OpenMed/multicare-articles huggingface dataset:
Case Report: Severe cutaneous adverse event associated with checkpoint inhibition in the setting of CAR T-cell therapy: beyond CRS
Authors: Chiara Masucci, Sara Pepe, Ursula La Rocca, Veronica Zullino, Maria Stefania De Propris, Walter Barberi, Anna Paola Iori, Sabina Martelli, Franco Ruberto, Maurizio Martelli, Alice Di Rocco
Journal: Front Oncol (2023)
Keywords: car t, crs, pmbcl, bullous erythema, checkpoint inhibitors, immunotherapy
MeSH terms: Case Reports

Anti-CD19 chimeric antigen receptor (CAR) T cell therapy actually represents the standard of care for multiple relapsed or refractory primary mediastinal B-cell lymphoma (r/r PMBCL). Checkpoint inhibitors, such as pembrolizumab, appear to be a safe and effective treatment strategy for patients who are ineligible for or resistant to autologous stem cell transplantation. Although preclinical studies suggested that checkpoint inhibitors may enhance the vitality and anti-tumor activity of CAR T cells, there are no substantial/robust clinical data about the immune-mediated toxicity of their association. We describe a case of a severe cutaneous adverse event arising immediately after Cytokine Release Syndrome (CRS) on day +6 from CAR T cells infusion in a young r/r PMBCL patient who previously received pembrolizumab. These skin lesions were interpreted as an immune mediated adverse event, considering their prompt improvement and fully recovering achieved with the addition of immunoglobulin infusion to systemic steroid therapy. This case of life-threatening cutaneous adverse event calls for further investigations about off-target immune-related adverse events deriving from the combination of CAR T cell therapy and checkpoint inhibition, whose synergic therapeutic effect is promising.
Suprasellar Mature Cystic Teratoma Mimicking Rathke's Cleft Cyst: A Case Report and Systematic Review of the Literature
Authors: Shenzhong Jiang, Zhaojian Wang, Yan You, Renzhi Wang, Xinjie Bao
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: case, mature cystic teratomas, neuropathology, rare lesion, sellar region
MeSH terms: Central Nervous System Cysts / complications, Central Nervous System Cysts / diagnosis, Sella Turcica / pathology, Teratoma / complications, Teratoma / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Systematic Review, Adult, Diagnosis, Differential, Endoscopy, Female, Humans

In this article, we present a 31-year-old female who presented with intermittent headache and oligomenorrhea of over 10 years' duration. Imaging revealed a large suprasellar mass with sellar extension. The patient underwent an endoscopic endonasal trans-sphenoidal surgery to resection of the mass. Clinical, radiological, and operative findings from this patient were initially considered to be Rathke's cleft cyst (RCC). However, postoperative histological examinations revealed a mature cystic teratoma. No radiotherapy was performed after surgery. At the most recent follow-up, approximately 1 year later, the patient is doing well with no headache and no recurrence of the teratoma.
Bleomycin sclerotherapy for severe symptomatic and persistent pelvic lymphocele
Authors: Ana Sofia Fernandes, Antónia Costa, Raquel Mota, Vera Paiva
Journal: Case Rep Obstet Gynecol (2014)

Background. Pelvic lymphoceles are frequently described as a complication of pelvic lymphadenectomy performed for surgical staging of gynaecologic malignancies. Case Report. A 72-year-old woman presented with severe symptomatic and refractory lymphocele associated with persistent lower limb lymphedema and recurrent erysipelas. After four CT fluoroscopy scan guided percutaneous catheter drainages, the lymphocele complicated with infection finally resolved with two sessions of bleomycin sclerotherapy. Conclusion. Symptomatic persistent lymphoceles require treatment and nowadays the first option is interventional radiologic procedures. Bleomycin is a safe and effective sclerosing agent and therefore should be regarded as a first-line treatment choice.
Gestational Tubal Choriocarcinoma Presenting as a Pregnancy of Unknown Location following Ovarian Induction
Authors: Lawrence Hsu Lin, Koji Fushida, Eliane Azeka Hase, Regina Schultz, Laysa Manatta Tenorio, Fabricia Andrea Rosa Madia, Evelin Aline Zanardo, Leslie Domenici Kulikowski, Rossana Pulcineli Vieira Francisco
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

The management of pregnancy of unknown location (PUL) can be a challenging situation, since it can present as several different conditions. Here we describe a rare case of gestational choriocarcinoma arising in the fallopian tube after ovarian induction in an infertile patient. The patient received clomiphene for ovarian induction and had rising levels of human chorionic gonadotropin (hCG) over nine months without sign of pregnancy. After referral to our center, the patient was diagnosed with a paraovarian tumor, which revealed a gestational choriocarcinoma arising in the fallopian tube; the final diagnosis was supported by pathological and cytogenomic analysis. Malignancies, such as gestational trophoblastic disease, should be in the differential diagnosis of PUL; the early recognition of these conditions is key for the proper treatment and favorable outcome.
Cephalic tetanus from penetrating orbital wound
Authors: Eloïse Guyennet, Jean-Laurent Guyomard, Emilie Barnay, Franck Jegoux, Jean-François Charlin
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Tetanus is a neurologic disorder caused by tetanospasmin, a protein toxin elaborated by Clostridium tetani. Cephalic tetanus is a localized form of the disease causing trismus and dysfunction of cranial nerves. We report the case of a man who presented with facial trauma, complete ophthalmoplegia, exophthalmos, areactive mydriasis, and periorbital hematoma. An orbital CT revealed air bubbles in the right orbital apex. The patient was given a tetanus toxoid booster and antibiotherapy. After extraction of a wooden foreign body, the patient developed right facial nerve palsy, disorders of swallowing, contralateral III cranial nerve palsy, and trismus. Only one case of cephalic tetanus from penetrating orbital wound has been reported in literature 20 years ago. When a patient presents with an orbital wound with ophthalmoplegia and signs of anaerobic infection, cephalic tetanus should be ruled out.
Hematuria: an uncommon presentation of Glanzmann's thrombasthenia-lessons learnt
Authors: Sriram Krishnamoorthy, Santosh Kumar, Nitin Kekre
Journal: Indian J Urol (2010)
Keywords: glanzmann's thrombasthenia, hematuria, platelet transfusions
MeSH terms: Case Reports

A 55-year-old man with Glanzmann's thrombasthenia had recurrent episodes of gross painless hematuria for the past 30 years. His last episode of hematuria occurred a month ago, associated with pain in the right loin and was diagnosed to have a right mid-ureteric calculus. Under adequate platelet cover, he underwent right ureteroscopy. Postoperatively, he had persistent significant hematuria that did not improve despite repeated platelet transfusions. Factor VIIa was also transfused, without much benefit. A ureteroscopy was done, which identified bleeding from within the renal pelvis. CT angiogram confirmed the rupture of an artery supplying the interpole segment of the right kidney. Bleeding settled after angioembolization. Indiscriminate use of platelet transfusions would result in a state of platelet refractoriness. It is also important to suspect an iatrogenic cause for any complication that occurs after a surgical procedure, even if there could be an underlying medical etiology that can be attributed to the development of such complication.
A case report of iatrogenic deterioration of yet undiagnosed Rhombencephalitis; always be careful with corticoids
Authors: L Mandigers, J L Epker
Journal: BMC Clin Pathol (2018)
Keywords: corticosteroid therapy, differential diagnosis, listeria monocytogenes, listeria rhombencephalitis
MeSH terms: Case Reports

Background:

Listeria monocytogenes is a bacterium present in some food products. It is rarely the cause of Rhombencephalitis in immunocompetent patients.
Case presentation:
We report a case of an immunocompetent patient, presenting with progressive perioral numbness and dizziness. Despite treatment with antiplatelet drugs, antiviral medication, antibiotics and corticosteroids for a wide differential diagnosis, the patient deteriorated tremendously. Eventually the patient died of Listeria rhombencephalitis, most likely due to the late diagnosis and concomitant late initiation of antibiotics combined with badly timed and inappropriate corticosteroid prescription.
Conclusion:
Early adequate antibiotic treatment is essential in Listeria rhombencephalitis and corticosteroid therapy should be avoided when Listeriosis is suspected.
An Asymptomatic and Overelongated Styloid Process
Authors: Emrah Soylu, Ahmet Altan, Ahmet Ercan Sekerci, Nıhat Akbulut
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Elongation of the styloid process is a rare condition. Only 4% of patients have clinical symptoms where elongated styloid process (ESP) occasionally irritates or disrupts adjacent anatomical structures, which is called Eagle syndrome. This present report was aimed at reporting an asymptomatic ESP with unusual width and length.
Case Report: Reconstruction of the Right Atrium With the Left Atrial Appendage
Authors: Xuan Jiang, Jinduo Liu, Yuhai Zhang, Tianxiang Gu, Bo Liu
Journal: Front Cardiovasc Med (2021)
Keywords: heart surgery, infection, infective endocarditis, left atrial appendage, right atrium
MeSH terms: Case Reports

We herein present a case of infective endocarditis of the mitral valve and a paravalvular abscess around the tricuspid valve. Preoperative blood culture confirmed the presence of pathogenic diphtheroids. During the operation, an unexpected infection of the free wall of the right atrium (RA) near the tricuspid annulus was found. We harvested the left atrial appendage (LAA) en bloc. After resection of the infected and abnormal tissues, the resected LAA was used to reconstruct the RA. The infected mitral valve was replaced with a mechanical valve without any accident. Postoperative echocardiography showed that the RA had a supple shape, with no kinking.
Lithium-Associated Hypercalcemia Presenting with Neuropsychiatric Manifestations in a Patient with Bipolar Disorder
Authors: Roukaya Benjelloun, Imane Motaib, Yassine Otheman
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

One of the overlooked adverse effects of lithium treatment is neuropsychiatric manifestations induced by hypercalcemia (LAH). Here, we present the case of a patient, with bipolar disorder under lithium, who presented with neuropsychiatric symptoms that revealed hyperparathyroidism-induced hypercalcemia. This case illustrates the importance of monitoring parathyroid function and calcium levels in patients under lithium, especially in premenopaused women. LAH may mimic symptoms of manic episodes and should be sought in the case of brutal onset of confusion, anxiety, and/or hallucinations in the course of a bipolar disorder.
Systemic inflammatory response syndrome in a patient diagnosed with high grade inflammatory triple negative breast cancer: a case report of a potentially rare paraneoplastic syndrome
Authors: Piers R Boshier, Rosie Sayers, Dimitri J Hadjiminas, Charles Mackworth-Young, Susan Cleator, Daniel R Leff
Journal: Exp Hematol Oncol (2016)
Keywords: case report, inflammatory breast cancer, paraneoplastic syndrome, systemic inflammatory response syndrome
MeSH terms: Case Reports

Background:
Inflammatory breast cancer is a complex pathological entity associated with poor outcomes. This loco-regional disease is characterised by a rapid clinical course in the presence breast erythema and infiltration of dermal lymphatics by tumours cells. Herein we describe a case of inflammatory breast cancer with a rare presentation and disease course defined by a profound systemic inflammatory response in the absence of an infective cause.
Case presentation:
The patient presented with pyrexia and malaise following a recent tissue diagnosis of inflammatory breast cancer. At the time of admission the patient demonstrated clinical features of the systemic inflammatory response syndrome (SIRS) in the presence of a negative septic screen. Her condition deteriorated despite systemic broad spectrum intravenous antibiotics and she underwent surgical debulking of a 180 × 135 × 100 mm (821 g) primary tumour composed of oedematous, friable and haemorrhagic tissue (pT4,N1a,M0; oestrogen/progesterone/HER-2 receptor negative). Following surgery, the clinical picture dramatically improved with cessation of SIRS and normalisation of inflammatory markers. After 4 weeks the patient required readmission to hospital due to recurrent SIRS and negative septic screen. The patient received treatment with systemic chemotherapy showing transient clinical improvement and suppression of SIRS. Despite on going chemotherapy, systemic antibiotics and a trial of steroid therapy the patient died 5 months after her initial presentation to hospital. At the time of death she demonstrated persistent SIRS with elevated inflammatory markers.
Conclusion:
This is the first case report of inflammatory breath cancer associated with SIRS in the absence of clinically confirmed infection. Important learning points highlighted by this case are: (a) recognition of the diagnostic and therapeutic uncertainties that still exist in the context of inflammatory breast cancer; (b) appreciation of the potential paraneoplastic systemic inflammatory manifestations of this disease, and finally; (c) the importance a multidisciplinary and multimodal approach to treatment.
First international workshop on human endogenous retroviruses and diseases, HERVs & disease 2015
Authors: Avindra Nath, Patrick Küry, Guilherme Sciascia do Olival, Antonina Dolei, Håkan Karlsson, Laurent Groc, Marion Schneider, John Kriesel, Jean-Louis Touraine, François Mallet, Patrice N Marche, Frederick Arnaud, Cédric Feschotte, Hervé Perron
Journal: Mob DNA (2015)
MeSH terms: Case Reports

The First International Scientific Conference on Human Endogenous Retroviruses (HERVs) and Disease, Lyon-France, May 26-27th 2015, brought together scientific and medical specialists from around the world investigating the involvement of human endogenous retroviruses (HERVs) in complex human diseases.
A Non-Resolving "Hematoma" Diagnosed as an Arteriovenous Malformation by POCUS
Authors: Michael Freilich, Benjamin Galen, Deborah Schwartz
Journal: POCUS J (2022)
Keywords: avm, pocus
MeSH terms: Case Reports

Point-of-care ultrasound (POCUS) is a useful tool for the evaluation of soft tissue masses. We present the case of a patient with a mass on his forehead initially thought to be a slowly resolving hematoma. POCUS examination of the mass revealed a vascular structure more consistent with a post-traumatic arteriovenous malformation (AVM). This case illustrates how POCUS can be utilized to rapidly assess soft tissue masses and even identify unexpected vascularity.
"If I get sick here, I will never see my children again": The mental health of international migrants during the COVID-19 pandemic in Chile
Authors: Alice Blukacz, Báltica Cabieses, Alexandra Obach, Paula Madrid, Alejandra Carreño, Kate E Pickett, Niina Markkula
Journal: PLoS One (2022)
MeSH terms: COVID-19 / epidemiology, Transients and Migrants, Research Support, Non-U.S. Gov't, Child, Chile / epidemiology, Humans, Mental Health, Pandemics

Background:
The COVID-19 pandemic has had an impact on the mental health of international migrants globally. Chile has managed its response to the pandemic in an ongoing context of social unrest and combined regional migratory and humanitarian crisis. The country's population presents a high prevalence of common mental disorders and a high suicide rate, with limited access to mental healthcare. International migrants in Chile represent 8% of the total population, and although a socioeconomically heterogenous group, they face social vulnerability, a range of mental health stressors and additional barriers to access mental healthcare. This study describes the mental health outcomes, stressors, response, and coping strategies perceived by international migrants during the COVID-19 pandemic in Chile.
Methods and findings:
A qualitative case study was carried out through individual online interviews to 30 international migrants living in Chile during the pandemic and 10 experts of the social and health care sectors. An inductive content analysis was carried out, a process during which the researchers sought to identify patterns and themes derived from the data. Participants experienced mainly negative mental health outcomes, including anxiety and depression symptomatology. Stressors included the virus itself, work, living and socioeconomic conditions, discrimination, fear for their family and distance caring. Institutional responses to address the mental health of international migrants during the pandemic in Chile were limited and participants relied mainly on individual coping strategies.
Conclusions:
The pandemic can represent an important opportunity to strengthen mental health systems for the general population as well as for population groups experiencing social vulnerability, if the issues identified and the lessons learned are translated into action at national, regional, and international level. Promoting the mental health of international migrants means recognising migration as a social determinant of mental health and adopting a cross-cultural as well as a Human Rights approach.
Successful treatment of a refractory intestinal Behcet's disease with an oncology history by Vedolizumab: a case report and literature review
Authors: Ruixia Li, Xiaofei Li, He Zhou, Yanting Shi, Fang Wang, Tong Wu, Jie Liang
Journal: Front Immunol (2023)
Keywords: behcet’s disease, case report, intestinal disease, tumor, vedolizumab
MeSH terms: Behcet Syndrome / complications, Behcet Syndrome / diagnosis, Behcet Syndrome / drug therapy, Biological Products / therapeutic use, Intestinal Diseases, Review, Case Reports, Research Support, Non-U.S. Gov't, Biological Factors / therapeutic use, Female, Humans, Middle Aged, Tumor Necrosis Factor Inhibitors / therapeutic use, Tumor Necrosis Factor-alpha / therapeutic use, Ulcer / drug therapy, Ulcer / etiology, vedolizumab, Tumor Necrosis Factor Inhibitors, Tumor Necrosis Factor-alpha, Biological Factors, Biological Products

Objective:
Behçet's Disease (BD) is an intractable systemic vasculitis. When accompanied by intestinal symptoms, the prognosis is usually poor. 5-Aminosalicylic acid (5-ASA), corticosteroids, immunosuppressive drugs, and anti-tumor necrosis factor-α (anti-TNF-α) biologics are standard therapies to induce or maintain remission for intestinal BD. However, they might not be effective in refractory cases. Safety should also be considered when patients have an oncology history. Regarding the pathogenesis of intestinal BD and the specific targeting effect of vedolizumab (VDZ) on the inflammation of the ileum tract, previous case reports suggested that VDZ might be a potential treatment for refractory intestinal BD.
Methods:
We report a 50-year-old woman patient with intestinal BD who had oral and genital ulcers, joint pain, and intestinal involvement for about 20 years. The patient responds well to anti-TNF-α biologics but not to conventional drugs. However, biologics treatment was discontinued due to the occurrence of colon cancer.
Results:
VDZ was intravenously administered at a dose of 300 mg at 0, 2, and 6 weeks and then every eight weeks. At the 6-month follow-up, the patient reported significant improvement in abdominal pain and arthralgia. We observed complete healing of intestinal mucosal ulcers under endoscopy. However, her oral and vulvar ulcers remained unresolved, which disappeared after adding thalidomide.
Conclusion:
VDZ may be a safe and effective option for refractory intestinal BD patients who do not respond well to conventional treatments, especially those with an oncology history.
Psychological Support for Young Adults with Down Syndrome: Dohsa-Hou Program for Maladaptive Behaviors and Internalizing Problems
Authors: Haruo Fujino
Journal: Front Psychol (2017)
Keywords: dohsa-hou, down syndrome, depression, mental disorders, mind-body therapies, regression, social withdrawal

Psychological and psychiatric dysfunction is a major problem in a substantial proportion of young adults with Down syndrome. Some patients develop psychiatric issues, such as depressive, obsessive-compulsive, or psychotic-like disorders, in their late adolescence or young adulthood. Furthermore, these individuals may experience moderate to severe emotional and psychological distress. Development of a psychosocial treatment to address these issues is needed in addition to psychotropic medication. The current study reports two cases of young adults with Down syndrome, who presented psychiatric symptoms and marked disruption in their daily lives. These individuals participated in a Dohsa-hou treatment program. Following treatment, adaptive levels, maladaptive behaviors, and internalizing problems were evaluated by the Vineland Adaptive Behavior Scales-II. Participants showed improvement in maladaptive behaviors and internalizing problems; however, improvement in these areas may be influenced by baseline severity of the problems. This case report suggests that Dohsa-hou could be an effective therapeutic approach for maladaptive and internalizing problems in adults with Down syndrome.
Acupuncture for the treatment of thalamencephalic and mesencephalic injury secondary to electrical trauma: A case report
Authors: Hailun Jiang, Yi Zhang, Jieying Zhang, Boxuan Li, Weiming Zhu, Chaoda Liu, Shizhe Deng, Yuzheng Du, Zhihong Meng
Journal: Front Neurosci (2023)
Keywords: acupuncture, brain injury, central nervous system disease, cerebral infarction, electrical trauma, neurological sequelae
MeSH terms: Case Reports

In a case of thalamencephalic and mesencephalic injury secondary to electrical trauma, a 29-year-old patient has been receiving manual acupuncture for 17 months in National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion. As a result of treatment, the patient's self-care ability and quality of life have greatly improved. In order to fully understand how acupuncture can benefit neurological sequelae resulting from electrical trauma, further research is needed. Additionally, there should be consideration given to the promotion of acupuncture therapy in the neurological sequelae of electric shock.
Case Report: Real NPSLE? A patient with systemic sclerosis overlapping systemic lupus erythematosus presenting as epilepsy
Authors: Jialin Zhang, Xiaodong Wu, Jing Xue, Lei Liu
Journal: Front Immunol (2023)
Keywords: glucocorticoid, neuropsychiatric systemic lupus erythematosus, rheumatic immune diseases, scleroderma renal crisis, systemic sclerosis
MeSH terms: Epilepsy / diagnosis, Epilepsy / drug therapy, Epilepsy / etiology, Lupus Erythematosus, Systemic / complications, Lupus Erythematosus, Systemic / diagnosis, Lupus Erythematosus, Systemic / drug therapy, Lupus Vasculitis, Central Nervous System / diagnosis, Lupus Vasculitis, Central Nervous System / drug therapy, Scleroderma, Localized, Scleroderma, Systemic / complications, Scleroderma, Systemic / diagnosis, Case Reports, Humans

Neuropsychiatric systemic lupus erythematosus (NPSLE) is the diagnosis that rheumatologists most often need to consider when a patient with lupus presents with neurologic symptoms. However, neurological involvement is rare in systemic sclerosis (SSc), and high doses of steroids tend to trigger scleroderma renal crisis (SRC). When a patient with SSc overlapping SLE presents with epilepsy and renal crisis, the exact diagnosis and whether to initiate high-dose glucocorticoid therapy are questions to ponder. Here, we report a patient with overlap syndrome (SSc overlapping SLE), who developed CNS symptoms, and improved after treatment against SRC after excluding NPSLE. We report this case with the aim of arousing the attention of rheumatologists to SSc and SRC-related encephalopathy when SSc was overlapped with SLE.