complaint was a headache that was exacerbated with exertion and sexual activity; there were no neurologic deficits. The diagnosis of basilar artery dissection was established and supported by findings on the CT angiogram of his head and neck. Basilar artery dissections are rarely seen, as they are likely underrecognized due to their varying clinical presentations; however, it is important to consider these phenomena due to the risk of progression and high morbidity rates.
Combined Rothia dentocariosa and Streptococcus viridans Corneal Ulcer in an Immunocompromised Patient
Authors: Jamie Dietze, Thomas Mauger
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Keratitis is a very common condition seen by ophthalmologists. However, many factors can complicate the treatment of this depending on the causative organism and other patient comorbid conditions. The objective of this clinical case report is to highlight the treatment of keratitis caused by Rothia dentocariosa. It also looks at the unique considerations in keratitis presentations for patients immunocompromised by chemotherapy agents. Our patient is a 58 yo female undergoing chemotherapy with folinic acid, fluorouracil, irinotecan, and panitumumab who presented with several days of a red, painful right eye with mucous discharge. Cultures were positive for Rothia dentocariosa and Streptococcus viridans. The patient ultimately underwent a conjunctival flap procedure as medical therapy with proper oral and topical antibiotics failed to resolve keratitis. This case is unique as previously, only a couple of cases of keratitis caused by Rothia dentocariosa have been reported and none of those patients were immunocompromised nor failed antibiotic therapy.
Anti-K1 (Kell) Antibody Expressed in Maternal Breastmilk: A Case Report of a Neonate with Multiple Intrauterine Transfusions and Postnatal Exposure to Kell Antibody in Maternal Breastmilk
Authors: Patrick DeMoss, Mohamed Asfour, Kelly Hersey
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Hemolytic disease of the fetus and newborn is a common consideration in newborn medicine, especially among the jaundiced. Maternal breastmilk provides numerous benefits to the infant, including nutrition and immunologic factors. Here, we present an infant who received three intrauterine transfusions for anemia secondary to anti-K1 (Kell), anti-C, and anti-e antibodies and whose maternal breastmilk tested positive for anti-Kell antibodies. The infant required another transfusion at 4 weeks of life for anemia. We review the pathophysiology of anti-Kell antibodies, the immunology of breast milk, and the intersection of these two topics.
Mouthwash with Active Oxygen (blue®m) Reduces Postoperative Inflammation and Pain
Authors: Bruna Marca Mattei, Soraia A W Imanishi, Grasieli de Oliveira Ramos, Paloma Santos de Campos, Suyany Gabriely Weiss, Tatiana Miranda Deliberador
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

The aim of this case series was to evaluate the effects of blue®m mouthwash on oral surgical wounds. Eleven patients underwent bilateral preprosthetic surgery and were instructed to apply the product only to the right side of the surgery. In this way, the right side corresponds to the test side and the left side (place without applying any type of solution) to the control side. After seven days of using the product (3 times a day), the following parameters were evaluated by means of a visual analogue scale: pain, changes in taste, and acceptance by the patient. Then, the level of tissue inflammation was assessed, by the number of pixels, using ImageJ® software. The main results show that the blue®m mouthwash was widely accepted by patients, reducing their pain. The number of inflammation pixels was lower on the test side (p < 0.05), indicating improved healing. It is suggested that blue®m mouthwash positively influences tissue healing reducing pain and the postsurgical inflammatory process; however, randomized clinical trials should be done to prove this clinical observation.