OpenMed/multicare-articles huggingface dataset:
Rapid Growth of Lung Nodules due to Combined Pulmonary Vasculitis, Silicoanthracosis, and Chondrocalcinosis
Authors: Wolfgang Jungraithmayr, Stefanos Tzafos, Oliver Distler, Antonios G A Kolios, Walter Weder, Daniel Franzen
Journal: Can Respir J (2016)
MeSH terms: Anthracosilicosis / complications, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / complications, Arthritis / complications, Chondrocalcinosis / complications, Multiple Pulmonary Nodules / complications, Case Reports, Anthracosilicosis / diagnostic imaging, Anthracosilicosis / pathology, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / diagnostic imaging, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / drug therapy, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / pathology, Antirheumatic Agents / therapeutic use, Arthritis / drug therapy, Chondrocalcinosis / diagnostic imaging, Chondrocalcinosis / drug therapy, Chondrocalcinosis / pathology, Humans, Immunologic Factors / therapeutic use, Lung / diagnostic imaging, Lung / pathology, Male, Methotrexate / therapeutic use, Middle Aged, Multiple Pulmonary Nodules / diagnostic imaging, Multiple Pulmonary Nodules / pathology, Rituximab / therapeutic use, Thoracoscopy, Tomography, X-Ray Computed, Antirheumatic Agents, Immunologic Factors, Rituximab, Methotrexate

Background. Silicoanthracosis is a pneumoconiosis due to occupational inhalation of silica and carbon dusts. Clinically, it can be associated with vasculitis or rheumatoid arthritis. In association with these diseases, silicoanthracosis can present within the lung with multiple pulmonary nodules which, as a differential diagnosis, can mimic metastatic disease or multiple abscesses. Case Presentation. We present the case of a 62-year old former pit worker with pulmonary nodules, chondrocalcinosis due to calcium pyrophosphate deposition (CPPD), and a history of renal cancer. Within a short period of time, pulmonary nodules grew rapidly. Thoracoscopically, the resected lung specimen revealed silicoanthracosis associated with small-to-medium-size vasculitis in the presence of antineutrophil cytoplasmatic autoantibodies (c-ANCA). Conclusion. Pulmonary silicoanthracotic lesions on the base of ANCA-associated vasculitis and CPPD arthritis can rapidly grow. A mutual correlation between silicoanthracosis, ANCA-associated vasculitis, and CPPD seems possible. Apart from this, consideration of metastatic disease should be obligatory in patients with a history of cancer at the same time being immunosuppressed.
Case Report: Intestinal Nodular Lymphoid Hyperplasia as First Manifestation of Activated PI3Kδ Syndrome Due to a Novel PIK3CD Variant
Authors: Antonio Marzollo, Silvia Bresolin, Davide Colavito, Alice Cani, Paola Gaio, Luca Bosa, Claudia Mescoli, Linda Rossini, Federica Barzaghi, Giorgio Perilongo, Alberta Leon, Alessandra Biffi, Mara Cananzi
Journal: Front Pediatr (2021)
Keywords: pik3cd, activated pi3k-delta syndrome, inborn error of immunity, nodular lymphoid hyperplasia-git, novel variant, sirolimus
MeSH terms: Case Reports

Nodular lymphoid hyperplasia (NLH) is a lymphoproliferative disease caused by non-clonal expansion of lymphoid cells in the gut mucosa. Little is known about the pathogenesis of NLH, which is often disregarded as an insignificant or para-physiologic phenomenon. We present the case of a girl with isolated diffuse NLH (extending from the stomach to the rectum) caused by activated PI3Kδ syndrome (APDS) due to the novel p.Glu525Gly variant in PIK3CD. The gain-of-function effect of the variant was confirmed by demonstration of over activation of the Akt/mTOR pathway in the patient's cells. APDS diagnosis led to treatment with sirolimus, which resulted in the complete remission of NLH and in the prevention of extra intestinal complications. In conclusion, we identify APDS as a novel cause of isolated NLH and suggest that patients with severe pan-enteric NLH should be screened for this disorder that may not be apparent on first-line immunological testing.
Critical appraisal of major depression with suicidal ideation
Authors: Maurizio Pompili
Journal: Ann Gen Psychiatry (2019)
MeSH terms: Case Reports

Background:
Regardless of its nature, suicidal ideation, in the absence of another diagnosis, is quintessentially associated with major clinical depression. Although for the characteristics of being depressed it is reasonable to have some wish to die, there is no real attempt to understanding the suicidal mind. Clinicians are therefore often inclined to consider suicidal ideation a symptom of major depression. Yet, most depressed patients do not die by suicide, and many of them never experience suicidal ideation even in the most severe depressing scenario. At a closer look, when one works with suicidal individual, suicide appears complex and not line with the obsolete medical model. There are often warning signs for suicide, and suicidal individuals experience mental pain as a common denominator of many adverse events.
Case presentation:
A case report of an entrepreneur with no previous psychiatric history describes the process of meditating suicide as a dimension overlapping the depressive disorder. Details of how this 63-year-old male developed high suicide risk are reported, and clinicians are guided into the understanding of suicide risk.
Conclusions:
Nowadays, clinicians are requested to provide an in-depth investigation into the suicidal mind, an assessment adjunctive to the psychiatric evaluation. A phenomenological approach may be the key to unlock the suicidal mind. Clinicians may use such tool in light of the need for the empathic understanding of human suffering as well as a paradigm shift in the care of suicidal individuals.
Case Report: Fascioliasis Hepatica Precisely Diagnosed by Metagenomic Next-Generation Sequencing and Treated With Albendazole
Authors: Yaling Zhang, Huan Xu, Yi Liu, Juan Kang, Hairu Chen, Zhiyi Wang, Dachuan Cai
Journal: Front Med (Lausanne) (2021)
Keywords: albendazole, case report, fascioliasis hepatica, metagenomic next-generation sequencing (mngs), precision treatment
MeSH terms: Case Reports

The clinical manifestations of fascioliasis hepatica in humans are unspecific. Traditional diagnosis relies on evidence of live parasites or eggs in the bile or feces. However, due to similar imaging manifestations, they are often misdiagnosed as malignant tumors. Here, we report a case of a 43-year-old woman with fever and space-occupying liver disease. Liver biopsy, parasite-specific antibody screening, and stool testing did not find any pathogens. Therefore, metagenomic next-generation sequencing (mNGS) and routine microbiological examinations were performed. Finally, Fasciola hepatica was only identified by mNGS. The body temperature of the patient and the eosinophil count remained normal, and the space-occupying liver lesions were significantly absorbed after more than 7 months of treatment with albendazole. The details of this case highlight the timely use of mNGS to identify parasites and judge therapeutic effects after treatment, providing important help for clinical decision-making.
Laparoscopic Unilateral Total and Contralateral Subtotal Adrenalectomy for Bilateral Adrenocorticotropic Hormone-Secreting Pheochromocytoma: Report of a Rare Case
Authors: Masanari Fukasawa, Norifumi Sawada, Tatsuya Miyamoto, Satoru Kira, Tadashi Aoki, Hidenori Zakoji, Takahiko Mitsui, Masayuki Takeda
Journal: J Endourol Case Rep (2016)
Keywords: ct scan, bilateral acth-secreting pheochromocytoma, immunostaining of acth, iodine-123-mibg scintigraphy, laparoscopic unilateral total and contralateral subtotal adrenalectomy
MeSH terms: Case Reports

Background: Bilateral adrenal tumors are not common in clinical practice, but are an important source of ectopic adrenocorticotropic hormone (ACTH) secretion. Standard operative management for bilateral pheochromocytomas might dictate the removal of the involved adrenal gland and the removal of the contralateral adrenal gland. We present a case of bilateral ACTH-secreting pheochromocytoma treated with staged laparoscopic unilateral total and contralateral subtotal adrenalectomy. Case Presentation: A 58-year-old male with elevated hyperglycemia and general fatigue was hospitalized for pneumonia. CT incidentally revealed bilateral adrenal tumor. Biochemical examination was significant for elevated urinary metanephrine and normetanephrines, and plasma catecholamine level. CT scan of the head, neck, thorax, and pelvis was normal. Under the clinical diagnosis of ACTH-dependent pheochromocytoma, laparoscopic right total adrenalectomy was performed. As endocrinologic examination showed residual ACTH-dependent pheochromocytoma after surgery, laparoscopic left subtotal adrenalectomy was performed. Pathology analysis revealed pheochromocytoma with stained ACTH lesions in both adrenal tumors. Conclusion: This is a rare case of ACTH-secreting bilateral pheochromocytoma effectively treated with staged laparoscopic unilateral total and contralateral subtotal adrenalectomy, in which the production of ACTH was confirmed by immunohistochemical staining.
A Method of Using a Pelvic C-Clamp for Intraoperative Reduction of a Zone 3 Sacral Fracture
Authors: Daniel H Wiznia, Nishwant Swami, Chang-Yeon Kim, Michael P Leslie
Journal: Case Rep Orthop (2016)
MeSH terms: Case Reports

It is challenging to properly reduce pelvic ring injuries that involve a zone 3 sacral fracture. Several open and closed reduction methods have been described. Percutaneous reductions are challenging, and improper reductions can have poor long-term outcomes. The pelvic C-clamp is a tool designed to provide emergency stabilization to patients suffering from c-type pelvic ring injuries. We describe a case in which a patient's open book pelvic ring injury with a zone three sacral fracture is reduced intraoperatively with the use of a pelvic C-clamp and stabilized with transsacral screws.
Severe neuropsychiatric reaction in a deployed military member after prophylactic mefloquine
Authors: Alan L Peterson, Robert A Seegmiller, Libby S Schindler
Journal: Case Rep Psychiatry (2011)
MeSH terms: Case Reports

Recent studies of military personnel who have deployed to Iraq and Afghanistan have reported a number of combat-related psychiatric disorders such as posttraumatic stress disorder, depression, and traumatic brain injury. This case report involves a 27-year-old male active-duty US military service member who developed severe depression, psychotic hallucinations, and neuropsychological sequelae following the prophylactic use of the antimalarial medication mefloquine hydrochloride. The patient had a recent history of depression and was taking antidepressant medications at the time of his deployment to the Middle East. Psychiatrists and other health care providers should be aware of the possible neuropsychiatric side effects of mefloquine in deployed military personnel and should consider the use of other medications for malaria prophylaxis in those individuals who may be at increased risk for side effects.
A Unique and Rare Presentation of Adult Congenital Heart Disease: Common Atrium Associated with Coronary Aneurysms and Fistula
Authors: Muhammad Shabbir Rawala, Alex Munoz, Mohammad Hassan Pervaiz
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

An atrial septal defect is the second most common congenital heart disease found in adults with a female to male ratio of 4 : 1. However, it is rare to have a complete absence of the interatrial septum (IAS) to be diagnosed in an elderly patient associated with other coexisting anomalies. We present a case of a 60-year-old female presenting with common atrium, coronary arteriovenous fistula, and coronary artery aneurysms. This case highlights rare adult congenital cardiac anomalies and the importance of thorough workup to evaluate for the intracardiac shunt in a patient who has right heart enlargement and development of pulmonary disease in adulthood without a significant history of chronic smoking. A 60-year-old female patient presented with substernal chest pain. The nuclear stress test showed no reversible ischemia; however, right ventricle (RV) dilation was present. The patient underwent further evaluation for RV dilation with a transthoracic echocardiogram that demonstrated a complete absence of IAS and was confirmed by a positive bubble study. The patient had an invasive angiography that showed severely elevated RV pressure. Oxygen saturation in the right atrium was higher than in the inferior vena cava. Hence, an intracardiac shunt with a 10% increase in oxygen saturation was identified. It also identified aneurysmal coronary arteries (measuring 0.8 to 1.0 cm). Cardiac computed tomography angiogram was performed that identified all coronary arteries to be ectatic/aneurysmal measuring up to 8-10 mm, an absence of IAS, and a possible fistula between the distal left anterior descending and a coronary vein. To our knowledge, this is the first-ever presentation of a complete congenital absence of IAS in a patient who has survived into adulthood with the development of severe pulmonary hypertension without Eisenmenger syndrome. It is unclear at this point if surgical treatment to correct the anatomical defect (which would be probably palliative) would be superior to conservative medical therapy. Besides, the presence of coronary arteriovenous fistula would make the decision-making process more complex regarding surgical versus conservative management.
Virilizing adrenal carcinoma in a 3-year-old boy: A rarity
Authors: Suresh Kumar, Punit Tiwari, Ranjeet Kr Das, Anup Kr Kundu
Journal: Indian J Med Paediatr Oncol (2010)
Keywords: adrenal carcinoma, adrenalectomy, virilization
MeSH terms: Case Reports

A 3-year-old boy presented with iso-sexual precocious puberty for 18 months. Radiological images revealed left suprarenal mass and hormonal profile showed markedly increased testosterone and dehydroepiandrosterone-sulfate. The child underwent open adrenalectomy and histopathology revealed adrenocortical carcinoma. At 3 months follow-up, the child is doing well.
Excellent Response to Nivolumab and Ipilimumab in Metastatic Gastroesophageal Junction Squamous Carcinoma
Authors: Narayanan Sadagopan, Craig Devoe
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Unresectable gastroesophageal junction (GEJ) cancers have a poor prognosis and limited treatment options. We report the case of a patient with a Siewert class III gastroesophageal junction squamous carcinoma with metastatic spread into the liver who had an exceptional response to a combination therapy of nivolumab and ipilimumab despite being programmed death-ligand 1 (PD-L1) negative, microsatellite stable (MSS), and having a low tumor mutational burden. He initially experienced disease progression on the chemotherapy regimens modified DCF and FOLFIRI resulting in limited functional status, esophageal stent placement, and feeding tube placement. After about 6 months on nivolumab and ipilimumab, he had near-complete disease resolution. He was able to return to his baseline functional status, as well as have the esophageal stent and feeding tube removed. Our case contributes to the value of exploring immunotherapy as an option for a variety of hard to treat cancers.
Cementoblastoma arising in the maxilla of an 8-year-old boy: a case report
Authors: Hiroyuki Harada, Ken Omura, Seiki Mogi, Norihiko Okada
Journal: Int J Dent (2011)
MeSH terms: Case Reports

Cementoblastoma is an uncommon disease, representing only 1-8% of all odontogenic tumours. Furthermore, this tumour is especially uncommon in children, as only five cases have been reported in this age group. Here, we describe a case of cementoblastoma arising in the maxilla of an 8-year-old boy, that was treated with a partial maxillectomy. The patient's facial appearance has remained satisfactory, and the tumour has not recurred in the 9 years after the operation.
Sensitivity to rocuronium-induced neuromuscular block and reversibility with sugammadex in a patient with myotonic dystrophy
Authors: Akihiro Kashiwai, Takahiro Suzuki, Setsuro Ogawa
Journal: Case Rep Anesthesiol (2012)
MeSH terms: Case Reports

We report a patient with myotonic dystrophy who showed prolonged rocuronium-induced neuromuscular blockade, although with a fast recovery with sugammadex. During general anesthesia with propofol and remifentanil, the times to spontaneous recovery of the first twitch (T1) of train of four to 10% of control values after an intubating dose of rocuronium 1 mg/kg and an additional dose of 0.2 mg/kg were 112 min and 62 min, respectively. Despite the high sensitivity to rocuronium, sugammadex 2 mg/kg administered at a T1 of 10% safely and effectively antagonized rocuronium-induced neuromuscular block in 90 s.
Biliary atresia associated with polysplenia syndrome, dextrocardia, situs inversus totalis and malrotation of intestines
Authors: Praveen Mathur, Rahul Gupta, Varsha Soni, Reyaz Ahmed, Ram Babu Goyal
Journal: J Neonatal Surg (2014)
Keywords: biliary atresia, malrotation, polysplenia
MeSH terms: Case Reports

Biliary atresia (BA) is a rare disease and the end result of a destructive, inflammatory cholangiopathy, leading to fibrosis and biliary cirrhosis. It is classified into syndromic variety with various congenital anomalies and non-syndromic (isolated anomaly). We present here a 1-month-old female child with the syndromic variety of BA associated with polysplenia syndrome, dextrocardia, situs inversus totalis and malrotation of intestines. She developed jaundice in the first week of life. Kasai operation was performed but she developed cholangitis and septicemia 2.5 months after surgery and succumbed later.
Small bowel metastases from a testicular choriocarcinoma revealed by gastrointestinal bleeding: a case report
Authors: Cherihane Dassouli, Chama El Manjra, Adil Ait Errami, Sofia Oubaha, Zouhour Samlani, Khadija Krati
Journal: Pan Afr Med J (2021)
Keywords: testicular choriocarcinoma, case report, intussusceptions, melenas, small bowel metastases
MeSH terms: Choriocarcinoma / diagnosis, Intestinal Neoplasms / diagnosis, Neoplasms, Germ Cell and Embryonal / diagnosis, Testicular Neoplasms / diagnosis, Case Reports, Adult, Choriocarcinoma / pathology, Gastrointestinal Hemorrhage / etiology, Humans, Intestinal Neoplasms / secondary, Intestine, Small / pathology, Intussusception / etiology, Male, Neoplasms, Germ Cell and Embryonal / pathology, Testicular Neoplasms / pathology, Testicular Germ Cell Tumor

Testicular germ cell tumors are the most common cancers in young men. In most cases, patients may present a painless testicular swelling. However, in 10% the presentation is variable and related to site of metastasis and complications. Clinically apparent gastrointestinal involvement was seen in 5% of cases and dominates by gastrointestinal bleeding. We report a case of testicular choriocarcinoma involving the small intestine revealed by melena and complicated by acute intussusception.
Late-onset doxorubicin-induced congestive heart failure in an elderly cancer survivor: A case report
Authors: Hirotaka Suto, Makiko Suto, Yumiko Inui, Atsuo Okamura
Journal: Front Cardiovasc Med (2023)
Keywords: cancer survivor, cardiotoxicity, doxorubicin, elderly, global longitudinal strain, onco-cardiology, troponin i
MeSH terms: Case Reports

Background:
Recently, the survival rate of patients with cancer has improved annually due to advancements in cancer diagnosis and treatment technologies. Meanwhile, late-onset complications associated with cancer treatment significantly affect survival and quality of life. However, different from pediatric cancer survivors, there is no unified view on the follow-up of late complications in elderly cancer survivors. We reported a case of congestive heart failure as a late-onset complication of doxorubicin (DXR) in an elderly cancer survivor.
Case report:
The patient is an 80-year-old woman with hypertension and chronic renal failure. She received six cycles of chemotherapy for Hodgkin's lymphoma that started in January 201X-2. The total dose of DXR was 300 mg/m2, and a transthoracic echocardiogram (TTE) performed in October 201X-2, showed good left ventricular wall motion (LVWM). In April 201X, she suddenly developed dyspnea. Upon arrival at the hospital, a physical examination revealed orthopnea, tachycardia, and leg edema. A chest radiograph showed cardiac enlargement and pleural effusion. A TTE showed diffusely reduced LVWM and a left ventricular ejection fraction in the 20% range. After close examination, the patient was diagnosed with congestive heart failure due to late-onset DXR-induced cardiomyopathy.
Conclusion:
Late-onset DXR-induced cardiotoxicity is considered high-risk from 250 mg/m2 or higher. Elderly cancer survivors are at higher risk of cardiotoxicity than non-elderly cancer survivors and may require closer follow-up.
Blue rubber bleb nevus syndrome as a cause of lower digestive bleeding
Authors: Carlos Augusto Real Martinez, Murilo Rocha Rodrigues, Daniela Tiemi Sato, Paulo Pedroso Silveira Júnior, Rafael Fernandes Gama, Christian Bornia Mattavelli, José Aires Pereira
Journal: Case Rep Surg (2014)

Introduction. Blue rubber bleb nevus syndrome is a rare disorder that is characterized by multiple recurrent vascular malformations that involve the skin and the gastrointestinal tract. The disease can present chronic anemia and severe episodes of gastrointestinal bleeding. Case Report. A 41-year-old man was admitted with recurrent episodes of lower gastrointestinal bleeding and anemia that had worsened over the last 3 months. The physical examination showed soft, diffuse, compressible, bluish nodules on all of the skin surfaces of the body. A biopsy from one of these skin lesions allowed a histological diagnosis of cavernous hemangioma. He submitted to a colonoscopy, which showed hemorrhoids and a plane vascular lesion mainly located on the right colon with recent signs of bleeding; this lesion was treated by local excision and sclerosis. The pathological study of the colon specimens also reflected the presence of cavernous hemangioma. The cutaneous hemangiomas and the presence of colonic venous malformations were compatible with blue rubber bleb nevus syndrome. The patient presented a favorable follow-up with clinical control of the anemia and without relapse of the gastrointestinal bleeding two years after the procedure. Conclusion. Although rarely diagnosed, blue rubber bleb nevus syndrome may be responsible for lower digestive bleeding.