OpenMed/multicare-articles huggingface dataset:
Thyroid-stimulating hormone-secreting pituitary adenoma presenting with recurrent hyperthyroidism in post-treated Graves' disease: a case report
Authors: Yoshikazu Ogawa, Teiji Tominaga
Journal: J Med Case Rep (2013)

Introduction:
The coexistence of autoimmune hyperthyroid disease and thyroid-stimulating hormone-secreting pituitary adenoma is rare. The simple presumption of coincidence of these two diseases has a calculated incidence of less than one/several hundred million, and only four cases with histological confirmation have been reported. A rapid decrease in thyroid-stimulating hormone level after pituitary tumor removal may induce subsequent activation of autoimmune responses against the thyroid gland. We report the first case of a sequential and paradoxical occurrence of Graves' disease and a thyroid-stimulating hormone-secreting pituitary adenoma.
Case presentation:
A 32-year-old Japanese woman had recurrent hyperthyroidism. She had a history of Graves' hyperthyroidism, which had been successfully treated with propylthiouracil. A head magnetic resonance imaging showed a less enhanced area in the left lateral wing of her sella turcica. Transsphenoidal surgery was performed, and the diagnosis was established as thyroid-stimulating hormone-secreting plurihormonal adenoma. A rapid reduction in thyroid hormone levels was achieved, and her blood pressure was normalized after the operation.
Conclusion:
Although incidental occurrence is the most probable etiology, long and repeated followup examinations of both thyroid and pituitary gland should be performed in patients with an atypical clinical course.
Physician Beware: Severe Cyanide Toxicity from Amygdalin Tablets Ingestion
Authors: Tam Dang, Cham Nguyen, Phu N Tran
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

Despite the risk of cyanide toxicity and lack of efficacy, amygdalin is still used as alternative cancer treatment. Due to the highly lethal nature of cyanide toxicity, many patients die before getting medical care. Herein, we describe the case of a 73-year-old female with metastatic pancreatic cancer who developed cyanide toxicity from taking amygdalin. Detailed history and physical examination prompted rapid clinical recognition and treatment with hydroxocobalamin, leading to resolution of her cyanide toxicity. Rapid clinical diagnosis and treatment of cyanide toxicity can rapidly improve patients' clinical outcome and survival. Inquiries for any forms of ingestion should be attempted in patients with clinical signs and symptoms suggestive of poisoning.
Variceal Bleed and Portal Hypertensive Gastropathy in a Noncirrhotic Patient with Isolated Splenomegaly
Authors: S M Mahmudul Hasan, Meghan Dmitriew, Jennifer Leonard
Journal: Case Reports Hepatol (2020)
MeSH terms: Case Reports

Portal hypertension caused by cirrhosis is the most common etiology of esophageal varices. However, abnormalities of the splenoportal axis in the absence of liver disease may also cause portal hypertension resulting in varices. We report a rare case of esophageal variceal bleed in a noncirrhotic patient with isolated splenomegaly secondary to chronic granulocyte colony stimulating factor (G-CSF) therapy. The patient is a 26-year-old male with Cohen syndrome who required long-term G-CSF treatment for chronic neutropenia. He presented with large volume hematemesis and pancytopenia in the setting of known splenomegaly with no evidence of cirrhosis. An urgent EGD revealed active variceal bleeding and portal hypertensive gastropathy. The patient was appropriately resuscitated and underwent a successful transjugular intrahepatic portosystemic shunt and CT-guided coil placement for the bleeding varices. We are the first to report variceal bleed as a complication of long-term G-CSF use, a life-threatening consequence that requires urgent intervention.
Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature
Authors: P Khanal, L Thapa, A M Shrestha, S Bhattarai, D Sapkota, N Sharma, U P Devkota
Journal: Case Rep Neurol Med (2016)

Cerebral venous sinus thrombosis (CVST) is a rare but serious disorder that is associated with a poor clinical outcome. We report a 35-year-old man who had a severe headache and diplopia while climbing Mount Everest. His MR venography showed right transverse and right sigmoid sinus thrombosis. He improved on anticoagulant and symptomatic measures. Cerebral venous sinus thrombosis at high altitude is discussed.
Empyema necessitans due to Nocardia farcinica
Authors: Kazuhiro Ishikawa, Nobuyoshi Mori
Journal: IDCases (2022)
Keywords: empyema necessitans, liver cirrhosis, nocardia farcinica
MeSH terms: Case Reports

An 84-year-old female with severe liver cirrhosis due to hepatitis C presented with a progressive bulging of the anterior chest wall for two weeks. On examination, 7 cm × 7 cm × 5 cm large subcutaneous mass was on the anterior chest wall and contrast enhanced computed tomography of the chest demonstrated loculated empyema with extension through the chest wall, into the anterior with rib destruction. Microscopic appearance of the abscess revealed filamentous branching rods, and eventually Nocardia farcinica was identified using Matrix-Assisted Laser Desorption Ionization-Time of Flight. The patient was successfully treated with trimethoprim/sulfamethoxazole and subcutaneous debridement. In general, Mycobacterium tuberculosis and Actinomyces spp. are the most common causative pathogens of empyema necessitans, and cases of Nocardia spp. are rarely seen. Clinicians should pay attention to the possibility of nocardial empyema necessitans in immunocompromised patients.
Coronary-Cameral Fistula Connecting the Left Anterior Descending Artery and the First Obtuse Marginal Artery to the Left Ventricle: A Rare Finding
Authors: Abdul Mannan Khan Minhas, Ehtesham Ul Haq, Ahmed Arslan Yousuf Awan, Arshad Ameer Khan, Ghazanfar Qureshi, Pragathi Balakrishna
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Coronary-cameral fistulas are rare congenital malformations, often incidentally found during cardiac catheterizations. The majority of these fistulas are congenital in nature but can be acquired secondary to trauma or invasive cardiac procedures. These fistulas most commonly originate in the right coronary artery and terminate into the right ventricle and least frequently drain into the left ventricle. Depending upon their size and location, coronary-cameral fistulas can lead to congestive heart failure, myocardial infarction, and bacterial endocarditis. We describe a case of 49-year-old woman who presented with worsening exertional dyspnea and leg swelling. Transthoracic echocardiogram revealed an ejection fraction of 35%. Cardiac catheterization demonstrated a fistula connecting the left anterior descending artery and the first obtuse marginal artery to the left ventricle. In this report, the authors provide a concise review on coronary fistulas, complications, and management options.
The MOG antibody associated encephalitis preceded by COVID-19 infection; a case study and systematic review of the literature
Authors: Michał Borończyk, Julia Węgrzynek, Agnieszka Borończyk, Joanna Siuda
Journal: Front Neurol (2023)
Keywords: adem-like, covid-19, mogad, encephalitis, myelin oligodendrocyte glycoprotein
MeSH terms: Case Reports

Background:
New neurological complications of COVID-19 infection have been reported in recent research. Among them, the spectrum of anti-MOG positive diseases, defined as anti-MOG antibody associated disease (MOGAD), is distinguished, which can manifest as optic neuritis, myelitis, or various forms of encephalitis (MOGAE).
Materials and methods:
This study reports a new case of MOGAE following SARS-CoV-2 infection. A literature review of other MOGAE cases associated with COVID-19 infection was conducted and summarized.
Results:
A 60-year-old male patient, who had previously been infected with COVID-19, was admitted to the Neurology Department with a rapidly progressive deterioration of his cognitive functions that lasted for about 3 months. On neurological examination, the Mini-Mental State Examination (MMSE) score was 17, which further deteriorated to 13. In addition, central paresis of the right VIIth nerve and pyramidal hemiparesis on the right side were noted. The MRI of the brain showed multiple hyperintense lesions. The CSF examination revealed an elevated total protein level with a normal cell count, and serum showed a positive finding of anti-MOG antibodies. Taking into account all the information, the diagnosis of MOGAE, following COVID-19 infection, was made. A total of 9 similar cases of MOGAE associated with SARS-CoV-2 infection were identified in the available literature. Among them 2 cases presented progressive cognitive dysfunction and another 5 altered mental status. The most frequently described MRI changes were hyperintense lesions located cortically and/or subcortically. Anti-MOG antibodies were positive in all patients. In 5 cases they were detected only in serum, in 2 cases in serum and CSF, and in 2 cases the origin was not reported.
Conclusion:
The reported cases of MOGAE following COVID-19 infection suggest an increasing new clinical problem, and show an association between COVID-19 and MOGADs.
Neurolysis for Treatment of Infraorbital Neuropathy
Authors: Ahmet Mahli, Demet Coskun
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Two patients, a woman aged 34 and a man aged 56, were included in the study. They reported the existence of pain in the areas of the infraorbital nerve, which, over the last four to five years, aggravated by the stimuli of eating, laughing, and being touched. 2 ml of 0.5% lidocaine was administered to these patients six times percutaneously. It was observed that the ease of pain lasted until the local anesthesia lost its effect, and the pain resumed its original intensity. Neurolysis with 0.5 ml of 50% ethanol was applied to the infraorbital nerve. This procedure was applied to the first patient twice and three times to the second. Thereafter, the patients were cured completely. For the treatment of idiopathic chronic infraorbital neuropathy, the neurolysis of the infraorbital nerve using 50% ethanol could be considered as an effective treatment alternative.
Primary nonfunction of renal allograft secondary to acute oxalate nephropathy
Authors: Ravi Parasuraman, Ping L Zhang, Dilip Samarapungavan, Krishna Pothugunta, Gampala Reddy, Leslie Rocher, Francis Dumler, Vandad Raofi, Steven Cohn, Alan Koffron
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

Primary nonfunction (PNF) accounts for 0.6 to 8% of renal allograft failure, and the focus on causes of PNF has changed from rejection to other causes. Calcium oxalate (CaOx) deposition is common in early allograft biopsies, and it contributes in moderate intensity to higher incidence of acute tubular necrosis and poor graft survival. A-49-year old male with ESRD secondary to polycystic kidney disease underwent extended criteria donor kidney transplantation. Posttransplant, patient developed delayed graft function (DGF), and the biopsy showed moderately intense CaOx deposition that persisted on subsequent biopsies for 16 weeks, eventually resulting in PNF. The serum oxalate level was 3 times more than normal at 85 μmol/L (normal <27 μmol/L). Allograft nephrectomy showed massive aggregates of CaOx crystal deposition in renal collecting system. In conclusion, acute oxalate nephropathy should be considered in the differential diagnosis of DGF since optimal management could change the outcome of the allograft.
Successful management of a rare radius schwannoma mimicking malignant bone tumors: A case report and literature review
Authors: Nianzhe Sun, Umar Zeb Khan, Lei Zeng, Panfeng Wu, Qin Xiong, Lushan Peng, Hong Yu, Juyu Tang
Journal: Front Surg (2023)
Keywords: bone tumor, intraosseous schwannomas, microreconstruction surgery, radius, vascularized bone flap
MeSH terms: Case Reports

Background:
Schwannomas are benign tumors originating from Schwann cells, frequently occurring in the spinal cord and peripheral nerves. Intraosseous schwannomas, a rare subset, account for approximately 0.2% of schwannomas. Intraosseous schwannomas commonly impinge the mandible, followed by the sacrum and the spine. By far, only three cases of radius intraosseous schwannomas have been reported in PubMed. The tumor was treated differently in all three cases, resulting in different outcomes.
Case presentation:
A 29-year-old male construction engineer who complained of a painless mass on the radial aspect of the right forearm was diagnosed with an intraosseous schwannoma of the radius based on radiography, three-dimensional computed tomography reconstruction, magnetic resonance imaging, pathological examination, and immunohistochemistry. A different surgical approach was employed to reconstruct the radial graft defect using bone microrepair techniques, resulting in more reliable bone healing and early functional recovery. Meanwhile, no clinical and radiographic findings suggestive of recurrence were observed at the 12-month follow-up.
Conclusion:
Vascularized bone flap transplantation combined with three-dimensional imaging reconstruction planning might yield better results for repairing small segmental bone defects of the radius caused by intraosseous schwannomas.
A 56-Year-Old Woman with Chronic Hepatitis C Liver Disease and Meningitis due to Streptococcus equi subsp. Zooepidemicus
Authors: Sebastian Klapa, Jochen Grefer, Ingo Sobottka, Volkhard Kurowski
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Streptococcus equi subsp. zooepidemicus (S. equi subsp. zooepidemicus), which carries the Lancefield group C antigen, is an uncommon human pathogen. It is considered an opportunistic commensal of the equine upper respiratory tract and causes invasive infections in immunocompromised hosts, following close contact to infected horses. Meningitis caused by S. equi subsp. zooepidemicus is a rare infectious disease with high rates of complications. We present the case of a 56-year-old female with acutely altered mental status following three days of fever and vomiting. For several months, she was taking care of horses. The most relevant preexisting illnesses were chronic hepatitis C infection and traumatic paraplegia due to spinal cord injury 30 years ago. Laboratory evaluation on admission revealed leukocytosis, hyponatremia, and elevated C-reactive protein. Cerebral CT scan showed diffuse cerebral edema. Whereas cerebrospinal fluid real-time PCR assay for common pathogens was negative, cultures showed S. equi subsp. zooepidemicus. She recovered fully after intravenous administration of ceftriaxone for four weeks. This is one of only few reported cases of S. equi subsp. zooepidemicus meningitis and the first case in chronic hepatitis C infection. Our case supports the necessity for extended microbiological examination especially in immunocompromised patients if PCR examination for common pathogens is negative.
Case report: Durable response to ruxolitinib in a child with TREX1-related disorder
Authors: Yasir Bin Khathlan, Sajdi Almutairi, Fahad B Albadr, Abdullah A Alangari, Abdulrahman Alsultan
Journal: Front Pediatr (2023)
Keywords: jak—stat signaling pathway, trex1 gene, child, pancytopenia, ruxolinitib
MeSH terms: Case Reports

Background:
JAK inhibitors are useful in treating interferonopathies, presumably because they downregulate the JAK/STAT signaling. There are limited studies about the safety and effectiveness of using JAK inhibitors in children with TREX1-related disorders.
Case presentation:
We report an 8-year-old female who presented at five years of age with features suggestive of hemophagocytic lymphohistiocytosis (HLH)-like disorder. The infectious disease workup was negative. Neurological assessment was normal. A brain CT scan was performed because of headache. It showed a faint subcortical calcification at right frontal lobe and almost symmetrical calcification within the basal ganglia. Brain MRI showed bilateral symmetrical globus pallidus, high T1 signal intensities, and a few scattered nonspecific FLAIR hyperintensities in subcortical and deep white matter. IVIG as an immune modulating agent was administered initially which led to the resolution of fever, improvement of blood count parameters, inflammatory markers, and normalization of liver enzymes. The child remained afebrile with no significant events for several months, then had disease flare up. The patient was started on pulse methylprednisolone 30 mg/kg for three days, then continued on 2 mg/kg. Whole exome sequencing revealed a novel heterozygous missense TREX1 mutation NM_016381.3:c.223G > A p.(Glu75Lys). The child was started on ruxolitinib, 5 mg orally twice daily. The child has prolonged, durable remission after initiating ruxolitinib with no adverse effects. Steroids were tapered off and the patient is no longer on IVIG. The patient is still on ruxolitinib for more than two years.
Conclusion:
This case highlights the potential role of ruxolitinib in the treatment of TREX1-related disorders. A longer follow-up period is required to evaluate the long-term outcome.
Typical pantothenate kinase-associated neurodegeneration caused by compound heterozygous mutations in PANK2 gene in a Chinese patient: a case report and literature review
Authors: Yilun Tao, Chen Zhao, Dong Han, Yiju Wei, Lihong Wang, Wenxia Song, Xiaoze Li
Journal: Front Neurol (2023)
Keywords: pank2 gene, case report, pantothenate kinase-associated neurodegeneration, review, whole exome sequencing
MeSH terms: Case Reports

Pantothenate kinase-associated neurodegeneration (PKAN) is a rare genetic neurodegenerative disorder with brain iron accumulation characterized as dysarthria, spasticity, cognitive impairment, parkinsonism, and retinopathy. PKAN is caused by biallelic mutations in the mitochondrial pantothenate kinase 2 (PANK2) gene. Herein, we report a 4-year-old patient with PKAN from a Han Chinese family, who presented with developmental regression, progressive inability to walk, and limb tremors. Neuroimaging demonstrated "eye-of-the-tiger" sign. Whole exome sequencing (WES) identified compound heterozygous mutations of c.1213T>G (p.Tyr405Asp) and c.1502T>A (p.Ile501Asn) in PANK2 gene. In addition, a review of all known PANK2 variants observed in reported PKAN patients was conducted, to improve understanding of the genotype-phenotype associations that occur in PKAN patients.
Laparoscopic hepatectomy for liver metastasis of lung large-cell neuroendocrine carcinoma: A case report
Authors: Hisoka Yamane, Sachiko Yoshida, Toshihiko Yoshida, Masayasu Nishi, Takashi Yamagishi, Hironobu Goto, Dai Otsubo, Akinobu Furutani, Taku Matsumoto, Yasuhiro Fujino, Kazuyoshi Kajimoto, Toshiko Sakuma, Masahiro Tominaga
Journal: Int J Surg Case Rep (2019)
Keywords: case report, laparoscopic hepatectomy, large cell neuroendocrine carcinoma, liver metastasis

Introduction:
Lung large-cell neuroendocrine carcinoma (LCNEC) is an aggressive and a rare type of lung cancer, and the prognosis of LCNEC with distant metastasis is extremely poor, with a five-year survival rate of 0%. Here, we report a case of laparoscopic hepatectomy for liver metastasis of lung LCNEC.
Presentation of case:
A 63-year-old man received a routine physical examination, and abnormal chest radiographic findings were observed; chest computed tomography (CT) in our hospital revealed that the patient had left pneumothorax and a lesion measuring 18 mm in the inferior lingular segment of the lung. The patient underwent thoracoscopic lobectomy, and the final pathological diagnosis was lung LCNEC. Four years after surgery, abdominal CT revealed a mass measuring 27 mm in the liver. The patient underwent laparoscopic partial hepatectomy, and postoperative pathological examination showed liver metastasis of LCNEC. There was no sign of recurrence 6 months after hepatectomy.
Discussion:
LCNEC with distant metastasis has a poor response to systemic chemotherapy, and the median survival time of patients with distant metastasis is estimated to be approximately 6 months, with a five-year survival rate of 0%. Although the common site of metastasis from LCNEC is the liver, there are no previous reports of hepatectomy for liver metastasis of LCNEC.
Conclusion:
We report a case of laparoscopic hepatectomy for liver metastasis of lung LCNEC. It is suggested that surgical resection for solitary distant metastasis of LCNEC may improve prognosis.
Pulmonary and peritoneal tuberculosis associated with tumor necrosis factor-alpha inhibitor use: a case report and review of the literature
Authors: Niharika Tipirneni, Marc O Siegel
Journal: Case Rep Pulmonol (2012)

The association between the use of tumor necrosis factor-α inhibitors and the increased risk of granulomatous infections, especially tuberculosis, has been well documented. Given the rapidly expanding list of inflammatory conditions for which tumor necrosis factor-α inhibitors are receiving FDA approval, the incidence of tuberculosis in this patient population has increased. Despite heightened awareness by physicians, the diagnosis of tuberculosis can remain challenging, given that extrapulmonary sites of infection are more frequently involved. We present a case of pulmonary and peritoneal tuberculosis in a gentleman being treated with a tumor necrosis factor-α inhibitor and discuss the diagnostic challenges of establishing the diagnosis.