OpenMed/multicare-articles huggingface dataset:
Case Report: Combination Therapy With PD-1 Blockade for Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation Resulted in Fatal GVHD
Authors: Sun Yao, Chen Jianlin, Qiao Zhuoqing, Li Yuhang, Hu Jiangwei, Hu Guoliang, Ning Hongmei, Zhang Bin, Hu Liangding
Journal: Front Immunol (2021)
Keywords: gvhd, acute myeloid leukemia, hypomethylating agents, immune checkpoint blockade, post-transplantation relapse
MeSH terms: Antineoplastic Combined Chemotherapy Protocols / adverse effects, Graft vs Host Disease / etiology, Leukemia, Myeloid, Acute / therapy, Case Reports, Research Support, Non-U.S. Gov't, Antibodies, Monoclonal, Humanized / adverse effects, Azacitidine / adverse effects, Combined Modality Therapy, Hematopoietic Stem Cell Transplantation / adverse effects, Humans, Lymphoma, Follicular / drug therapy, Male, Middle Aged, Myelodysplastic Syndromes / etiology, Transplantation, Homologous, Antibodies, Monoclonal, Humanized, tislelizumab, Azacitidine

Background: Azacitidine is commonly used in the treatment of relapsed acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT), but the effectiveness of this monotherapy is still very low. A possible mechanism of resistance to hypomethylating agents (HMAs) is the upregulation of the expression of inhibitory checkpoint receptors and their ligands, making the combination of HMAs and immune checkpoint blockade therapy a rational approach. Although the safety of anti-programmed cell death protein (PD)-1 antibodies for patients with post-allo-HSCT remains a complicated issue, the preliminary clinical result of combining azacitidine with anti-PD-1 antibodies is encouraging; however, the safety and efficacy of this approach need further investigation. Case Presentation: We reported a case of treated secondary (ts)-AML in a patient who received tislelizumab (an anti-PD-1 antibody) in combination with azacitidine. The patient relapsed after allo-HSCT and was previously exposed to HMAs-based therapy. The patient received tislelizumab for compassionate use. After the combination treatment, the patient achieved complete remission with incomplete hematologic recovery, negative minimal residual disease (MRD) by flow cytometry (FCM), and negative Wilms' tumor protein 1 (WT1). However, the patient successively developed serious immune-related adverse events (irAEs) and graft vs. host disease (GVHD) and eventually died from complications of GVHD. Conclusion: To our knowledge, this is the first case to report the combined use of tislelizumab and azacitidine to treat relapsed AML posttransplantation. This report highlights the safety concerns of using an anti-PD-1 antibody in combination with azacitidine after allo-HSCT, especially the risk of GVHD, and provides a basis for future studies.
Multifocal brain abscesses caused by invasive Streptococcus intermedia: A case report
Authors: Lin Yao, Sansong Chen, Zuan Yu, Tao Yu
Journal: Front Neurol (2022)
Keywords: streptococcus intermedia, case report, cerebrospinal fluid, meta-genomic next-generation sequencing, multiple brain abscesses
MeSH terms: Case Reports

Multifocal brain abscesses caused by invasive Streptococcus intermedia are relatively rare. Here, we present a 67-year-old male was admitted to the hospital for unconsciousness and fever. The computed tomography (CT) examination showed multiple intracranial space-occupying and "cavity-like" changes in the right lower lung. The examination of cerebrospinal fluid (CSF) was consistent with typical bacterial meningitis, CSF analyses revealed leukocytosis (10,300 × 106/L), elevated protein levels (140.39 mg/dL), decreased glucose levels (0.27 mmol/L), and normal chloride concentration level (120.2 mmol/L), however, pathogens were not detected in the cultures. Then, the CSF and sputum samples were analyzed using meta-genomic next-generation sequencing (mNGS), and S. intermedia was detected in both samples. We adjusted the use of antibiotics according to the results of mNGS in time. After anti-infective treatment, the patient achieved good treatment results in a very short time. This case highlights the mNGS can identify pathogens of brain abscess, and provide strong evidence for clinical diagnosis and treatment strategy.
A Case of Acute Aortoiliac Occlusive Disease Presenting as Cauda Equina Syndrome and Fournier´s Gangrene
Authors: Rosalba Paone, Pekka Romsi
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Aortoiliac occlusive disease presents itself more frequently as chronic claudication, erectile dysfunction, and absent femoral pulses. Its acute manifestation is less frequently encountered in a clinical practice; hence, it presents sometimes as a diagnostic challenge. We illustrate a case of acute aortoiliac occlusive disease presenting with spinal cord ischemia and gluteal and scrotal necroses, which was initially diagnosed and treated as spinal cord compression. In order to avoid misdiagnosis, careful examination of peripheral pulses of both lower limbs should always be part of the initial evaluation of cauda syndrome and paraplegia and when Fournier's gangrene is suspected.
The Role of Acetylcholinesterase Inhibitors in the Treatment of Prolonged Postelectroconvulsive Therapy Delirium
Authors: Brianna Gutowski, Emily Bomasang-Layno
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Electroconvulsive therapy (ECT) is an extremely effective treatment modality for severe depression but is often associated with transient or persistent cognitive impairment. ECT-induced cognitive impairment, however, can serve as a deterrent to completion of treatment. We present a case of a prolonged post-ECT delirium lasting approximately 3 weeks in which donepezil, an acetylcholinesterase inhibitor, was used and was successful in shortening the duration of post-ECT delirium.
The First Case of Ischemia-Free Kidney Transplantation in Humans
Authors: Xiaoshun He, Guodong Chen, Zebin Zhu, Zhiheng Zhang, Xiaopeng Yuan, Ming Han, Qiang Zhao, Yitao Zheng, Yunhua Tang, Shanzhou Huang, Linhe Wang, Otto B van Leeuwen, Xiaoping Wang, Chuanbao Chen, Liqiu Mo, Xingyuan Jiao, Xianchang Li, Changxi Wang, Jiefu Huang, Jun Cui, Zhiyong Guo
Journal: Front Med (Lausanne) (2019)
Keywords: ischemia-free kidney transplantation, ischemia-free organ transplantation, ischemia-reperfusion injury, kidney transplantation, normothermic machine perfusion
MeSH terms: Case Reports

Background: Ischemia-reperfusion injury (IRI) has been considered an inevitable event in organ transplantation since the first successful kidney transplant was performed in 1954. To avoid IRI, we have established a novel procedure called ischemia-free organ transplantation. Here, we describe the first case of ischemia-free kidney transplantation (IFKT). Materials and Methods: The kidney graft was donated by a 19-year-old brain-dead donor. The recipient was a 47-year-old man with end-stage diabetic nephropathy. The graft was procured, preserved, and implanted without cessation of blood supply using normothermic machine perfusion. Results: The graft appearance, perfusion flow, and urine production suggested that the kidney was functioning well-during the whole procedure. The creatinine dropped rapidly to normal range within 3 days post-transplantation. The levels of serum renal injury markers were low post-transplantation. No rejection or vascular or infectious complications occurred. The patient had an uneventful recovery. Conclusion: This paper marks the first case of IFKT in humans. This innovation may offer a unique solution to optimizing transplant outcomes in kidney transplantation.
Web queries as a source for syndromic surveillance
Authors: Anette Hulth, Gustaf Rydevik, Annika Linde
Journal: PLoS One (2009)
MeSH terms: Influenza, Human / epidemiology, Internet, Sentinel Surveillance, Research Support, Non-U.S. Gov't, Humans, Reproducibility of Results, Time Factors

In the field of syndromic surveillance, various sources are exploited for outbreak detection, monitoring and prediction. This paper describes a study on queries submitted to a medical web site, with influenza as a case study. The hypothesis of the work was that queries on influenza and influenza-like illness would provide a basis for the estimation of the timing of the peak and the intensity of the yearly influenza outbreaks that would be as good as the existing laboratory and sentinel surveillance. We calculated the occurrence of various queries related to influenza from search logs submitted to a Swedish medical web site for two influenza seasons. These figures were subsequently used to generate two models, one to estimate the number of laboratory verified influenza cases and one to estimate the proportion of patients with influenza-like illness reported by selected General Practitioners in Sweden. We applied an approach designed for highly correlated data, partial least squares regression. In our work, we found that certain web queries on influenza follow the same pattern as that obtained by the two other surveillance systems for influenza epidemics, and that they have equal power for the estimation of the influenza burden in society. Web queries give a unique access to ill individuals who are not (yet) seeking care. This paper shows the potential of web queries as an accurate, cheap and labour extensive source for syndromic surveillance.
Ovarian splenosis: a case report
Authors: H Talati, Jasim Radhi
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Splenosis is auto transplantation of splenic tissue following traumatic rupture of the spleen. In females it can mimic endometriosis when symptomatic. Asymptomatic splenosis is common than previously suspected and it can also involve ovary. In a patient with a history of splenectomy, splenosis can act and provide the function of the spleen and thus should not be routinely excised. We report a case of an asymptomatic, incidental ovarian splenosis of left ovary accompanying multiple pelvic and serosal splenotic nodules. To our best knowledge, total three cases of ovarian splenosis have been reported previously including two cases of ovarian splenosis accompanying pelvic and serosal splenotic nodules and one case of solitary ovarian splenosis.
Creutzfeldt-Jakob disease: A case report
Authors: Razieh Salehian, Farzad Sina, Sussan Moudi
Journal: Caspian J Intern Med (2021)
Keywords: cognitive decline, creutzfeldt-jakob disease, neurodegenerative disorders
MeSH terms: Case Reports

Background:
Creutzfeldt-Jakob disease (CJD) as a life-threatening neurodegenerative disorder is not usually diagnosed in early stages of the disease because of a variety in its clinical manifestations. This study aimed to present a middle-aged woman with psychiatric symptoms who ultimately was diagnosed as a CJD case.
Case presentation:
This 48-year-old woman had progressive symptoms of depressed mood, decreased sleep and appetite and mutism which started two months before the first visit. Gradually, slowness in movements, dysarthria and decreased performance were observed. Subsequently, when antidepressant and antipsychotic drugs were prescribed other symptoms such as ataxia and rigidity manifested in the patient. The problem list which led to final confirmation of the disease included non-specific neuropsychological presentations, hypersignality in caudate and putamen areas in brain MRI, generalized high frequency sharp waves in EEG, and protein 14-3-3 identification in cerebrospinal fluid.
Conclusion:
Although CJD is not a common disease, it should be considered in differential diagnoses whenever neuropsychological manifestations, especially progressive decline in cognition, along with symptoms such as visual hallucinations, myoclonus and ataxia are observed in the patient.
Prune belly syndrome
Authors: Koyye Ravindranath Tagore, Asok Kumar S Ramineni, A R Vijaya Lakshmi, Bhavani N
Journal: Case Rep Pediatr (2011)
MeSH terms: Case Reports

Prune belly syndrome is a rare congenital disorder of the urinary system, characterized by a triad of abnormalities. The aetiology is not known. Many infants are either stillborn or die within the first few weeks of life from severe lung or kidney problems, or a combination of congenital anomalies.
Case report: Chronic lymphocytic leukemia/small lymphocytic lymphoma and monomorphic epitheliotropic intestinal T-cell lymphoma: A composite lymphoma
Authors: Bing Zhang, Yangyang Zhang, Quan Li, Qingjun Jiang, Wei Chu, Haifeng Gong, Ruyuan Li, Hong Ji
Journal: Pathol Oncol Res (2022)
Keywords: case report, chronic lymphocytic leukemia, composite lymphoma, monomorphic epitheliotropic intestinal t-cell lymphoma, small lymphocytic lymphoma
MeSH terms: Composite Lymphoma / pathology, Leukemia, Lymphocytic, Chronic, B-Cell / genetics, Leukemia, Lymphocytic, Chronic, B-Cell / pathology, Lymphoma, T-Cell, Case Reports, Humans, Male, Middle Aged, Mutation / genetics

Background: Composite lymphomas involving B-cell and T-cell lymphomas is very rare. Case presentation: We reported a 63-year-old gentleman with composite chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL). The patient was admitted to our hospital due to abdominal pain, and was diagnosed with CLL/SLL after bone marrow (BM) biopsy, BM aspiration, and flow cytometry. Two weeks later, he was diagnosed with MEITL based on pathological analysis after intestine excision. Next gene sequencing (NGS) findings identified two hotspot mutation sites (STAT5B and DNMT3A) closely related with the pathogenesis of CLL/SLL and MEILT. Additionally, BCOR mutation was only detected in the CLL/SLL area. The likely pathogenic mutations of CLL were SETD2, NOTCH1, SF3B1, and PTPN11, while the likely pathogenic mutations related with the MEILT were TET2 and ZRSR2. Mutations of GATA3, PLCG2, and FAT1 were identified in both CLL/SLL and MEITL areas, but the clinical significance was unknown. Finally, the patient died in the 12-month follow-up after surgery. Conclusion: We report a rare case of composite CLL/SLL and MEITL that highlights the importance of careful inspection of hematologic neoplasms. We also present the results of NGS of different gene mutations in CLL and MEITL tissues.
Basidiobolomycosis Simulating a Mycobacterium ulcerans Infection in a Togolese Rural Child
Authors: Bayaki Saka, Waguena Gnassingbe, Garba Mahamadou, Sefako Akakpo, Julienne Teclessou, Aurel Abilogun-Chokki, Abas Mouhari-Toure, Koussake Kombate, Palokinam Pitché
Journal: Case Rep Dermatol Med (2017)
MeSH terms: Case Reports

Background:
Basidiobolomycosis is a deep mycosis which preferentially affects rural young people in tropical countries. We report an atypical case, with multiple ulcers, simulating a Buruli ulcer.
Case report:
A 5-year-old boy, living in a rural area, was seen for ulcers on the buttocks and at the back and right flank that had been in progress for 4 months. On examination, we found an infiltrated plaque with sharp edges, little painful, located on the buttocks, back, and the right flank. On this plaque, there were multiple ulcers with polycyclic contours and fibrinous bottom. There were inguinal inflammatory lymph nodes. The patient had an altered general condition. Examination of other organs was normal. The diagnosis of Buruli ulcer was evoked first; the search for Mycobacterium ulcerans by polymerase chain reaction was negative. Histology test performed revealed hypodermic granulomatous inflammation with predominant macrophage and eosinophils. The mycological culture was not done. The child was treated successfully with ketoconazole (10 mg/kg/day) during eight weeks.
Discussion:
Our observation shows great clinical and epidemiological similarities between basidiobolomycosis and Buruli ulcer. It confirms the efficacy of ketoconazole in severe basidiobolomycosis infection with alteration of general condition. Histopathology is very important for differential diagnosis between these two diseases.
Isolated Liver Metastasis in Hürthle Cell Thyroid Cancer Treated with Microwave Ablation
Authors: Konstantinos Segkos, Carl Schmidt, Fadi Nabhan
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Hürthle cell thyroid cancer (HCTC) is a less common form of differentiated thyroid cancer. It rarely metastasizes to the liver, and when it does, the metastasis is almost never isolated. Here we report a 62-year-old male with widely invasive Hürthle cell thyroid cancer, who underwent total thyroidectomy and received adjuvant treatment with I-131 with posttreatment scan showing no evidence of metastatic disease. His thyroglobulin however continued to rise after that and eventually an isolated liver metastasis was identified. He underwent laparoscopic microwave ablation of the liver metastasis, with dramatic decline in thyroglobulin and no structural disease identified to date. This case highlights the rare occurrence of isolated liver metastasis from HCTC and also illustrates the utility of thermoablation as an alternative to surgical resection in the treatment of small isolated liver metastases from HCTC.
Hydatid Cyst Diagnosed by Endoscopic Ultrasound
Authors: F Castro-Poças, Tarcísio Araújo, André Coelho, Donzilia Silva, Isabel Pedroto
Journal: Can J Gastroenterol Hepatol (2016)
MeSH terms: Dyspepsia / diagnostic imaging, Echinococcosis, Hepatic / diagnostic imaging, Endosonography / methods, Case Reports, Aged, Dyspepsia / parasitology, Echinococcosis, Hepatic / complications, Female, Humans, Stomach / diagnostic imaging, Stomach / parasitology

A 69-year-old female with unremarkable past history underwent endoscopy for dyspepsia. She denied weight loss or anorexia. Upper endoscopy revealed a bulge in the lesser curvature and posterior wall of the stomach with 4-5 cm. Endoscopic ultrasound was performed which showed a heterogeneous lesion, anechogenic in the major part, with a floating membrane inside, the greatest diameter of 90.8 × 17.2 mm, originated in the left liver lobe. Surgical resection was performed. Pathologic examination revealed a cystic lesion with an acellular thick fibrous wall, surrounded by a conspicuous inflammatory reaction. The cyst wall revealed a characteristic lamellar pattern of the fibers. In the internal surface of the lesion, there were remains of membranous structures, amidst which a vestigial Protoscolex was noted. In the presented case, a floating membrane was observed, which is a pathognomonic feature, establishing the diagnosis of hydatid cyst type 3. Fine needle aspiration guided by ultrasound was not performed due to the certainty in the diagnosis. To the authors' knowledge, these are the first images by endoscopic ultrasound of hydatid cyst of liver presented as a bulge in the stomach with pathognomonic features, which allowed the definitive diagnosis with no need for further diagnostic tests.
Two cases of primary solitary fibrous tumor in the pelvis resected using laparoscopic surgery
Authors: Yuki Matsui, Madoka Hamada, Fusao Sumiyama, Toshinori Kobayashi, Yuki Matsumi, Hisanori Miki, Mitsuaki Ishida, Hiroaki Kurokawa, Mitsugu Sekimoto, Yoko Sekita-Hatakeyama, Kinta Hatakeyama, Chiho Ohbayashi
Journal: Int J Surg Case Rep (2020)
Keywords: fusion gene, laparoscopic surgery, pelvic tumor, stat6, solitary fibrous tumor
MeSH terms: Case Reports

Background:
We report two resected cases of solitary fibrous tumors (SFT) that were accidentally found in the pelvic cavity.
Case presentation:
Case 1 was a 54-year-old male. A colonoscopy for the examination of intestinal polyps revealed an extramural tumor in the right anterior wall of the low rectum. A preoperative MRI showed a well-demarcated T1 low and T2 mixed intensity extramural tumor (53 × 36 mm) located right lateral to the low rectum and behind the seminal vesicle. Laparoscopic surgery was successful for tumor extirpation. Immunohistochemical examination of the specimen revealed STAT6 (+) and CD34 (+) cells, a Ki67 positivity of 7-8%, a mitotic index of 4-5/50 HPF, and a diagnosis of SFT. There was no recurrence 29 months after surgery. Using RT-PCR and sequencing, we detected the NAB2-STAT6 fusion gene but the locus of genomic inversion was not detected. Case 2 was a 43-year-old male that received conservative treatment for appendicitis. A CT scan accidentally revealed a tumor of 40 mm of length in the left obturator area. A MRI revealed a well-demarcated T1 and T2 high intensity tumor. The patient underwent surgical biopsy. Immunohistochemical examination of the biopsy revealed STAT6 (+) and CD34 (+) cells, Ki67 positive cells < 1%, and a diagnosis of SFT. We could not detect the NAB2-STAT6 fusion gene in the extirpated tumor.
Conclusions:
Two cases of pelvic SFT were diagnosed by immunohistochemical examination, RT-PCR and sequencing and successfully resected by laparoscopic surgery.
Intra-articular osteotomy for distal humerus malunion
Authors: René K Marti, Job Doornberg
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular necrosis of capitellum or trochlea is a major pitfall of the this technically challenging procedure. Two cases are presented which illustrate the potential problems of intra-articular osteotomy for malunion of the distal humerus.
Neuromyelitis Optica Spectrum Disorder Attack Triggered by Herpes Zoster Infection
Authors: Emanuela Claudia Turco, Erica Curti, Valentina Maffini, Francesco Pisani, Franco Granella
Journal: Mult Scler Int (2020)

Neuromyelitis optica spectrum disorder is a severe autoimmune disease of the central nervous system characterized by recurrent inflammatory events primarily involving the optic nerves and spinal cord. Recently, a triggering role of infectious events in the development of NMOSD has been suggested. Varicella zoster virus is the most common viral infection involved, though the linkage with anti-aquaporin-4 antibodies is so far unknown. We report, to the best of our knowledge, the first pediatric case report about NMOSD relapse triggered by herpes zoster infection. The strict temporal relationship between VZV infection and NMO attacks seems to be more than simply due to chance; however, further reports are needed to be confirmed.