OpenMed/multicare-articles huggingface dataset:
Non-bacterial cystitis caused by pembrolizumab therapy for adenocarcinoma of the lung: a case report
Authors: Caixia Di, Teng Yu, Lei Ni
Journal: Front Immunol (2024)
Keywords: cystitis, immune checkpoint inhibitors, immunotherapy, lung cancer, pembrolizumab
MeSH terms: Adenocarcinoma of Lung / drug therapy, Antibodies, Monoclonal, Humanized / adverse effects, Antibodies, Monoclonal, Humanized / therapeutic use, Cystitis / chemically induced, Lung Neoplasms / drug therapy, Case Reports, Adult, Antineoplastic Agents, Immunological / adverse effects, Antineoplastic Agents, Immunological / therapeutic use, Female, Humans, Immune Checkpoint Inhibitors / adverse effects, Immune Checkpoint Inhibitors / therapeutic use, Urinary Bladder Neoplasms / drug therapy, pembrolizumab, Antibodies, Monoclonal, Humanized, Antineoplastic Agents, Immunological, Immune Checkpoint Inhibitors

Immune checkpoint inhibitors (ICIs) including anti-programmed death cell protein 1 (anti-PD1) and anti-programmed cell death-ligand 1 (PD-L1), by disinhibiting the antitumor responses of lymphocytes, have extended survival benefits for patients in lung cancer. ICIs can also lead to a wide spectrum of immune-related adverse events (irAEs), due to dysregulation of immune reactions. Here, we report a 27-year-old female patient with adenocarcinoma of the lung treated with pembrolizumab-combined chemotherapy treatment, who complained of urinary irritation symptoms. No bacteria were found in multiple urine cultures. B-mode ultrasonography indicated a high echo in the right lateral wall of the bladder, about 5.6 × 4.5 mm in size. Transurethral bladder tumor resection (TURBT) was operated. At biopsy, we found CD3+ CD8+ lymphocyte, plasma cell, and eosinophil infiltration and lymphoid follicle formation in the bladder mucosal layer. This is a report of non-bacterial inflammation of the urinary tract caused by immunotherapy.
A case report of a patient with recurrent and severe infections highlighting the importance of considering inborn errors of immunity
Authors: Fajer Altammar, Mohammed Alshamali, Marwan Alqunaee, Ahmad J Alali, Reem M Elshafie, Waleed Al-Herz
Journal: Front Pediatr (2024)
Keywords: fess [functional endoscopic sinus surgery], irak-4, immunodeficiency, inborn errors of immunity, pseudomonas aeruginosa
MeSH terms: Case Reports

Inborn errors of immunity (IEI) can often be misdiagnosed early in life due to their heterogenous clinical presentations. Interleukin-1 receptor-associated kinase 4 (IRAK-4) deficiency is one of the rare innate immunodeficiency disorders. We present the case of a patient who presented at the age of 15 days with meningitis and septic shock that responded to antibiotics. She was admitted again at the age of 45 days with pseudomonas aeruginosa bacteremia that was associated with increased inflammatory markers. Her third admission was at the age of 2.5 months due to left sided peri-orbital cellulitis that was again associated with elevated inflammatory markers. At 3.5 months, she experienced left orbital cellulitis, which was complicated by extensive sinus involvement, erosion, and abscess formation in the pterygopalatine fossa. Her condition progressed to septic shock and required multiple antibiotics and surgical interventions for drainage and control of the infection source. Both abscess and blood culture were positive for pseudomonas aeruginosa. An IEI was suspected but basic immunology testing was normal. Whole Exome Sequencing was performed and a novel mutation in IRAK4 was detected. In conclusion, we highlight the importance of raising awareness among pediatricians about the potentially lethal IEI and the need to consult specialists when these diseases are suspected. Among them is IRAK-4 deficiency which can be diagnosed by sophisticated functional assays and/or genetic testing.
Primary Undifferentiated Pleomorphic Sarcoma of the Breast: A Case Report with Literature Review of Similar Cases
Authors: Amirhossein Jafarian, Mohaddeseh Shahraki, Samaneh Sajjadi, Behrooz Daneshmand
Journal: Iran J Pathol (2024)
Keywords: breast, breast neoplasms, mastectomysarcoma
MeSH terms: Case Reports

Breast sarcoma is a rare but aggressive tumor. There are few case reports in the literature and several aspects of this disease are still not completely comprehended. Therefore, reporting new cases can help to enrich the literature. We report a patient with breast mass and pus secretion from her right breast, misdiagnosed as an abscess and mistreated by antibiotics. The patient was referred for an ultrasound examination and mammography, and a needle biopsy was performed that suggested an aggressive tumor. By the pathologist's suggestion, a total mastectomy of the right breast was performed with the excision of sentinel nodes. A pathological examination revealed a high-grade undifferentiated pleomorphic sarcoma (UPS) without vascular or lymph node invasion as the final diagnosis. The patient underwent postoperative chemotherapy and is currently in good condition. This case emphasizes considering this rare tumor when approaching a breast mass. Performing surgery with adequate resection margin can improve the patient's prognosis. Some suggested breast UPS cases with lung and brain metastasis would be more aggressive tumors than other breast sarcomas. Total mastectomy with negative margins and free-of-tumor lymph nodes may be the key to improve prognosis in such patients.
Electroacupuncture stimulation modulates functional brain connectivity in the treatment of pediatric cerebral palsy: a case report
Authors: Zongbo Sun, Chenglin Li, Laixin Sun, Wenwen Yang, Xueli Qu, Yuanyuan Li, Xiao Duan, Fengyu Guo, Xuejing Sun, Mingzhu Yang, Tong Qi, Longyun Zhu, Shuai Wang, Yu Xia, Yanan Du, Shuhui Luo, Lingling Li, Yu Gu, Yaya Wang, Li Yang
Journal: Front Psychiatry (2024)
Keywords: brain functional connectivity, electroacupuncture, language, meta-analysis, pediatric cerebral palsy
MeSH terms: Case Reports

Background:
Pediatric cerebral palsy (CP) is a non-progressive brain injury syndrome characterized by central motor dysfunction and insufficient brain coordination ability. The etiology of CP is complex and often accompanied by diverse complications such as intellectual disability and language disorders, making clinical treatment difficult. Despite the availability of pharmacological interventions, rehabilitation programs, and spasticity relief surgery as treatment options for CP, their effectiveness is still constrained. Electroacupuncture (EA) stimulation has demonstrated great improvements in motor function, but its comprehensive, objective therapeutic effects on pediatric CP remain to be clarified.
Methods:
We present a case of a 5-year-old Chinese female child who was diagnosed with CP at the age of 4. The patient exhibited severe impairments in motor, language, social, and cognitive functions. We performed a 3-month period of EA rehabilitation, obtaining resting state functional magnetic resonance imaging (rs-fMRI) of the patient at 0 month, 3 months and 5 months since treatment started, then characterized brain functional connectivity patterns in each phase for comparison.
Results:
After a 12-month follow-up, notable advancements were observed in the patient's language and social symptoms. Changes of functional connectivity patterns confirmed this therapeutic effect and showed specific benefits for different recovery phase: starting from language functions then modulating social participation and other developmental behaviors.
Conclusion:
This is a pioneering report demonstrating the longitudinal effect of EA stimulation on functional brain connectivity in CP patients, suggesting EA an effective intervention for developmental disabilities (especially language and social dysfunctions) associated with pediatric CP.
Stifle arthrodesis in a feline pelvic limb amputee
Authors: Wei Tze Goh, Jarrod Drew
Journal: JFMS Open Rep (2024)
Keywords: stifle, amputee, arthrodesis, hindlimb, salvage
MeSH terms: Case Reports

Case summary:
A domestic shorthair cat presented to the Animal Referral Hospital (Brisbane, Australia) after having the left pelvic limb incorrectly amputated. The cat was unable to ambulate on the remaining right pelvic limb due to a chronically subluxated stifle. A stifle arthrodesis was performed on the right pelvic limb to manage the injury. Follow-up radiographs performed 5 months postoperatively demonstrated stifle arthrodesis with no detectable complications. The owner reported that aside from some difficulties in toileting, the cat had a good quality of life and was capable of performing the majority of daily activities. Stifle arthrodesis in a feline pelvic limb amputee appears to be a viable treatment option. After a period of rehabilitation and adaptation, the cat in the case report has been able to lead a near-normal lifestyle.
Relevance and novel information:
To the authors' knowledge, this is the first report of the outcome and complications associated with stifle arthrodesis in a feline pelvic limb amputee. This is also the first report of stifle arthrodesis in a cat using the bilateral plating technique.
Case report: Clinical features and management outcomes of isolated corneal intraepithelial neoplasia
Authors: Samar A Al-Swailem, Hind M Alkatan, Huda Saif AlDhaheri, Sara M AlHilali, Azza M Y Maktabi
Journal: Front Ophthalmol (Lausanne) (2024)
Keywords: interferon, mitomycin c, ocular surface squamous neoplasia, squamous cell carcinoma, stem cell deficiency
MeSH terms: Case Reports

Purpose:
To report clinical features and treatment outcome of three cases with isolated corneal intraepithelial neoplasia (CIN).
Methods:
This case series presents 3 patients with isolated CIN. Data collected included, presenting signs and symptoms including vision, anterior segment examination, medical and surgical outcomes and signs and symptoms at lost post-treatment visit.
Results:
Case 1 was a 45-year-old male who presented with an isolated grayish amoeboid corneal lesion which was excised with alcohol assisted epitheliectomy, he also received 6 cycles of topical mitomycin C (MMC) 0.02% and one injection of interferon alfa-2b with no recurrence during the 10-year follow-up period. Case 2 was 78-year-old male referred for a suspicious white corneal lesion which was completely excised, the patient also received 6 subconjunctival injections of interferon alpha-2b. However, the lesion recurred at 2.5-years post-treatment. Case 3 was a 63-year-old male patient who presented with an isolated corneal lesion that was excised using alcohol-assisted epitheliectomy, patient received four cycles of topical 5-fluorouracil with no recurrence at last follow-up visit at 6 months.
Conclusion:
Isolated corneal intraepithelial neoplasia (CIN) is a rare entity with few reported cases in the literature. In this case series, we report long and short-term management outcomes of combined surgical and medical therapy for isolated CIN.
Successful Treatment of Refractory Generalized Granuloma Annulare with Upadacitinib
Authors: Alexis Coican, Abigail Meckley, Nathan Sagasser, Melinda Greenfield, Eingun James Song, Jessica El-Bahri
Journal: Case Rep Dermatol Med (2024)
MeSH terms: Case Reports

Granuloma annulare is a poorly understood dermatosis that, when generalized, can occur in up to 15 percent of patients. In these cases, treatment is frustrating and experimental. We report a case of a 60-year-old woman and a 41-year-old woman who demonstrated resolution of recalcitrant, generalized granuloma annulare (GA) following oral treatment with upadacitinib. After showing little to no response to other various treatments, such as steroids, antibiotic regimens, and systemic therapies, each patient was started on 15 mg of daily upadacitinib. At 2 months, one patient had complete clearance of all lesions while the other patient experienced noticeable improvement. Within 4 months, the other patient reached total resolution of her lesions. These cases provide evidence of a therapeutic option that may shorten disease duration and provide relief from cutaneous disease.
Laser-Assisted Gingival Depigmentation: A Case Report
Authors: Shrishti S Salian, Prasad V Dhadse, Ruchita T Patil
Journal: Cureus (2024)
Keywords: aesthetics, diode laser, gingival depigmentation, hyperpigmentation, melanin
MeSH terms: Case Reports

The gingiva's colour varies in different individuals and is assumed to be related to cutaneous pigmentation. The most frequent natural pigment causing endogenous gingival pigmentation is melanin, a brown pigment. Depigmentation is a therapy of choice when individuals are concerned about their appearance and demand it for their aesthetic satisfaction. It is not a clinical indication. This article demonstrates gingival depigmentation using a laser diode with a 90-day follow‑up. A 23-year-old male patient visited the Periodontology Department, complaining of poor aesthetics owing to dark-coloured gums. Depigmentation with a laser diode was selected as the treatment plan for both the maxillary and mandibular arches, at an interval of a week. The choice of a procedure is largely influenced by the gingival thickness, the clinician's experience, the patient's preferences, and the rate of recurrence. According to reports, using lasers produces better aesthetic outcomes and has a low recurrence rate.
Case Report: A novel mixture of dose-fractioned radiation and immunotherapy for treatment of cholangiocarcinoma
Authors: Ningyu Wang, Linfang Wang, Ai Huang, Jun Han, Ting Cao, Xiangping Mei, Jing Yao, Yong Xiao, Hong Ma
Journal: Front Immunol (2023)
Keywords: cholangiocarcinoma, immunotherapy, radiation dose-fractionation, radiotherapy, tumor microenvironment
MeSH terms: Bile Duct Neoplasms / therapy, Cholangiocarcinoma / therapy, Case Reports, Research Support, Non-U.S. Gov't, Adult, Bile Ducts, Intrahepatic / pathology, Humans, Immunotherapy, Male, Treatment Outcome, Tumor Microenvironment

Malignant tumors of the biliary tract exhibit a high degree of malignancy and heterogeneity with a poor overall prognosis. Immunotherapy has limited benefits for patients with cholangiocarcinoma. Radiation therapy can change the tumor microenvironment, but its effect heavily depends on radiation dose and fraction. We report a case of advanced intrahepatic cholangiocarcinoma in a 43-year-old male patient, with a huge liver mass of 16.5 cm in diameter, with bone and liver metastases at the first diagnosis. First-line treatment with chemotherapy and PD1 inhibitor was sustained only for 8 months. In second-line treatment, radiotherapy was administered, with 5 Gy in 5 fractions administered to the entire tumor area and 25 Gy in 5 fractions to the solid lesions of the tumor. After the completion of radiotherapy, programmed cell death 1 inhibitor combined with tyrosine kinase inhibitor was maintained. The patient achieved a progression-free-survival time of 12 months and an overall survival time of 25 months. The success of our case suggests that mixed low- and high-dose radiation can significantly improve tumor control and survival time. In clinical practice, based on the characteristics of the tumor and existing treatment options, the rational combination of existing treatment regimens can improve the prognosis of cholangiocarcinoma.
Case report: Acute HHV6B encephalitis/myelitis post CAR-T cell therapy in patients with relapsed/refractory aggressive B-cell lymphoma
Authors: Ningwen Li, Ruoxuan Zhang, Jue Wang, Xiaojian Zhu, Fankai Meng, Yang Cao, Gaoxiang Wang, Yang Yang
Journal: Front Neurol (2024)
Keywords: car-t cell therapy, hhv6b, encephalitis, mngs, myelitis
MeSH terms: Case Reports

Background:
The development of chimeric antigen receptor (CAR)-T cell therapy has revolutionized treatment outcomes in patients with lymphoid malignancies. However, several studies have reported a relatively high rate of infection in adult patients following CD19-targeting CAR T-cell therapy, particularly in the first 28 days. Notably, acute human herpesvirus 6 B (HHV6B) reactivation occurs in up to two-thirds of allogeneic hematopoietic stem cell transplantation patients.
Case presentations:
Herein, we describe a report of HHV6B encephalitis/myelitis in three patients with relapsed/refractory diffuse large B-cell lymphoma post CAR T-cell therapy. All three patients received multiple lines of prior treatment (range: 2-9 lines). All patients presented with fever that persisted for at least 2 weeks after CAR-T cell infusion (CTI). Both the onset time and duration were similar to those of the cytokine release syndrome (CRS); nevertheless, the CRS grades of the patients were low (grade 1 or 2). Delirium and memory loss after CTI were the earliest notable mental presentations. Neurological manifestations progressed rapidly, with patients experiencing varying degrees of impaired consciousness, seizures, and coma. Back pain, lumbago, lower limb weakness and uroschesis were also observed in Patient 3, indicating myelitis. High HHV6B loads were detected in all Cerebral spinal fluid (CSF) samples using metagenomic next-generation sequencing (mNGS). Only one patient required high-activity antivirals and IgG intravenous pulse treatment finally recovered, whereas the other two patients died from HHV6B encephalitis.
Conclusion:
Considering its fatal potential, HHV6B encephalitis/myelitis should be urgently diagnosed post CAR-T cell-based therapy. Furthermore, hematologists should differentially diagnose these conditions from CRS or other immunotherapy-related neurotoxicities as early as possible. The results of this study demonstrate the potential of mNGS in the early diagnosis of HHV6B infection, particularly when the organism is difficult to culture.
Conquering Phagophobia: A Journey to Overcoming the Fear of Choking
Authors: R Rijal, P Pokhrel
Journal: Case Rep Psychiatry (2024)
MeSH terms: Case Reports

Phagophobia is a rare and debilitating mental health condition characterized by an intense fear of choking solid food or liquids. Usually there is no underlying anatomical or physiological abnormalities. Choking phobia can lead to the avoidance of solid foods and liquids. This can give rise to other psychiatric disorders like major depressive disorder and anxiety disorder. Only few case reports of choking phobia are available in the literature. Here we present the case of a middle-aged man, with a 10-year history of fear of choking, starting after an aspiration episode and later maintained by a similar episode. The patient felt that food would be stuck in the windpipe, and he could not breathe while swallowing solid food and liquids. This eventually led to reduced eating and drinking causing significant weight loss. He also isolated himself and became depressed. After several searches for help in somatic healthcare, including surgery for deviated nasal septum, the patient was finally investigated in a psychiatric clinic and treated with pharmacological measures and behavioral therapy with considerable improvement within a few months. Choking phobia can mimic different physical conditions and is often misdiagnosed. Early recognition and timely referral to mental health professionals are vital for effective management.
Laparoscopic transabdominal preperitoneal (TAPP) groin hernia repair using n-butyl-2-cyanoacrylate (LiquiBandFIX8) for mesh fixation and peritoneal closure: case report about extraperitoneal hematoma
Authors: Sandra Raab, Livia Huber, René Fortelny, Andreas Shamiyeh
Journal: Ann Med Surg (Lond) (2023)
Keywords: liquibandfix8, case report, hematoma, inguinal hernia, mesh fixation, peritoneal closure, postoperative bleeding
MeSH terms: Case Reports

Introduction:
A symptomatic inguinal hernia is a prevalent condition that typically requires surgical intervention. Various surgical approaches have been established for hernia repair, including several techniques for peritoneal closure and mesh fixation in laparoscopic surgery. N-butyl-2-cyanoacrylate, such as LiquiBandFIX8, offers a time-saving alternative to invasive methods for both mesh fixation and peritoneal closure. While n-butyl-2-cyanoacrylate is employed in various closure procedures, LiquiBandFIX8 is specifically designed for mesh fixation in inguinal hernia repair.
Case presentation:
We present a case of a 68-year old man undergoing transabdominal preperitoneal inguinal hernia repair under full heparinization. LiquiBandFIX8 was employed for mesh fixation and peritoneal closure. Upon conducting a revision laparoscopy due to a significant postoperative hematoma, we found that the mesh and peritoneum remained undamaged and fully sealed, indicating an effective fixing technique. Both the initial repair and the subsequent revision surgery were documented and the videos were subsequently analyzed.
Conclusion:
LiquiBandFIX8 provides a reliable adhesive strength and appropriate application for peritoneal closure and mesh fixation. When encountering extraperitoneal fluid collection, there is no anticipation of intraabdominal complications.
A Case of Sublingual Gland Hypertrophy in the Setting of Submandibular Gland Aplasia Presenting as a Neck Mass
Authors: Colten Wolf, Richard Hubbell
Journal: Case Rep Otolaryngol (2024)
MeSH terms: Case Reports

Background:
Absence or aplasia of the major salivary glands is an uncommon diagnosis and is often associated with other congenital abnormalities. Agenesis of a single submandibular gland, however, is an even more rare phenomenon and can be associated with hypertrophy of other salivary glands.
Methods:
A 48-year-old female presented to the clinic with a left-sided neck mass below her mandible. Workup including a CT scan showed an absent left-sided submandibular gland and an enlarged sublingual gland protruding through the mylohyoid muscle.
Results:
The patient underwent a transoral resection of the mass with subsequent resolution of the mass. The pathology returned as normal salivary gland tissue.
Conclusions:
Sublingual gland hypertrophy is a very uncommon presentation for a patient with a neck mass. This situation can arise in the setting of submandibular gland aplasia and compensatory hypertrophy of other salivary glands.
Focal aware somatosensory seizures with paresis as a complication of surgery for chronic subdural hematoma
Authors: Shohei Ishida, Naoki Nitta, Kazumichi Yoshida
Journal: Epilepsy Behav Rep (2023)
Keywords: akinetic seizure, hemiparetic seizure, ictal paresis, inhibitory motor seizure, negative motor area
MeSH terms: Case Reports

There has been only one previous published report of focal aware somatosensory seizures with paresis as a postoperative complication of chronic subdural hematoma (cSDH). This is the second case report of this condition captured on electroencephalography (EEG) as a postoperative complication of cSDH. A 76-year-old man with no history of epilepsy was taken to the emergency department of Shiga University of Medical Science Hospital because of transient weakness of the lower extremities. Head computed tomography showed bilateral cSDH that was larger on the left. Seven days after burr-hole evacuation of the left cSDH, the patient experienced a brief clonic seizure of the right hand without postoperative recurrence of cSDH. He then experienced a tingling sensation in, followed by clumsiness and weakness of, the right upper extremity without fluctuations in consciousness or convulsive movements. These symptoms appeared repeatedly, with intermittent improvement, persisting for 6 days after onset. Scalp EEG showed an electrographic seizure in the left central area, suggesting that the symptoms corresponded to focal aware somatosensory seizures with paresis. The symptoms and epileptiform patterns and electrographic seizures on the EEG disappeared with antiseizure medications.