OpenMed/multicare-articles huggingface dataset:
Pancreaticopericardial Fistula: A Case Report and Literature Review
Authors: Muhammad S Khan, Najmi Shahbaz, Hassaan A Zia, Muhammad Hamza, Henna Iqbal, Ahmed Awab
Journal: Case Rep Crit Care (2016)

Purpose. Pancreaticopericardial fistula (PPF) is an extremely rare complication of acute or chronic pancreatitis. This paper presents a rare case of PPF and provides systematic review of existing cases from 1970 to 2014. Methods. A PubMed search using key words was performed for all the cases of PPF from January 1970 to December 2014. Fourteen cases were included in the study. The cases were reviewed for demographic characteristics, diagnostic modalities, and treatment. Descriptive analysis of these variables was performed. Results. Median age was 43 years. 78% were known alcoholics and 73.3% had chronic pancreatitis. Dyspnea was present in 78%. Cardiac tamponade was present in 53%; 75% of patients had known chronic pancreatitis (RR = 0.74). Surgery was associated with best treatment outcomes and 50% of patients who underwent endoscopic treatment survived. Conclusion. PPF is a rare disease. This paper indicates that acute cardiac tamponade in patients with history of alcoholism and chronic pancreatitis could be a sign of an existing pancreaticopericardial fistula and early surgical intervention could be life-saving.
Cardiac Dysrhythmias and Neurological Dysregulation: Manifestations of Profound Hypomagnesemia
Authors: Sagger Mawri, Edward Gildeh, Namita Joseph, Bobak Rabbani, Bryan Zweig
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Magnesium is the second most common intracellular cation and serves as an important metabolic cofactor to over 300 enzymatic reactions throughout the human body. Among its various roles, magnesium modulates calcium entry and release from sarcoplasmic reticulum and regulates ATP pumps in myocytes and neurons, thereby regulating cardiac and neuronal excitability. Therefore, deficiency of this essential mineral may result in serious cardiovascular and neurologic derangements. In this case, we present the clinical course of a 76-year-old woman who presented with marked cardiac and neurological signs and symptoms which developed as a result of severe hypomagnesemia. The patient promptly responded to magnesium replacement once the diagnosis was established. We herein discuss the clinical presentation, pathophysiology, diagnosis, and management of severe hypomagnesemia and emphasize the implications of magnesium deficiency in the cardiovascular and central nervous systems. Furthermore, this case highlights the importance of having high vigilance for hypomagnesemia in the appropriate clinical setting.
Pericardial Effusion-Associated Hyponatremia
Authors: Ahmed A Hanfy, Nicholas T Manasewitsch, Bryce D Beutler, Daniel Antwi-Amoabeng, Mohamed Elnaggar, Munadel Awad, Gurpreet S Chahal
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

Pericardial effusion has been identified as a rare cause of hyponatremia. In most patients, pericardiocentesis results in rapid correction. We describe a 67-year-old male who presented with pericardial effusion-associated hyponatremia secondary to cardiac resynchronization therapy-D placement that resolved following evacuation. In addition, we review the literature on pericardial effusion-associated hyponatremia.
Thyrotoxicosis and Choledocholithiasis Masquerading as Thyroid Storm
Authors: Christian L Horn, Patricia A Short
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

A 26-year-old female, thirteen months postpartum, presented to the emergency department for four weeks of epigastric abdominal pain, pruritus, new onset jaundice, and 11.3 kgs (25 lbs) unintentional weight loss. On examination, she was afebrile, tachycardic, alert, and oriented and had jaundice with scleral icterus. Labs were significant for undetectable TSH, FT4 that was too high to measure, and elevated total bilirubin, direct bilirubin, alkaline phosphatase, and transaminases. Abdominal ultrasound revealed cholelithiasis without biliary ductal dilation. Treatment for presumed thyroid storm was initiated. Further work-up with magnetic resonance cholangiopancreatography (MRCP) revealed an obstructing cholelith within the distal common bile duct. With the presence of choledocholithiasis explaining the jaundice and abdominal pain, plus the absence of CNS alterations, the diagnosis of thyroid storm was revised to thyrotoxicosis complicated by choledocholithiasis. Endoscopic retrograde cholangiopancreatogram (ERCP) with sphincterotomy was performed to alleviate the biliary obstruction, with prompt symptomatic improvement. Thyroid storm is a rare manifestation of hyperthyroidism with a high rate of morbidity and mortality. The diagnosis of thyroid storm is based on clinical examination, and abnormal thyroid function tests do not correlate with disease severity. Knowledge of the many manifestations of thyroid storm will facilitate a quick and accurate diagnosis and treatment.
Ring-shaped meniscus formation may arise from the regenerative response to meniscectomy during growth spurts: A case report
Authors: Masaki Nagashima, Toshiro Otani, Kota Kojima, Shinsuke Aida, Ken Ishii
Journal: Int J Surg Case Rep (2019)
Keywords: arthroscopic meniscectomy, case report, discoid meniscus, knee, ring-shaped meniscus

Introduction:
Ring-shaped meniscus is very rare and generally considered to be a congenital malformation. Here, we report a case of newly formed ring-shaped meniscus-like tissue following arthroscopic partial meniscectomy for a complete discoid lateral meniscus.
Presentation of case:
A 14-year-old boy underwent arthroscopic partial meniscectomy for complete discoid lateral meniscus of the left knee. The growth plates were present at the surgery. Although pain improved immediately after surgery, he reported left knee pain at the 7-month follow-up. Magnetic resonance imaging revealed a bucket-handle tear of the lateral meniscus and a second arthroscopic surgery was performed. During arthroscopy, we found that the anterior and posterior horns of the lateral meniscus were connected by meniscus-like tissue forming a ring-shaped meniscus and the newly formed interhorn meniscal bridge was resected. Histological evaluation indicated that the newly formed tissue was meniscus-like tissue that had appeared secondary to tissue repair. He visited our hospital at 16 years old, after the growth plates had closed, complaining of right knee pain. Arthroscopic partial meniscectomy was performed for complete discoid lateral meniscus of the right knee. As of two years after this surgery, no morphological changes have been observed.
Discussion:
Although the exact mechanisms of meniscus-like tissue formation remain unclear, the growth spurt may promote the mechanisms of tissue repair, forming ring-shaped meniscus-like tissue.
Conclusion:
This is the first case of ring-shaped meniscus-like tissue forming after partial resection of a complete discoid lateral meniscus. Ring-shaped meniscus-like tissue can develop in growing patients.
Polyostotic Fibrous Dysplasia Complicated by Pathological Fracture of Right Femoral Shaft with Nonunion: A Case Report
Authors: Qifan Yang, Jing Liu, Lei Tan, Ye Jiang, Dong Zhu
Journal: Front Surg (2022)
Keywords: femoral shaft fracture, fibrous dysplasia, nonunion, osteotomies, shepherd’s crook deformity
MeSH terms: Case Reports

Introduction:
Fibrous dysplasia is a benign fibrous bone tumor that accounts for 5% to 10% of benign bone tumors. It can manifest as simple fibrous dysplasia (70%-80%), polyostotic fibrous dysplasia (20%-30%), with approximately the same incidence in men and women. We report a patient with a rare case of multiple fibrous dysplasia combined with proximal femoral shepherd deformity with pathological fracture of the femoral shaft complicated by nonunion. It is necessary to understand the disease in more detail to avoid overtreatment of benign lesions or misdiagnosis of malignant tumors and other diseases.
Case presentation:
A 58-year-old man with polyostotic fibrous dysplasia, bilateral proximal femur deformity, Shepherd's angle deformity, right femoral shaft pathological fracture complicated by nonunion, we under fluoroscopy, in the obvious proximal fracture, take osteotomy, and process the shape of the cut bone fragment to adapt it to the corrected force line, and then restore it back to its original position, using intramedullary nailing technology complete the operation. Three months after the operation, he came to the hospital for re-examination, and an X-ray of the right femur was taken. It was found that the fractured end had a tendency to heal. The patient was instructed to gradually bear weight. After six months of re-examination, the patient could walk with a walker. One year after the operation, the patient could walk without a walker and take care of himself at home. However, there was still stretch-like pain in the right lower back, but it was tolerable.
Conclusions:
For patients with polyostotic fibrous dysplasia combined with proximal femoral shepherd deformity and pathological fracture of the femoral shaft with nonunion, osteotomy combined with intramedullary nailing is a simple and convenient way to correct the deformity and obtain correct fracture alignment.
Localized pleural metastasis without other organ metastases after nephrectomy for renal cell carcinoma
Authors: Zenya Saito, Kenichi Hata, Saiko Nishioka, Kentaro Tamura, Nobumasa Tamura, Masahiro Yoshida, Kentaro Kasa, Jun Hirano, Masataka Masubuchi, Kazuyoshi Kuwano
Journal: Respir Med Case Rep (2021)
Keywords: metastasis, pleural effusion, pleuritis, renal cell carcinoma
MeSH terms: Case Reports

We present a case of a 69-year-old man who had localized pleural metastasis without other organ metastases after nephrectomy for right renal cell carcinoma (RCC). He complained of respiratory symptoms for more than two years after the operation and was confirmed to have right pleural effusion and multiple pleural masses on computed tomography (CT). There were no abnormal findings in the other organs, but the pleural mass gradually increased in size on CT. We suspected malignant tumors such as malignant pleural mesothelioma and synovial sarcoma in addition to RCC metastasis. Finally, we performed surgical resection of the pleural mass under general anesthesia, and we diagnosed pathologically as metastasis from RCC. Distant metastases of RCC are common in the lungs, bones, brain, and liver. To our knowledge, localized pleural metastases from RCC is rare.
Potential side effect of propofol and sevoflurane for anesthesia of anti-NMDA-R encephalitis
Authors: François-Xavier Lapébie, Céline Kennel, Laurent Magy, Fabrice Projetti, Jérôme Honnorat, Nicolas Pichon, Philippe Vignon, Bruno François
Journal: BMC Anesthesiol (2014)
MeSH terms: Anesthesia / adverse effects, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis, Dyskinesia, Drug-Induced / diagnosis, Methyl Ethers / adverse effects, Propofol / adverse effects, Case Reports, Anesthesia / methods, Anesthetics, Inhalation, Anesthetics, Intravenous, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications, Anti-N-Methyl-D-Aspartate Receptor Encephalitis / therapy, Drug Therapy, Combination / adverse effects, Dyskinesia, Drug-Induced / complications, Female, Humans, Methyl Ethers / administration & dosage, Propofol / administration & dosage, Sevoflurane, Young Adult, Anesthetics, Inhalation, Anesthetics, Intravenous, Methyl Ethers, Sevoflurane, Propofol

Background:
Many anesthetic drugs interact with the NMDA receptor and may therefore alter the clinical presentation of anti-NMDA-R encephalitis.
Case presentation:
A 24-year-old woman was admitted to hospital for decreased consciousness and hyperthermia. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, and elevated protein. Cultures were negative. Patient state worsened with agitation, facial dyskinesia, ocular deviation, and limb dystonia. Diagnosis of anti-NMDA-R encephalitis was evidenced by specific antibodies. High doses of methylprednisolone were administered. CT scan disclosed an ovarian teratoma and tumor resection was scheduled under anesthesia with propofol, sufentanil, atracurium and sevoflurane. Sedation after surgery was maintained with propofol. Rapidly after surgery, patient's condition deteriorated with increase of dyskinesias, and two tonic-clonic generalized seizure events.
Conclusion:
In patients with anti-NMDA-R encephalitis, anesthesia using benzodiazepines, opiates and curares, which fail to interfere with the NMDA pathway, should be preferred.
Mandibular Osteitis Fibrosa Cystica as First Sign of Vitamin D Deficiency
Authors: Nour Mellouli, Raouaa Belkacem Chebil, Marwa Darej, Yosra Hasni, Lamia Oualha, Nabiha Douki
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Introduction:
Brown tumors of hyperparathyroidism are locally destructive bone lesions. They are the late clinical consequence of the disease. They can occur in primary, secondary, and rarely tertiary forms. They affect usually long bones and less frequently those of the maxilla.
Case report:
Our 45-year-old female patient presented with a mandibular tumor next to the first right lower molar. At first, we have chosen tooth extraction and tumor excision. When the histological report showed the giant cell tumor we suspected a metabolic bone disorder. Biochemical tests screened hyperparathyroidism and severe vitamin D deficiency, and parathyroid scintiscan revealed parathyroid adenoma.
Discussion:
The association of hyperparathyroidism and vitamin D deficiency leads to diagnostic uncertainty. First, secondary hyperparathyroidism can be due vitamin D deficiency. Second, data available show that vitamin D deficiency is more prevalent in patients with primary hyperparathyroidism than in general population. Hyperparathyroidism management is based on correct and precise diagnosis. Furthermore, the resolution of brown tumors depends on the cure of hyperparathyroidism. In fact, bone lesions should regress after biological tests' normalization.
Conclusion:
Clinicians should be aware of such rare and complicated presentation. They must consider the diagnosis of the brown tumor to avoid extensive surgical excision and teeth extractions.
Case report: Short-term eculizumab use in atypical HUS associated with Lemierre's syndrome and post-infectious glomerulonephritis
Authors: Sanober Sadiq, Anatoly Urisman, Onur Cil
Journal: Front Med (Lausanne) (2023)
Keywords: eikenella, fusobacterium, atypical hus, eculizumab discontinuation, prognosis
MeSH terms: Case Reports

Atypical hemolytic uremic syndrome (aHUS) is a rare disease caused by genetic abnormalities, infections, autoimmune diseases, drugs, and malignancies. Anti-C5 monoclonal antibody eculizumab is the mainstay of treatment of aHUS caused by the genetic defects of the alternative complement pathway. However, the utility of eculizumab in non-genetic forms of aHUS and the timing of treatment discontinuation remain controversial. Here, we report successful short-term eculizumab use in two young adult patients with aHUS due to rare infectious and autoimmune etiologies: Lemierre's syndrome and post-infectious glomerulonephritis, respectively. Eculizumab was rapidly discontinued in both patients with no aHUS recurrence during long-term follow-up. Considering its favorable safety profile with appropriate meningococcal prophylaxis, eculizumab can be considered as a treatment option for non-genetic aHUS.
Case Report: Midshaft clavicle fracture with concomitant high grade (Type V) acromioclavicular joint dislocation
Authors: Filip Cosic, Lukas Ernstbrunner, Greg A Hoy, Keat S Ooi, Eugene T Ek
Journal: Front Surg (2022)
Keywords: acromioclavicular (ac) joint, clavicle, fracture, internal fixation, joint stabilization
MeSH terms: Case Reports

Introduction:
Concomitant acromioclavicular joint dislocation and midshaft clavicle fracture are rare injuries, generally resulting from high energy trauma, with limited previous experience in management.
Case:
A 30 year old male presented following a pushbike accident. He had suffered a head on collision with another cyclist. Radiographic examination demonstrated a displaced midshaft clavicle fracture with a Rockwood Type V acromioclavicular joint dislocation. Operative management was undertaken using a dual plating technique. At six month follow up the patient demonstrated full range of motion and had no pain.
Conclusion:
Appropriate radiographic evaluation and careful intraoperative assessment are required using the principles of management for acromioclavicular joint injuries, along with stabilization of the mid-clavicular fracture to reduce the risk of non-union.
Pregnancy-related acquired hemophilia A initially manifesting as pleural hemorrhage: A case report
Authors: Lili Qian, Hangping Ge, Pingping Hu, Ni Zhu, Junfa Chen, Jianping Shen, Yu Zhang
Journal: Medicine (Baltimore) (2019)
MeSH terms: Hemophilia A / complications, Hemothorax / etiology, Pregnancy Complications, Hematologic / etiology, Case Reports, Adult, Female, Humans, Pregnancy, Factor 8 deficiency, acquired

Rationale:
Acquired hemophilia A is a rare hemorrhagic disease in which the body produces specific antibodies that attack factor VIII, resulting in bleeding that is mainly mucocutaneous and associated with soft tissue and the gastrointestinal system. Approximately 50% of this disease derives from basic diseases, such as autoimmune diseases, cancer, and pregnancy.
Patient concerns:
We report a 35-year-old postpartum female with acquired hemophilia A who initially presented with pleural hemorrhage.
Diagnoses:
In this patient activated prothrombin time (PT) and activated partial thromboplastin time (APTT) were found, and the factor VIII activity was 12.6%, furthermore Bethesda assay showed a FVIII antibody titer of 7.4 Bethesda units (BUs).
Interventions:
The treatment requires a 2-pronged approach: treatment of the bleeding and elimination of the inhibitor.
Outcomes:
After hemostatic agents were used and inhibitors were eradicated, the patient achieved complete remission without relapse.
Lessons:
It is essential to recognize the development of disease earlier in pregnant woman.
Vascular Complications following Isolated Limb Perfusion for Local Recurrence of Extremity Melanoma: A Case Report and Literature Review
Authors: M Trezzi, A Parolari, C Loardi, F Alamanni
Journal: Int J Vasc Med (2011)
MeSH terms: Case Reports

Introduction. To evaluate the role of hyperthermic isolated limb perfusion (HILP) in arterial thrombosis following melanoma-soft tissue sarcoma chemotherapy. Report. Here is presented one case of iliac-common femoral artery subacute thrombosis and a review of the appropriate literature performed using a MEDLINE search. Acute/subacute arterial occlusion is one of the most feared vascular complications of HILP, located nearly always in the external iliac-femoral artery axis, being those vessels cannulated for perfusion. Conclusions. The small number of reported cases indicates either the rarity of this complication or unawareness of its existence. The true incidence of this complication is probably underreported.
Case Report: Rare Systemic and Aggressive ALK-Positive Histiocytosis With Recurrent Pancreatitis Treating by Alectinib
Authors: Yanchu Li, Changle Shi, Yu Wu, Mingmin He, Xueming Xia, Jie Liu, Yu Jiang
Journal: Front Med (Lausanne) (2022)
Keywords: alk inhibitor, alk-positive histiocytosis, case report, distinct entity, pancreatitis
MeSH terms: Case Reports

ALK-positive histiocytosis (APH) is a rare and recently described, solitary or generalized, histiocytic proliferative disorder with a characteristic gene translocation involving the fusion of the ALK gene at chromosome 2p23. To date, only 25 cases of APH have been reported. The patient presented with multiple nodules in the lung, liver, gallbladder, pancreas, kidney, and skin rashes, along with recurrent pancreatitis and cholecystitis. The histiocytes from the lesion were positive for CD68 and ALK and negative for S100 and CD1α. A reduced dose of the ALK inhibitor alectinib was administered rather than the standard dose of alectinib or chemotherapy because of recurrent pancreatitis, which has not been previously reported in APH cases. After 18 months of follow-up, the patient was maintained on alectinib, and a partial response (PR) was achieved.
RHUPUS Syndrome in Children: A Case Series and Literature Review
Authors: Vahid Ziaee, Mohammad Hassan Moradinejad, Reyhaneh Bayat
Journal: Case Rep Rheumatol (2013)

Objective. Overlap of juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) is a rare clinical condition in children. This condition has been described as RHUPUS syndrome. Prevalence of this syndrome and 3 cases are reported in this paper. Cases Presentation. During 10 years, 3 patients with SLE had chronic arthritis before or after diagnosis of SLE. Prevalence of this disorder in JSLE was 2.5%. Two patients were females and one of them was a male. According to our review, mean delay between chronic joint involvement and JSLE diagnosis was 50.1 months. In our case report, two females had joint erosion and one of them died due to heart failure, but in the literature review, just 45% cases had joint erosion and 70% cases were polyarticulare form. Conclusion. RHUPUS is unusual presentation of lupus in children. It seems that clinical feature and outcome of RHUPUS syndrome are different in children due to difference between RA and JIA. We suggest juvenile RHUPUS for overlap of JIA and JSLE.
Preservation of auditory P300-like potentials in cortical deafness
Authors: Marianna Cavinato, Jessica Rigon, Chiara Volpato, Carlo Semenza, Francesco Piccione
Journal: PLoS One (2012)
MeSH terms: Auditory Cortex / physiopathology, Event-Related Potentials, P300 / physiology, Evoked Potentials, Auditory / physiology, Hearing Loss, Central / physiopathology, Case Reports, Auditory Cortex / pathology, Brain / pathology, Brain / physiopathology, Electrophysiology, Female, Hearing Loss, Central / etiology, Humans, Magnetic Resonance Imaging, Middle Aged, Stroke / complications

The phenomenon of blindsight has been largely studied and refers to residual abilities of blind patients without an acknowledged visual awareness. Similarly, "deaf hearing" might represent a further example of dissociation between detection and perception of sounds. Here we report the rare case of a patient with a persistent and complete cortical deafness caused by damage to the bilateral temporo-parietal lobes who occasionally showed unexpected reactions to environmental sounds despite she denied hearing. We applied for the first time electrophysiological techniques to better understand auditory processing and perceptual awareness of the patient. While auditory brainstem responses were within normal limits, no middle- and long-latency waveforms could be identified. However, event-related potentials showed conflicting results. While the Mismatch Negativity could not be evoked, robust P3-like waveforms were surprisingly found in the latency range of 600-700 ms. The generation of P3-like potentials, despite extensive destruction of the auditory cortex, might imply the integrity of independent circuits necessary to process auditory stimuli even in the absence of consciousness of sound. Our results support the reverse hierarchy theory that asserts that the higher levels of the hierarchy are immediately available for perception, while low-level information requires more specific conditions. The accurate characterization in terms of anatomy and neurophysiology of the auditory lesions might facilitate understanding of the neural substrates involved in deaf-hearing.