OpenMed/multicare-articles huggingface dataset:
Potential contribution of anti-p200 autoantibodies to mucosal lesions in anti-p200 pemphigoid
Authors: Yangmin Gao, Hua Qian, Takashi Hashimoto, Xiaoguang Li
Journal: Front Immunol (2023)
Keywords: anti-p200 mucous membrane pemphigoid, anti-p200 pemphigoid, genital mucosa, mucosal lesions, oral mucosa
MeSH terms: Epidermolysis Bullosa Acquisita, Pemphigoid, Bullous, Psoriasis, Skin Diseases, Vesiculobullous, Review, Research Support, Non-U.S. Gov't, Autoantibodies, Humans, Autoantibodies

Anti-p200 pemphigoid is a relatively rare subepidermal autoimmune bullous disease (AIBD), which was firstly reported by Detlef Zillikens, Takashi Hashimoto and others in 1996. Skin lesions are considered as the major clinical features of this disease, with occasional involvement of mucosal lesions. The mechanism of mucosal lesions involved in anti-p200 pemphigoid is still unclear. In the present study, we aimed to analyze published data on cases and case series of anti-p200 pemphigoid with mucosal lesions and explored the potential contribution of anti-p200 autoantibodies to mucosal lesions. A total of 32 papers that comprised 52 anti-p200 pemphigoid patients with various mucosal lesions were included in this review. Oral lesions were involved in 75.0% patients, followed by genital lesions (26.9%) and ocular lesions (11.54%). Only one patient had psoriasis, 26.9% patients had multiple mucosal lesions, and 30.8% cases had comorbidity of other AIBDs, particularly anti-laminin (LM) 332-type mucous membrane pemphigoid (MMP). In comparison with anti-LM332-type MMP, anti-BP180-type MMP and epidermolysis bullosa acquisita, higher frequency of genital lesions was identified as a unique character of anti-p200 pemphigoid with mucosal lesions. These results indicated that anti-p200 autoantibodies might contribute to mucosal lesions in a pattern different from other MMP-related autoantibodies, although its pathogenetic mechanisms are still unclear.
Case report: Indocyanine green fluorescence-guided imaging in laparoscope, a more sensitive detection technique of lateral lymph nodes metastases from rectal neuroendocrine tumors
Authors: Yueyang Zhang, Yi Zhang, Yi Yang, Zheng Xu, Changyuan Gao, Meixi Liu, Wenjia Zhu, Hong Zhao, Haitao Zhou
Journal: Front Oncol (2022)
Keywords: indocyanine green, laparoscope, lateral lymph nodes metastases, lymph nodes dissection, rectal neuroendocrine tumors
MeSH terms: Case Reports

Background:
The diagnosis and surgical strategy of lateral lymph node metastases of rectal neuroendocrine tumors are still controversial. At present, the major diagnostic means rely on imaging examinations, but will be affected by the size of lymph nodes leading to false negativity. We provide a new technique to determine lateral lymph node metastases during surgery.
Clinical case:
A 68-year-old man developed abdominal pain, bloating and fever for a month. Colonoscopy revealed the mass is 2.4 cm x 2.0 cm in size, with a wide stratum, poor mobility, and a rough but intact surface mucosa. Therefore, rectal neuroendocrine tumors (R-NET) were diagnosed. Multiple imaging methods, such as CT, octreotide imaging and endoscopic ultrasonography, have not found lateral lymph node metastases from rectal neuroendocrine tumors. But indocyanine green (ICG)-enhanced near-infrared fluorescence-guided imaging during surgery found left lateral lymph nodes metastases, which was proved by postoperative pathological examination.
Conclusions:
We believe that applying ICG-enhanced near-infrared fluorescence-guided imaging in laparoscope can improve the detection of positive LLNs in those R-NET patients who did not reveal LNM on imaging examinations.
Life threatening self starvation; a case report
Authors: Chaturaka Rodrigo, Thushani Henegama, Raveen Hanwella
Journal: BMC Res Notes (2013)
MeSH terms: Obsessive-Compulsive Disorder / physiopathology, Starvation, Case Reports, Adult, Humans, Male, Obsessive-Compulsive Disorder / psychology, Young Adult

Background:
Obsessive compulsive disorders are a complex group that can have a variety of manifestations. Many authors now describe an obsessive compulsive spectrum disorder where many other specific diagnostic entities such as trichotillomania, tic disorders and body dysmorphic disorder are considered to be related and linked disorders.
Case presentation:
We report a case of a twenty two year old Sri Lankan male who presented with life threatening self starvation due to severe obsessive compulsive disorder. The diagnosis was not considered till late due to the atypical presentation of the patient. While his symptoms bordered on a delusional psychosis, a decision was made to treat him as for obsessive compulsive disorder with behavioural therapy which was successful in the end.
Conclusions:
In analysis of a patient with severe anorexia, the psychological causes should not be forgotten. In fact, if the feeding pattern of the patient was observed at the beginning, unnecessary investigating and life threatening worsening of the condition could have been avoided.
Total hip replacement infected with Mycobacterium tuberculosis complicated by Addison disease and psoas muscle abscess: a case report
Authors: Pasquale De Nardo, Angela Corpolongo, Aristide Conte, Elisa Gentilotti, Pasquale Narciso
Journal: J Med Case Rep (2012)

Introduction:
Prosthetic joint infection due to Mycobacterium tuberculosis is occasionally encountered in clinical practice. To the best of our knowledge, this is the first report of a prosthetic joint infection due to Mycobacterium tuberculosis complicated by psoas abscesses and secondary Addison disease.
Case presentation:
A 67-year-old immunocompetent Caucasian woman underwent total left hip arthroplasty because of osteoarthritis. After 18 months, she underwent arthroplasty revision for a possible prosthetic infection. Periprosthetic tissue specimens for bacteria were negative, and empirical antibiotic therapy was unsuccessful. She was then admitted to our department because of complications arising 22 months after arthroplasty. A physical examination revealed a sinus tract overlying her left hip and skin and mucosal pigmentation. Her levels of C-reactive protein, basal cortisol, adrenocorticotropic hormone, and sodium were out of normal range. Results of the tuberculin skin test and QuantiFERON-TB Gold test were positive. Computed tomography revealed a periprosthetic abscess and the inclusion of the left psoas muscle. Results of microbiological tests were negative, but polymerase chain reaction of a specimen taken from the hip fistula was positive for Mycobacterium tuberculosis. Our patient's condition was diagnosed as prosthetic joint infection and muscle psoas abscess due to Mycobacterium tuberculosis and secondary Addison disease. She underwent standard treatment with rifampicin, ethambutol, isoniazid, and pyrazinamide associated with hydrocortisone and fludrocortisone. At 15 months from the beginning of therapy, she was in good clinical condition and free of symptoms.
Conclusions:
Prosthetic joint infection with Mycobacterium tuberculosis is uncommon. A differential diagnosis of tuberculosis should be considered when dealing with prosthetic joint infection, especially when repeated smears and histology examination from infected joints are negative. Clinical outcomes of prosthetic joint infection by Mycobacterium tuberculosis are unpredictable, especially given the limited literature in this field and the uncertainty of whether medical treatment alone can eradicate the infection without prosthesis removal. Furthermore, this case report raises interesting issues such as the necessity of a follow-up evaluation after treatment based on clinical conditions, the utility of a more standardized length of treatment for periprosthetic tuberculous infection, and the importance of a high diffusion capacity of anti-mycobacterial agents in order to eradicate the infection.
Synchronous large tumoral pseudoangiomatous stromal hyperplasia (PASH) in the breast and axilla with subsequent carcinoma in the contralateral breast: routine and strain imaging with histopathological correlation
Authors: T R Shimpi, V Baksa Reynolds, S Shikhare, S Srinivasan, M J Clarke, W C G Peh
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast disorder with the tumoral variety being extremely rare. We report a rare case of synchronous, massive axillary and breast tumoral PASH in a 55-year-old post-menopausal woman. Mammography, ultrasonography and sonoelastography features are illustrated with histopathological correlation. A high-grade invasive ductal carcinoma was detected in the contralateral breast on annual follow-up imaging. Radiologists need to be familiar with the imaging appearances of PASH and be aware of its association with subsequent cancer risk. To the best of our knowledge, the present case of synchronous tumoral PASH in the breast and axillary tissue is the second reported case till now.
A case of subdural hematoma with a medical history of hemophilia a and a review of related literature
Authors: Yi Zhao, Xin-Jie Bao, Yong Yao, Yuan-Fan Yang, Jun-Ji Wei, Wen-Bin Ma, Ren-Zhi Wang
Journal: Chin Neurosurg J (2018)
Keywords: factor viii, hemophilia, intracerebral hemorrhage
MeSH terms: Case Reports

Background:
Intracranial hemorrhage is the most common emergency in the neurology department, and patients with a medical history of hemophilia have a risk of severe bleeding.
Case presentation:
A 56-year-old man was admitted to the emergency department in our hospital. He was diagnosed with hemophilia A and subdural hematoma. We administered an infusion of factor VIII to decrease the risk of bleeding and improve the prognosis. Factor VIII infusion is the most important factor in treating hemophilia A patients.
Conclusion:
We recommend carefully checking coagulation function and the medical history once these patients are admitted, especially in the emergency department.
Atrial septal defect in an elderly woman-a case report
Authors: C C Diaconu
Journal: J Med Life (2011)
Keywords: echocardiography, malformation, transthoracic
MeSH terms: Heart Septal Defects, Atrial / diagnostic imaging, Case Reports, Aged, Echocardiography, Female, Humans

Rationale:
The atrial septal defect is one of the most common congenital anomalies in adults, but it is rarely diagnosed. It is characterized by a defect in the interatrial septum that allows pulmonary venous return to pass from the left to the right atrium.
Objective:
A case of a 75-year-old female who presented with dyspnea, orthopnea, lower extremities swelling and palpitations is reported here. She had a 3 years history of atrial fibrillation and one-year history of cardiac failure NYHA (New York Heart Association) class Ⅱ.
Methods and results:
Transthoracic echocardiography revealed a dilated right atrium of 74,2 mm, a dilated left atrium of 55,2 mm, a dilated left ventricle of 64/72,3 mm, a dilated right ventricle of 44,4 mm. Atrial septal defect ostium secundum type, with left-to-right shunt. Severe tricuspid insufficiency with a maximum gradient of 55,4 mm Hg. 4th degree mitral insufficiency. Severe pulmonary hypertension of 75 mm Hg. The ejection fraction of 29%. Atrial fibrillation. Interventricular sept with paradoxical motion.
Discussion:
Ostium secundum defect is the most common type of atrial septal defect and accounts for 60-70% of all cases. The malformation often goes unnoticed for decades because symptoms may be absent and because physical signs are subtle. Symptoms usually take 30-40 years to develop. They are the consequences of pulmonary hypertension, atrial tachyarrhythmias and, sometimes, associated mitral valve disease. The echocardiography can establish the size and location of the atrial septal defect, the magnitude and hemodynamic impact of the left-to-right shunt, and the presence and degree of pulmonary hypertension. The particularity of this case is that the patient lived for over 70 years almost asymptomatic.
Acute thrombotic occlusion of right coronary and left circumflex coronary arteries in a patient with antiphospholipid syndrome: successful stent implantation
Authors: Serdar Biceroglu, Muge Ildizli Demirbas, Mustafa Karaca, Murat Yalcin, Hasan Yilmaz
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Antiphospholipid syndrome is a rare disorder. Acute myocardial infarction is uncommon among these patients. Here we report a case of a 44-year-old man with antiphospholipid syndrome admitted for acute inferior myocardial infarction. Performed coronary angiography revealed that both the right coronary and the left circumflex coronary arteries were occluded by thrombi. We successfully performed primary angioplasty and stent implantation for both of the occluded coronary arteries. In the literature, this is the first case with antiphospholipid syndrome in which primary coronary angioplasty with stent implantation was successfully performed for two coronary arteries with acute thrombotic occlusion.
A case report of adult juvenile polyposis syndrome with SMAD4 pathogenic variant
Authors: Yutong Liu, Zeyu Wang, Zhongyu Zhang, Yuanyuan Sun, Yanyan Zhang, Jiamei Yang
Journal: Front Oncol (2023)
Keywords: smad4 pathogenic variants, case report, gastric polyposis, juvenile polyposis, juvenile polyposis syndrome
MeSH terms: Case Reports

Background:
Juvenile polyposis syndrome (JPS) is a rare autosomal dominant disorder that is a type of hamartomatous polyp syndrome, and its incidence rate is approximately 1/100000. The main clinical feature is the presence of multiple juvenile polyps in the gastrointestinal tract, most often in the colorectal tract. We present a case of juvenile polyposis syndrome with massive gastric polyposis.
Case presentation:
A 50-year-old male was admitted to the hospital due to abdominal distension and poor appetite. Gastroscopy revealed a large number of gastric polyps. Pathological findings revealed gastric juvenile polyps. Genetic testing revealed that he and his brother both carried SMAD4: c.266_269del germline pathogenic variant. The final diagnosis was juvenile polyposis syndrome of the stomach. He once suffered from colon cancer and bladder cancer. One of his brothers died of colon cancer, and the other brother suffered from colon polyps.
Conclusions:
Gastric involvement in juvenile polyposis syndrome is relatively rare. When massive gastric polyposis is found, gene detection should be carried out as soon as possible, so that rapid diagnosis and treatment can be obtained.
Radiation-induced angiosarcoma: case report
Authors: Lucas Aguiar Alencar de Oliveira, Antonio Fortes de Pádua Filho, Maria Adélia Medeiros E Melo, Elisa Rosa de Carvalho Gonçalves Nunes Galvão, Mharcus Carneiro Vieira, Jerúsia Oliveira Ibiapina, Danilo Rafael da Silva Fontinele, Sabas Carlos Vieira
Journal: Einstein (Sao Paulo) (2020)
MeSH terms: Breast Neoplasms / surgery, Hemangiosarcoma / diagnostic imaging, Hemangiosarcoma / etiology, Hemangiosarcoma / surgery, Neoplasms, Radiation-Induced / etiology, Case Reports, Aged, Breast, Female, Humans, Mastectomy

Angiosarcoma of the breast accounts for less than 1% of breast tumors. This tumor may be primary or secondary to previous radiation therapy and it is also named "radiogenic angiosarcoma of the breast", which is still a rare entity with a poor prognosis. So far, there are only 307 cases reported about these tumors in the literature. We present a case of a 73-year-old woman with a prior history of breast-conserving treatment of right breast cancer, exhibiting mild pinkish skin changes in the ipsilateral breast. Her mammography was consistent with benign alterations (BI-RADS 2). On incisional biopsy specimens, hematoxylin-eosin showed atypical vascular lesion and suggested immunohistochemisty for diagnostic elucidation. Resection of the lesions was performed and histology showed radiogenic angiosarcoma. The patient underwent simple mastectomy. Immunohistochemistry was positive for antigens related to CD31 and CD34, and C-MYC oncogene amplification, confirming the diagnosis of angiosarcoma induced by breast irradiation. A delayed diagnosis is an important concern. Initial skin changes in radiogenic angiosarcoma are subtle, therefore, these alterations may be confused with other benign skin conditions such as telangiectasia. We highlight this case clinical aspects with the intention of alerting to the possibility of angiosarcoma of the breast in patients with a previous history of adjuvant radiation therapy for breast cancer treatment. Sixteen months after the surgery the patient remains asymptomatic.
Clozapine Use During Pregnancy and Lactation: A Case-Series Report
Authors: M Luisa Imaz, Giovanni Oriolo, Mercè Torra, Dolors Soy, Lluïsa García-Esteve, Rocio Martin-Santos
Journal: Front Pharmacol (2018)
Keywords: amniotic, clozapine, lactation, neonatal, pharmacokinetics, placental, pregnancy, schizophrenia
MeSH terms: Case Reports

The current prescription of clozapine in psychotic women of reproductive age makes it crucial to understand its pharmacokinetics during pregnancy and lactation as well as its risk profile for neonatal outcome. The aim of this case series was to provide new evidence on the pharmacokinetic features of clozapine that determine its passage through the placenta and amniotic fluid, as well as the neonatal clozapine elimination half-life (t1/2). This case series demonstrates for the first time that clozapine might show partial placental passage similar to other atypical antipsychotics. Clozapine levels decreased during the first few days in nursing infants. The half-life of clozapine in neonates was slightly higher than previously estimated. Clozapine use in pregnancy may be associated with diabetes mellitus, especially if there is a family history of this disease. Although no acute toxicological effects were observed in the intrauterine exposed newborn, close follow-up of pregnancy is recommended. However, these results must be taken with caution being a case series with small sample size.
Mycobacterial Cell Wall Stimulant in the Treatment of Squamous Cell Carcinoma: A Case Series Regarding Treatment in Equine, Bovine and Caprine Patients
Authors: Jennifer Halleran, Katie Yau, Jillian Paegelow, Robert Streeter, Derek Foster
Journal: Front Vet Sci (2021)
Keywords: equine, immunotherapy, neoplasia, ruminant, squamous cell carcinoma

Squamous cell carcinoma (SCC) is a common dermatological neoplasia found in large animal species. Treatment options, such as surgery and cryotherapy may be difficult or not feasible. Alternative therapies, such as immunomodulating drugs, can potentially be used for companion large animals. The hypothesis of the following retrospective study is: following multiple intravenous and intralesional injections of a mycobacterial cell wall stimulant (MCW) regression of SCC in equine, bovine and caprine patients will be observed. In this observational-retrospective case series, patients included are 2 bovine, 2 caprine and 3 equine patients. The medical records at two different teaching veterinary hospitals were searched for cases with a positive histopathological diagnosis of squamous cell carcinoma that were subsequently treated with MCW, as either the sole therapy, or in conjunction with other therapies. Seven cases were included in this retrospective study. The median duration of therapy was 56.5 days, with 3 of the 7 patients being euthanized. Significant complications were seen in 3/7 patients. Repeated injections of a MCW may lead to reduction in lesion size of SCC in some cases, but long-term resolution is unlikely and the risk of significant complications is high; due to limited sample size and the variety in species, it is difficult to conclude if MCW is an effective therapy for SCC.
Trigeminal Neuralgia in an HIV Patient
Authors: Mohammad A Hashmi, Gautam Guha, Bibhuti Saha
Journal: J Glob Infect Dis (2010)
Keywords: human immunodeficiency virus, magnetic resonance imaging (mri), trigeminal nerve
MeSH terms: Case Reports

Trigeminal neuralgia is a painful condition affecting face. Its commonest cause is the tortuous vessels in prepontine cistern. There are other causes also, like brainstem lesions and mass lesions, as well as inflammatory causes. We present a case of an HIV patient with marked involvement of trigeminal nerves, which is a unique finding in immunocompromised patients.
Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA-1273
Authors: Po-Hsu Su, Yi-Ching Yu, Wen-Hsin Chen, Hsuan-Ching Lin, Yih-Ting Chen, Ming-Huei Cheng, Yen-Min Huang
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, messenger rna-1273, pancreatic cancer, platelet factor 4 (pf4), vaccine-induced immune thrombotic thrombocytopenia
MeSH terms: Case Reports

Vaccination plays an important role during the COVID-19 pandemic. Vaccine-induced thrombotic thrombocytopenia (VITT) is a major adverse effect that could be lethal. For cancer patients, cancer-related thromboembolism is another lethal complication. When cancer patients receive their COVID-19 vaccines, the following thromboembolic events will be more complicated. We presented a case recently diagnosed with pancreatic cancer, who had received the mRNA-1273 (Moderna) vaccination 12 days prior. Ischemic stroke and VITT were also diagnosed. We aggressively treated the patient with steroids, immunoglobulin, and plasma exchange. The titer of anti-platelet factor four and d-dimer level decreased, but the patient ultimately died. The complicated condition of VITT superimposed cancer-related thromboembolism was considered. To our knowledge, only one case of mRNA-1273 related VITT was reported, and this case study was the first to report a cancer patient who was diagnosed with VITT after mRNA-1273 vaccination. Therefore, when the need for vaccination among cancer patients increased under the current COVID-19 pandemic, the possible risk of VITT for cancer patients should be carefully managed. Further studies of the risk evaluation of the COVID-19 vaccine in cancer patients might be required in the future.