OpenMed/multicare-articles huggingface dataset:
A Rare Case of Acute Myeloid Leukemia Initially Presenting With Fever of Unknown Origin and Rapidly Progressing Pericardial Effusion
Authors: Charity Iheagwara, Folasade Ajayi, Onyinye N Otaluka, Carlos Cantu Lopez, Jihad Slim, Hamid S Shaaban, Ala Muhanna, Bereket Tewoldemedhin, Maria Szabela, Jack Boghossian
Journal: Cureus (2024)
Keywords: acute myeloid leukemia, acute myeloid leukemia and fever of undetermined origin, acute myeloid leukemia and pericardial effusion, aml, fever of undetermined origin, fever of unknown origin, hemophagocytic lymphohistiocytosis and aml, pericardial effusion, pericardial effusion and aml, post covid pericardial effusion
MeSH terms: Case Reports

This case report highlights a patient who had persistent fevers for weeks and rapidly progressing pericardial effusion following a positive test for coronavirus disease 2019 (COVID-19) two weeks before presentation to the hospital. The initial thought was that her fever was of infectious etiology, but relevant investigations led to the diagnosis of acute myeloid leukemia (AML). AML, which is characterized by clonal expansion of immature "blast cells" in the peripheral blood and bone marrow resulting in ineffective erythropoiesis and bone marrow failure, is the most prevalent form of leukemia. It is the most aggressive form of leukemia, which has varying prognoses determined by the subtypes. This report explores the association between AML, fever of unknown origin, and pericardial effusion, shedding light on a notable clinical aspect. Fever in AML may be attributed to underlying inflammatory processes, cytokine dysregulation, or bone marrow failure. Recognition of fever as a potential indicator of AML contributes to enhanced clinical vigilance. Pericardial effusions and cardiac tamponade, although rare, can be a presenting feature of AML, and can present side by side with fever of unknown origin as seen in this case report.
Data management plan and REDCap mobile data capture for a multi-country Household Air Pollution Intervention Network (HAPIN) trial
Authors: Shirin Jabbarzadeh, Lindsay M Jaacks, Amy Lovvorn, Yunyun Chen, Jiantong Wang, Lisa Elon, Azhar Nizam, Vigneswari Aravindalochanan, Jean de Dieu Ntivuguruzwa, Kendra N Willams, Alexander Ramirez, Michael A Johnson, Ajay Pillarisetti, Thangavel Gurusamy, Ghislaine Rosa, Anaité Diaz-Artiga, Juan C Romero, Kalpana Balakrishnan, William Checkley, Jennifer L Peel, Thomas F Clasen, Lance A Waller
Journal: Digit Health (2024)
Keywords: data collection, hapin, redcap, redcap mobile app, data management, digital data capture, household air pollution, multi-country

Background:
Household air pollution (HAP) is a leading environmental risk factor accounting for about 1.6 million premature deaths mainly in low- and middle-income countries (LMICs). However, no multicounty randomized controlled trials have assessed the effect of liquefied petroleum gas (LPG) stove intervention on HAP and maternal and child health outcomes. The Household Air Pollution Intervention Network (HAPIN) was the first to assess this by implementing a common protocol in four LMICs.
Objective:
This manuscript describes the implementation of the HAPIN data management protocol via Research Electronic Data Capture (REDCap) used to collect over 50 million data points in more than 4000 variables from 80 case report forms (CRFs).
Methods:
We recruited 800 pregnant women in each study country (Guatemala, India, Peru, and Rwanda) who used biomass fuels in their households. Households were randomly assigned to receive LPG stoves and 18 months of free LPG supply (intervention) or to continue using biomass fuels (control). Households were followed for 18 months and assessed for primary health outcomes: low birth weight, severe pneumonia, and stunting. The HAPIN Data Management Core (DMC) implemented identical REDCap projects for each study site using shared variable names and timelines in local languages. Field staff collected data offline using tablets on the REDCap Mobile Application.
Results:
Utilizing the REDCap application allowed the HAPIN DMC to collect and store data securely, access data (near real-time), create reports, perform quality control, update questionnaires, and provide timely feedback to local data management teams. Additional REDCap functionalities (e.g. scheduling, data validation, and barcode scanning) supported the study.
Conclusions:
While the HAPIN trial experienced some challenges, REDCap effectively met HAPIN study goals, including quality data collection and timely reporting and analysis on this important global health trial, and supported more than 40 peer-reviewed scientific publications to date.
Efficacy of steroid therapy in the acute stage of anti-NMDAR and anti-MOG antibody overlapping encephalitis: a case report and literature review
Authors: Hikari Kondo, Yuko Takeuchi, Junichi Niwa, Kenji Yoshida, Naoaki Takemura, Sachiko Hosoyama, Tomotsugu Kaga, Kimihiko Kaneko, Naoki Mabuchi
Journal: Front Immunol (2024)
Keywords: n-methyl-d-aspartate receptor (nmdar), anti-nmdar encephalitis, autoimmune encephalitis, myelin oligodendrocyte glycoprotein (mog), overlapping encephalitis, steroid
MeSH terms: Autoantibodies / blood, Autoantibodies / immunology, Myelin-Oligodendrocyte Glycoprotein / immunology, Steroids / therapeutic use, Case Reports, Review, Adult, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / drug therapy, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / immunology, Encephalitis / diagnosis, Encephalitis / drug therapy, Encephalitis / immunology, Humans, Male, Receptors, N-Methyl-D-Aspartate / antagonists & inhibitors, Receptors, N-Methyl-D-Aspartate / immunology, Treatment Outcome, Myelin-Oligodendrocyte Glycoprotein, Autoantibodies, Steroids, Receptors, N-Methyl-D-Aspartate, MOG protein, human

Background:
Recently, cases of overlapping encephalitis caused by anti-N-methyl-D-aspartate receptor (anti-NMDAR) and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies have been reported, and their clinical characteristics are gradually becoming clear. Acute-phase treatment typically involves the use of steroids, and although some studies have suggested that steroids can be effective, the extent of their efficacy has not yet been fully explored.
Case presentation:
We present the case of a 25-year-old man with anti-NMDAR and anti-MOG antibody overlapping encephalitis who showed considerable improvement after steroid treatment. To gain a deeper understanding of the efficacy of steroids in managing this condition, we conducted a literature review of cases of anti-NMDAR and anti-MOG antibody double-positive encephalitis that were treated with steroids during the acute phase. Thirteen cases were analyzed, including a new case diagnosed at our hospital. All patients showed improvement after receiving steroid treatment in the acute phase. Ten patients did not have any sequelae, and nine of them showed a rapid or major response during the acute phase. In contrast, three patients experienced sequelae (mild cognitive decline, visual impairment, and memory impairment, respectively), with their response to steroids in the acute phase being slow or limited. Relapses occurred in five patients, in one patient during steroid tapering, and in another two patients after cessation of steroids.
Conclusion:
Steroid therapy can be effective in the acute stage of anti-NMDAR and anti-MOG antibody overlapping encephalitis. A positive prognosis may be expected in patients who experience substantial improvement with steroid therapy during the acute phase.
Diagnosis and treatment of coronary spasm in China: a case report
Authors: Hongyang Zhang, Xianglin Ye, Haifeng Pei
Journal: Front Cardiovasc Med (2024)
Keywords: angina, coronary angiography, coronary vasospasm, intracoronary ultrasound, myocardial bridging
MeSH terms: Case Reports

Background:
Coronary vasospasm (CVS) is a common cardiovascular condition, yet its implications should not be underestimated. Regrettably, the current diagnostic and treatment standards for CVS in China are not standardized, severely affecting the quality of life for patients with this condition.
Case presentation:
A 68-year-old male presented to the hospital one month prior due to recurrent chest pain. Coronary angiography (CAG) revealed a mid-segment muscle bridge with plaque formation in the left anterior descending artery, followed by pharmacological balloon angioplasty. The primary diagnosis post-operation was acute non-ST elevation myocardial infarction (NSTEMI) and coronary artery myocardial bridging. This time, the patient experienced nocturnal chest pain with a dynamic increase in troponin levels. Emergency CAG showed the left anterior descending and right coronary arteries were fine, with segmental narrowing reaching 95%-99%. Intravascular ultrasound (IVUS) indicated negative remodeling of the mid-segment lumen associated with myocardial bridging, with the smallest lumen area being 2.19 mm2. After intracoronary administration of nitroglycerin, the original most narrowed lumen area increased to 8.81 mm2. Consequently, a definitive diagnosis of CVS with coronary artery myocardial bridging was made, and the medication treatment plan was promptly adjusted. The patient's symptoms disappeared, and he was discharged. Follow-up after more than three months showed no recurrence of symptoms.
Conclusion:
In cases where provocative agents are contraindicated, CAG combined with IVUS can optimize the differential diagnosis of CVS. There is an urgent need in China to improve epidemiological data on CVS and establish standardized diagnostic and treatment protocols.
Navigating Interstitial Heterotopic Pregnancy: A Case Report
Authors: Rayhan Karimi, Rachael McCabe
Journal: Cureus (2024)
Keywords: cornual pregnancy, cornuostomy, ectopic pregnancy, heterotopic interstitial pregnancy, intrauterine pregnancy
MeSH terms: Case Reports

Interstitial heterotopic pregnancy (IHP), an exceedingly rare and clinically intricate phenomenon, presents a diagnosis that challenges healthcare providers in obstetric care. This case report provides valuable insights into the complexities of diagnosing and managing IHPs, shedding light on the pivotal role of early and precise identification. Through a meticulous examination of a 28-year-old patient's clinical history and diagnostic journey, this report underscores the significance of advanced imaging techniques and swift decision making, ultimately leading to the accurate diagnosis of an IHP. Furthermore, it highlights the life-saving importance of cornuostomy as a safe and effective intervention, preserving the intrauterine pregnancy while successfully resolving the ectopic gestation. This case report serves as a compelling reminder of the critical need for timely diagnosis and individualized treatment in cases of IHPs, ultimately enhancing the understanding and management of this rare obstetric condition.
Transcatheter arterial embolization followed by laparoscopic anatomic hepatectomy for spontaneous rupture of a giant hepatic angiomyolipoma: a case report
Authors: Jianjun Wang, Ruizi Shi, Hua Luo, Pei Yang, Huiwen Luo, Ziqing Gao, Decai Wang, Xintao Zeng
Journal: Front Surg (2023)
Keywords: case report, hepatic angiomyolipoma, laparoscopic hepatectomy, rupture, transcatheter arterial embolization
MeSH terms: Case Reports

Hepatic angiomyolipoma is a rare and possibly cancerous mesenchymal tumor that consists of three components: blood vessels, smooth muscle cells, and adipose tissue. In this paper, we reported a case of a 36-year-old man who had a giant hepatic angiomyolipoma with spontaneous rupture and hemorrhage. The patient was admitted to our hospital with sudden upper abdominal pain for 3 h. A giant tumor was found in the left and caudate lobes of the liver, as well as significant blood collection around the liver and in the pelvis. Hemoglobin, liver function test results, and serum tumor maker levels were all within normal ranges. To prevent bleeding, emergency angiography and embolization were performed. During angiography, it was discovered that the tumor was supplied by the left hepatic artery and had a very rich internal blood supply. A massive left hepatic mass of about 11 cm in diameter was found bulging from the surface of the liver and rupturing there during laparoscopic exploration a week later. The rupture was strongly adhered to the smaller curvature of the stomach. The patient underwent laparoscopic left hemihepatectomy and caudate lobectomy, and the tumor specimen was brown, with clear boundaries with the surrounding normal liver parenchyma, and there were a large number of necrotic lesions inside the tumor. Histopathological results confirmed the mass as hepatic angiomyolipoma with negative resection margins. Immunohistochemical staining indicated that the tumor had positive homatropine methylbromide-45. After 13 months of follow-up, no tumor recurrence or metastasis occurred in the patient.
Blastic Plasmacytoid Dendritic Cell Neoplasm: A Rare Entity in Clinical Practice
Authors: Bárbara Oliveira, Carolina Nogueira, Luís Dias, Teresa Ribeiro, Guilherme Gomes
Journal: Cureus (2024)
Keywords: bpdcn, cd56+ natural killer (nk) cells, hematological malignancy, non-cutaneous bpdcn, rare cancers
MeSH terms: Case Reports

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an exceedingly rare and aggressive hematologic malignancy. In the current World Health Organization classification, it is classified among histiocytic/dendritic cell neoplasms. This report describes the case of an 85-year-old female with a complex medical history, including rheumatoid arthritis, who presented with a one-month history of low-grade fever, anorexia, and unexplained weight loss. The diagnosis of BPDCN was confirmed following an immunophenotyping analysis of a bone marrow aspirate. With this report, the authors intend to shed some light on BPDCN's clinical presentation, diagnostic journey, therapeutic approaches, and patient outcomes, and denote the significance of early detection and interdisciplinary collaboration in enhancing patient care.
Resection of unresectable hepatocellular carcinoma after conversion therapy with apatinib and camrelizumab: a case report and literature review
Authors: Xin-Liang Liu, Xiang-Ze Li, Yi-Fu Chu, Feng Liu, Hu Tian
Journal: Front Oncol (2024)
Keywords: apatinib, camrelizumab, conversion therapy, hepatocellular carcinoma, immune checkpoint inhibitors, surgical resection, tyrosine kinase inhibitors
MeSH terms: Case Reports

Hepatocellular carcinoma is a rather common malignant tumor. Most patients with hepatocellular carcinoma receive their diagnosis at an advanced stage, at which surgical resection is no longer appropriate. A growing body of research has demonstrated the value of convention therapy for patients with intermediate-stage hepatocellular carcinoma, while specific application protocols and treatment guidelines are not well developed. Emerging clinical researches suggest that a tyrosine kinase inhibitor in combination with an immune checkpoint inhibitor is a reasonable strategy for unresectable hepatocellular carcinoma. However, there are relatively few reports on the efficacy of apatinib and camrelizumab in the treatment of hepatocellular carcinoma. We were able to successfully remove one patient's hepatocellular carcinoma after 8 cycles of conversion therapy with apatinib (250 mg orally every day) and camrelizumab (200 mg intravenously every 2 weeks). The patient continued to receive the same dose of 16 cycles of apatinib and camrelizumab after hepatectomy. By the time of this study, the patient has completed 18 months of follow-up, and no tumor recurrence or metastasis was found in tumor markers and imaging examinations. Apatinib in combination with camrelizumab is an effective therapy for the treatment of advanced hepatocellular carcinoma, and surgical resection after this conversion therapy may provide patients with long-term oncological benefits. However, this requires more samples to validate the conclusion.
Hypercalcemia and Bone Metastasis in a Case of Large Cell Neuroendocrine Carcinoma With Unknown Primary
Authors: Ekrem Yetiskul, Jordyn Salak, Fatema Arafa, Alaukika Agarwal, Amanda Matra, Muhammad Niazi, Marcel Odaimi
Journal: Case Rep Oncol Med (2024)
MeSH terms: Case Reports

Large cell neuroendocrine carcinoma (LCNEC) constitutes a rare subset of highly undifferentiated malignancies known for their aggressive nature. Although these tumors commonly originate in the lungs and gastrointestinal tract, their potential occurrence is not restricted to specific anatomical sites, giving rise to a variety of symptoms. Notably, cases of neuroendocrine tumors (NETs) with an unidentified primary source exhibit a graver prognosis and shorter survival periods compared to those with clearly identified origins. NETs frequently demonstrate a propensity to metastasize, spreading to diverse anatomical regions such as the liver, lungs, lymph nodes, and bones, illustrating their aggressive nature and the complexity of their management. In this context, we present the case of a 59-year-old male who sought medical attention in the emergency department due to right upper quadrant (RUQ) abdominal pain. Initial diagnostic assessments revealed significantly elevated liver function tests and severe hypercalcemia. A right upper quadrant ultrasound (RUQ US) was subsequently performed, which revealed heterogeneous hepatic echotexture with innumerable echogenic masses, suggesting a metastatic process. A computed tomography (CT) scan was then ordered to evaluate further the RUQ US findings, which showed numerous hypovascular liver masses, raising concerns of malignancy. A liver biopsy confirmed a diagnosis of LCNEC with an unidentified primary source.
Bartonella henselae Hepatic Abscesses and Associated Osteomyelitis in a Pediatric Patient
Authors: Molly Antonson, Lauren Klingemann, Kari Neemann
Journal: Case Rep Infect Dis (2024)
MeSH terms: Case Reports

Bartonella henselae is a Gram-negative bacillus transmitted to humans via cat saliva or scratch. Cat scratch disease, the typical clinical manifestation of B. henselae infection, presents as localized cutaneous or regional lymphadenopathy. Rare, atypical presentations, generally reflecting bloodborne disseminated disease, can include hepatosplenic, cardiac, ocular, neurologic, or musculoskeletal involvement. Here, we present a case of disseminated B. henselae with hepatic abscesses and associated ischial osteomyelitis in an immunocompetent 2-year-old male patient. Although osteomyelitis is a rare manifestation of B. henselae infection, it should be included in the differential diagnosis in pediatric patients presenting with fever of unknown origin and musculoskeletal pain, especially in the setting of cat exposure. Hepatic involvement of B. henselae infection is associated with significant morbidity; therefore, abdominal imaging is critical in the diagnostic workup. This patient was successfully treated after a 6-week course of azithromycin and rifampin, as evidenced by symptom resolution and improved fluid collections on repeat imaging. While most cases of B. henselae resolve without treatment, in severe or disseminated infection such as this case, antibiotics such as azithromycin and rifampin should be considered for treatment.
Successful Retrieval of Rota Burr After Driveshaft Fracture
Authors: Tsuyoshi Kobayashi, Takeo Horikoshi, Toru Yoshizaki, Akira Sato
Journal: Case Rep Cardiol (2024)
MeSH terms: Case Reports

Rotational atherectomy is an effective procedure for heavily calcified lesions and those that cannot be crossed using conventional percutaneous coronary intervention (PCI) devices. Here, we report a rare case of intracoronary burr entrapment in the coronary artery due to burr disconnection from the driveshaft. A 67-year-old man undergoing hemodialysis for nephrosclerosis presented with exertional chest discomfort. Coronary angiography revealed stenotic lesions in the right coronary artery, and PCI was performed using a Rotawire Floppy. During the procedure, the disconnected burr was successfully removed without surgery using the child-in-mother technique with a guide extension catheter. Notably, the patient remained hemodynamically stable throughout the procedure and his recovery was uncomplicated. He was discharged on the second postprocedural day. At the 6-month follow-up, the patient remained asymptomatic with no evidence of myocardial ischemia. This report informs clinicians of the possibility of burr disconnection and the non-surgical intervention used for its removal.
Toxic epidermal necrolysis caused by phenobarbital: a case report and literature review
Authors: Jie Cheng, Hui Li, Yan Li, Xiao Li, Jianjun Wang, Xin Huang, XueYan Cui
Journal: Front Pharmacol (2024)
Keywords: cyp2c19∗1/∗2, hla-b∗15
MeSH terms: Case Reports

Background:
Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare, life-threatening immunologic reactions. Previous relevant literature has provided limited information regarding this disease's genetic susceptibility and management principles.
Objectives:
This study aimed to describe a phenobarbital-induced TEN case report with HLA-B*15:02 and HLA-B*58:01 negative, CYP2C19*1/*2. In addition, we revised the existing literature on phenobarbital-induced SJS/TEN to explore its clinical characteristics.
Methods:
We describe a woman undergoing treatment with Phenobarbital for status epilepticus who developed classic cutaneous findings of TEN. A systematic search was conducted in the PubMed, Medline, WanFang, and CNKI databases from 1995 to 2023. The search terms used were "Stevens-Johnson Syndrome," "Toxic Epidermal Necrolysis," and "Phenobarbital."
Results:
We report a case of TEN resulting from phenobarbital; it tested negative for the HLA-B*15:02 and HLA-B*58:01 allele and CYP2C19*1/*2 intermediate metabolism. Supportive treatment with steroids and antihistamines resulted in complete resolution of the skin lesions and improvement in clinical symptoms after 14 days. Physicians and clinical pharmacists should be aware of these potential phenobarbital-related adverse events and closely monitor patients with first-time use of phenobarbital. Among 19 cases were identified in the literature, with 11 (57.9%) cases of SJS, 6 (31.6%) cases of TEN, and 2 (7.2%) cases of SJS-TEN/DRESS overlap. A total of 5 (26.3%) did not survive, of which 4 (21.1%) were under 12 years old and 1 (5.3%) was over 12 years old.
Conclusion:
Phenobarbital-induced SJS/TEN may still occur in patients who test negative for HLA-B*15:02 and HLA-B*58:01, CYP2C19*1/*2. Most cutaneous adverse events occur early in the course of Phenobarbital therapy and should be closely monitored early in the course of treatment. In addition, Phenobarbital should be used with caution in patients with a history of asthma and allergy to antipyretics and analgesics.
Successful Use of Bortezomib in an Adolescent with Refractory TTP
Authors: Junaid Ahmad Wali, Brian M Quigley, Beverly Schaefer
Journal: Case Rep Hematol (2023)
MeSH terms: Case Reports

With increasing early and upfront use of rituximab and caplacizumab in the modern management of immune-mediated thrombotic thrombocytopenic purpura (iTTP), the risk of refractory disease is expected to decline. However, despite the use of adequate initial therapy, a small subset of patients develop a refractory disease which is difficult to manage. Bortezomib has come to be known as a safe and effective treatment option for refractory iTTP, but its use in children is limited. Here, we describe the case of an adolescent patient with refractory iTTP who had a satisfactory and sustained response to the use of bortezomib.