OpenMed/multicare-articles huggingface dataset:
Transient aplastic crisis triggered by parvovirus B19 in a family with hereditary spherocytosis
Authors: Nicolas Cilla, Léa Domitien, Neila Arrada, Delphine Chiffre, Perrine Mahe, Laure Vincent, Patricia Aguilar-Martinez, Vincent Foulongne
Journal: IDCases (2020)
Keywords: erythroblastopenia, hereditary spherocytosis, parvovirus b19
MeSH terms: Case Reports

Acute parvovirus B19 infection may lead to erythroblastopenia crisis in patients with underlying red blood cells disorders. We report herein an uncommon concomitant transient aplastic crisis in a mother and her daughter, both affected by hereditary spherocytosis. The diagnosis was confirmed by the detection of a very high parvovirus B19 DNA load in both the mother's and daughter's sera, associated with the presence of parvovirus B19 specific immunoglobulin-M antibodies. This rapid etiologic diagnosis allowed to save bone marrow sampling, although blood transfusion was required regarding the severe anemia associated with pancytopenia. Our observation illustrates first line parvovirus B19 hypothesis in the context of transient aplastic crisis and that contagiousness in household contacts should be considered in family with a medical history of red blood cell pathology.
Is There a Major Role for Undetected Autism Spectrum Disorder with Childhood Trauma in a Patient with a Diagnosis of Bipolar Disorder, Self-Injuring, and Multiple Comorbidities?
Authors: Claudia Carmassi, Carlo Antonio Bertelloni, Gianluca Salarpi, Elisa Diadema, Maria Teresa Avella, Valerio Dell'Oste, Liliana Dell'Osso
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

This case report highlights the relevance of the consequences of trauma in a female patient with an undetected autism spectrum disorder (ASD) affected by bipolar disorder (BD) with multiple comorbidities. A 35-year-old woman with BD type II, binge eating disorder and panic disorder was admitted in the Inpatient Unit of the Psychiatric Clinic of the University of Pisa because of a recrudescence of depressive symptomatology, associated with increase of anxiety, noticeable ruminations, significant alteration in neurovegetative pattern, and serious suicide ideation. During the hospitalization, a diagnosis of ASD emerged besides a history of childhood trauma and affective dysregulation, marked impulsivity, feeling of emptiness, and self-harm behavior. The patient was assessed by the Autism-Spectrum Quotient (AQ), Ritvo Autism and Asperger Diagnostic Scale (RAADS-R), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), Trauma and Loss Spectrum (TALS-SR), and Ruminative Response Scale (RRS). Total scores of 38/50 in the AQ, 146/240 in the RAADS-R, 99/160 in the AdAS Spectrum emerged, compatible with ASD, 47/116 in the TALS-SR, and 64/88 in the RRS. We discuss the implications of the trauma she underwent during her childhood, in the sense that caused a complex posttraumatic disorder, a lifelong disease favored and boosted by the rumination tendency of high functioning ASD.
Severe Hyperlipidemia Induced Hemorrhagic Pancreatitis during Pregnancy
Authors: Karen L Koscica, Uzoma Nwaubani, Munir Nazir, Martin Gimovsky
Journal: Obstet Gynecol Int (2009)
MeSH terms: Case Reports

Background. We report a case of familial hyperlipidemia in pregnancy that resulted in hemorrhagic pancreatitis. Case. A patient at 27-week gestation was admitted for recurrent pancreatitis secondary to severe hyperlipidemia. With conservative care, the patient improved but on the fourth day of admission she experienced a sudden onset of hypotension and was diagnosed with hemorrhagic pancreatitis. Conclusion. Pancreatitis caused by hyperlipidemia is an uncommon event during pregnancy. A familiarity with the severe complications associated with this potentially life-threatening condition is important.
The forearm fillet flap: 'spare parts' reconstruction for forequarter amputations
Authors: Haripriya S Ayyala, Omar M Mohamed, Paul J Therattil, Edward S Lee, Jonathan D Keith
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: microsurgery, fillet flap, free flap, limb salvage, sarcoma
MeSH terms: Case Reports

Radical forequarter amputation is often performed for recurrent proximal extremity tumors. A free forearm fillet flap is used to provide excellent coverage of the resultant defect without donor site morbidity. Use of a free flap from the distal portion of the extremity with proximal tumor burden is safe and effective.
Long-term isoflurane therapy for refractory bronchospasm associated with herpes simplex pneumonia in a heart transplant patient
Authors: C Hornuss, M Firsching, M Dolch, A Martignoni, A Peraud, J Briegel
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

A 47-year-old man with a history of heart transplant was admitted after severe traumatic brain injury and seizures. During mechanical ventilation, the patient developed bronchospasm that severely compromised respiratory function that led to cardiac arrest. After resuscitation, application of isoflurane through the Anaesthetic Conserving Device (AnaConDa) in the ICU successfully treated bronchospasm, provided adequate sedation, and enabled appropriate ventilation and diagnostic bronchoscopy. A subsequent bronchoalveolar lavage revealed a high amount of Herpes simplex DNA. Herpes simplex pneumonia was diagnosed and treated with acyclovir. Isoflurane treatment was applied for twelve days total without side effects on renal and cerebral function. The patient recovered quickly after the termination of sedation. At discharge, he was fully awake without focal neurological deficiency and his long-term outcome was excellent. This case demonstrates that isoflurane is a treatment option in life-threatening cases of bronchospasm and a safe option for long-term sedation.
Chondromesenchymal Hamartoma in Ectopic Thyroid Tissue in a Neonate
Authors: Agnes Szepesi, Zsolt Juhasz, Anna Kover, Bela Kajtar, Noemi Benedek, Endre Kalman, Tamas Kovesi, Marianna Imre, Peter Vajda
Journal: European J Pediatr Surg Rep (2019)
Keywords: chondromesenchymal, ectopic, hamartoma, thyroid
MeSH terms: Case Reports

A full-term male neonate presented with a left sided cervical lump at the level of the thyroid gland. Magnetic resonance imaging (MRI) showed a benign heterogeneous solid mass with lobulated margins. The tumor underwent complete excision. Histology revealed the diagnosis of chondromesenchymal hamartoma in ectopic thyroid tissue.
Thyroid-Associated Ophthalmopathy after Radioactive Iodine Therapy for Metastatic Follicular Thyroid Carcinoma
Authors: Daisuke Murayama, Soji Toda, Yoichiro Okubo, Hiroyuki Hayashi, Ai Matsui, Mio Yasukawa, Hiroyuki Iwasaki
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Thyroid-associated ophthalmopathy (TAO) is an inflammation of the extraocular muscles and periorbital connective tissue caused by autoantibodies against common antigens to both the thyroid and orbit. The release of antigens and induction of hypothyroidism caused by radioactive iodine (RAI) therapy may exacerbate TAO. Here, we present the case of a 67-year-old-woman treated with RAI therapy for metastatic follicular thyroid carcinoma who presented with TAO during the course of sorafenib administration. Tg and TgAb levels were gradually decreased with sorafenib and lenvatinib treatment, and TAO was improved without any ophthalmologic treatment.
Trisomy 19 and t(9;22) in a patient with acute basophilic leukemia
Authors: Alicia Rojas-Atencio, Karelis Urdaneta, Marisol Soto-Quintana, Francisco Alvarez Nava, Jenny Cañizales, Ernesto Solis
Journal: Case Rep Pathol (2011)
MeSH terms: Case Reports

We report a case of acute basophilic leukemia with two coexisting clonal abnormalities, t(9;22) and trisomy 19. The blast showed positive reaction with myeloperoxidase but negative reaction with chloroacetate esterase and acid phosphatase. Metachromatic features of the blast were observed with toluidine blue stain. Ultrastructure study showed the presence of azurophilic granules in basophils and blast mast cells. Conventional and molecular cytogenetic studies revealed, t(9;22) with BCR/ABL positive and trisomy 19 in all metaphase cells. To our knowledge, this paper here is the first to present acute basophilic leukemia with trisomy 19 and t(9;22).
A case of disseminated Legionnaires' disease: The value of metagenome next-generation sequencing in the diagnosis of Legionnaires
Authors: Shan Li, Wei Jiang, Chun-Yao Wang, Li Weng, Bin Du, Jin-Min Peng
Journal: Front Med (Lausanne) (2022)
Keywords: blood, disseminated legionnaires’ disease, hospital-acquired pneumonia, immunocompromised adult, metagenome next-generation sequencing
MeSH terms: Case Reports

Background:

Legionella rarely causes hospital-acquired pneumonia (HAP), although it is one of the most common pathogens of community-acquired pneumonia. Hospital-acquired Legionnaires' disease, mainly occurring in immunocompromised patients, is often delayed in diagnosis with high mortality. The use of the metagenome Next-Generation Sequencing (mNGS) method, which is fast and unbiased, allows for the early detection and identification of microorganisms using a culture-independent strategy.
Case report:
A 52-year-old male, with a past medical history of Goods syndrome, was admitted due to nephrotic syndrome. The patient developed severe pneumonia, rhabdomyolysis, and soft tissue infection after receiving immunosuppressive therapy. He did not respond well to empiric antibiotics and was eventually transferred to the medical intensive care unit because of an acute respiratory failure and septic shock. The patient then underwent a comprehensive conventional microbiological screening in bronchoalveolar lavage fluid (BALF) and blood, and the results were all negative. As a last resort, mNGS of blood was performed. Extracellular cell-free and intracellular DNA fragments of Legionella were detected in plasma and blood cell layer by mNGS, respectively. Subsequent positive results of polymerase chain reaction for Legionella in BALF and soft tissue specimens confirmed the diagnosis of disseminated Legionnaires' disease involving the lungs, soft tissue, and blood stream. The patient's condition improved promptly after a combination therapy of azithromycin and moxifloxacin. He was soon extubated and discharged from ICU with good recovery.
Conclusion:
Early recognition and diagnosis of disseminated Legionnaires' disease is challenging. The emergence and innovation of mNGS of blood has the potential to address this difficult clinical issue.
Mitral Valve Endocarditis with Perforation from a Urinary Source: An Unusual Case and Literature Review
Authors: Fernando Figueroa Rodriguez, Antonio Faieta Lasarcina, Francisco Davila Grijalva
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Aerococcus urinae (AU) is a rare pathogen, identified as gram-positive, catalase-negative coccus that grows in pairs and clusters which has been reported to mainly cause urinary tract infections (UTI), especially in elderly males. Treatment for this microorganism is usually with beta-lactams although cultures with antibiotic susceptibility testing are imperative. We present a case of AU endocarditis initially treated with IV antibiotics; nevertheless, the patient required emergent mitral valve replacement due to severe mitral insufficiency and perforation. We also present an analysis with high-yield points summarizing epidemiology, risk factors, microbiology, clinical features, diagnostic workup, and management of AU in general and AU endocarditis. Finally, we post a literature review of relevant cases and the impact of different variables associated with it.
Oncocytic Adrenocortical Neoplasm with Concomitant Papillary Thyroid Cancer
Authors: Michele Podetta, Marc Pusztaszeri, Christian Toso, Michel Procopiou, Frédéric Triponez, Samira Mercedes Sadowski
Journal: Front Endocrinol (Lausanne) (2018)
Keywords: adrenal oncocytoma, concomitant neoplasia, functional adrenal neoplasm, hereditary cancer syndrome, papillary thyroid cancer
MeSH terms: Case Reports

Adrenal oncocytoma (AO) is an extremely rare adrenocortical neoplasm and little is known about its malignant potential, secretory properties, and hereditary origin. We present the case of a benign AO with concomitant incidentally found papillary thyroid cancer (PTC) and review similar cases in the literature. Immunohistochemistry and next-generation sequencing (NGS) were performed. A 66-year-old women was incidentally found to have a large, androgen-secreting right adrenal mass. 18F-Fluorodeoxyglucose positron emission tomography showed intense uptake (SUVmax 88.7) of this mass and found a hypermetabolic right thyroid mass. Open adrenalectomy was performed for this highly suspicious adrenal mass. Histopathology revealed benign AO that was BRAFV600E negative, with low Ki-67, and no somatic mutation found on NGS. Thyroidectomy revealed invasive, BRAFV600E-positive PTC. At 6 months follow-up, androgen levels returned to normal, and no recurrence was seen on imaging. To our knowledge, this is the first report of an androgen-secreting AO with concomitant PTC. Possibly the simultaneous discovery of two independent neoplasms was observed. In conclusion, this case highlights that care should be given to exclude concomitant neoplasms. Long-term and regular imaging with biochemical follow-up is warranted, since the outcome and clinical behavior of AO remains uncertain.
Malignant struma ovarii: good response after thyroidectomy and I ablation therapy
Authors: Erica W M Janszen, Helena C van Doorn, Patricia C Ewing, Ronald R de Krijger, Johannes H W de Wilt, Boen L R Kam, Wouter W de Herder
Journal: Clin Med Oncol (2008)
Keywords: germ cell tumors, malignant struma ovarii, multidisciplinary approach, radioiodine therapy, thyroidectomy
MeSH terms: Case Reports

Background:
Malignant struma ovarii is a rare malignant germ cell tumor of the ovary. Due to the rarity of this disease, treatment has not been uniform throughout the published literature.
Cases:
We present three cases of malignant struma ovarii. Following primary surgery, all were subsequently treated with thyroidectomy and (131)I ablation therapy, two patients as first line management, one following the occurrence of metastatic disease.
Conclusion:
Histological diagnosis of malignant struma ovarii is similar to that of well differentiated thyroid carcinoma (WDTC). In line with the latest advice on treatment of WDTC, we believe that the best option for patients with malignant struma ovarii is surgical removal of the ovarian lesion followed by total thyroidectomy which allows the exclusion of primary thyroid carcinoma, and in addition, allows radioiodine ((131)I) ablation therapy for (micro) metastasis. After thyroidectomy, thyroglobulin can be used as a tumor marker for follow-up. Moreover, nuclear medicine imaging using radioiodine ((123)I) can be performed to demonstrate metastatic carcinoma. A multidisciplinary approach is essential.
Brain Injury and Mental Health Among the Victims of Intimate Partner Violence: A Case-Series Exploratory Study
Authors: Gunnur Karakurt, Kathleen Whiting, Stephen E Jones, Mark J Lowe, Stephen M Rao
Journal: Front Psychol (2021)
Keywords: abusive relationship, brain imaging, intimate partner violence, mental health, traumatic brain injury

Intimate partner violence (IPV) survivors frequently report face, head, and neck as their injury site. Many mild traumatic brain injuries (TBIs) are undiagnosed or underreported among IPV survivors while these injuries may be linked to changes in brain function or pathology. TBI sustained due to IPV often occurs over time and ranges in severity. The aim of this case-series study was to explore risk factors, symptoms, and brain changes unique to survivors of intimate partner violence with suspicion of TBI. This case-series exploratory study examines the potential relationships among IPV, mental health issues, and TBI. Participants of this study included six women: 3 women with a history of IPV without any experience of concussive blunt force to the head, and 3 women with a history of IPV with concussive head trauma. Participants completed 7T MRI of the brain, self-report psychological questionnaires regarding their mental health, relationships, and IPV, and the Structured Clinical Interview. MRI scans were analyzed for cerebral hemorrhage, white matter disturbance, and cortical thinning. Results indicated significant differences in resting-state connectivity among survivors of partner violence as well as differences in relationship dynamics and mental health symptoms. White matter hyperintensities are also observed among the survivors. Developing guidelines and recommendations for TBI-risk screening, referrals, and appropriate service provision is crucial for the effective treatment of TBI-associated IPV. Early and accurate characterization of TBI in survivors of IPV may relieve certain neuropsychological consequences.
Locally Advanced Thyroglossal Duct Cyst Carcinoma Presenting as a Neck Mass
Authors: Niranjan Tachamo, Brian Le, Jeffrey Driben, Vasudev Magaji
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Thyroglossal duct cyst carcinoma is rare and occurs in just 1% of cases with thyroglossal duct cysts. It is not always possible to distinguish a thyroglossal cyst harboring malignancy from its benign counterparts unless biopsied, thus posing the dilemma. Currently there is no clear consensus on the optimal management of thyroglossal duct cyst carcinoma. Here we present the case of a 69-year-old female who presented with a midline neck mass and dysphagia and was found to have papillary thyroid cancer in the biopsy specimen of the neck mass. She underwent excision of the mass and the thyroglossal duct cyst along with total thyroidectomy; however, the thyroidectomy specimen showed no malignancy. Her lymph node mapping was negative and she is awaiting radioactive iodine treatment.
Tapering Antidepressants While Receiving Digital Preventive Cognitive Therapy During Pregnancy: An Experience Sampling Methodology Trial
Authors: Marlies E Brouwer, Nina M Molenaar, Huibert Burger, Alishia D Williams, Casper J Albers, Mijke P Lambregtse-van den Berg, Claudi L H Bockting
Journal: Front Psychiatry (2020)
Keywords: antidepressants, experience sampling methodology (esm), offspring, pregnancy, preventive cognitive therapy, proof-of-principle, tapering and discontinuation
MeSH terms: Case Reports

Background: Previous studies indicated that affect fluctuations, the use of antidepressant medication (ADM), as well as depression during pregnancy might have adverse effects on offspring outcomes. The aim of the current proof-of-principle study is to explore the effect of tapering ADM while receiving online preventive cognitive therapy (PCT) on pregnant women and the offspring as compared to pregnant women continuing ADM. Objectives: We sought to compare positive and negative affect fluctuations in pregnant women receiving online PCT while tapering ADM vs. pregnant women continuing ADM, and to investigate if affect fluctuations in early pregnancy were related to offspring birth weight. Method: An experience sampling methodology (ESM)-trial ran alongside a Dutch randomized controlled trial (RCT) and prospective observational cohort of women using ADM at the start of pregnancy. In the ESM-trial fluctuations of positive and negative affect were assessed in the first 8 weeks after inclusion. Recurrences of depression were assessed up to 12 weeks post-partum, and birth records were used to assess offspring birth weight. The RCT has been registered at the Netherlands Trial Register (NTR4694, https://www.trialregister.nl/trial/4551). Results: In total, 19 pregnant women using ADM at start of their pregnancy participated in the ESM-trial. There were no significant differences in positive and negative affect fluctuations, nor recurrence rates between women receiving PCT while tapering ADM vs. women continuing ADM. We found no association between affect fluctuations, pre-natal depressive symptoms, and birth weight (all p > 0.05). Conclusion: This explorative study showed that tapering ADM while receiving online PCT may protect pregnant women against recurrences of depression and affect fluctuations, without affecting birth weight. There is a high need for more controlled studies focusing on tapering ADM with (online) psychological interventions during pregnancy.
A Rapid Biochemical and Radiological Response to the Concomitant Therapy with Temozolomide and Radiotherapy in an Aggressive ACTH Pituitary Adenoma
Authors: Ana Misir Krpan, Tina Dusek, Zoran Rakusic, Mirsala Solak, Ivana Kraljevic, Vesna Bisof, David Ozretic, Darko Kastelan
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Background and Importance. In the last eight years temozolomide (TMZ) has been used as the last-line treatment modality for aggressive pituitary tumors to be applied after the failure of surgery, medical therapy, and radiotherapy. The objective was to achieve a rapid control of tumor growth and hormone normalization with concurrent chemoradiotherapy in a patient with very aggressive ACTH pituitary adenoma. Clinical Presentation. We describe a patient with an aggressive ACTH-producing adenoma treated with concurrent temozolomide and radiotherapy. The patient suffered from an aggressive ACTH adenoma resistant to surgical and medical treatment. After two months of concurrent temozolomide and radiotherapy, cortisol normalization and significant tumor shrinkage were observed. After 22 months of follow-up, there is still no evidence of tumor recurrence. Conclusion. Concurrent treatment with temozolomide and irradiation appears to be highly effective in the achievement of the tumor volume control as well as in the control of ACTH secretion in aggressive ACTH adenoma.
Management of Late-Onset Complete Atrioventricular Block Post Transcatheter Closure of Perimembranous Ventricular Septal Defects
Authors: Lijian Xie, Han Zhang, Rufang Zhang, Tingting Xiao
Journal: Front Pediatr (2020)
Keywords: complete atrioventricular block, occluder, perimembranous ventricular septal defect, surgical, transcatheter
MeSH terms: Case Reports

Long-term late-onset complete atrioventricular block (CAVB) is one of the most serious complications of transcatheter closure of perimembranous ventricular septal defect (pmVSD); it can cause an Adams-Stoke attack or even sudden death. Transcatheter closure of pmVSD is not approved by the FDA, yet the procedure has proved to be a successful alternative to a surgical strategy in China. Although transcatheter closure of pmVSD is widely and successfully performed, especially in China, late-onset CAVB is still difficult to avoid. Here, we report a case with late-onset CAVB post transcatheter closure that was successfully treated. By doing so, we reassess the safety of pmVSD occluder closure and highlight that use of this procedure should adhere to more stringent indications.