OpenMed/multicare-articles huggingface dataset:
Case Report: Exploration of changes in serum immunoinflammation-related protein complexes of patients with metastatic breast cancer
Authors: Chang Chen, Yali Xu, Zhizhen Lai, Zhili Li, Qiang Sun
Journal: Front Oncol (2023)
Keywords: biomarker, breast cancer, disease surveillance, immunoinflammation-related protein complexes, serum
MeSH terms: Case Reports

Patients with advanced breast cancer are difficult to treat and have poor prognosis. At present, the commonly used methods to monitor the disease progression of breast cancer are imaging examinations such as breast ultrasound, mammography and peripheral blood tumor markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA15-3). However, none of them can detect tumor progression at an early stage. Serum immunoinflammation-related protein complexes (IIRPCs) showed potential to indicate cancer progression. Therefore, we attempted to monitor the level of IIRPCs in peripheral blood of patients with metastatic breast cancer and compare it with patients' treatment and disease progression, and here we performed case reports of two of them.
Morquio's Syndrome: A Case Report of Two Siblings
Authors: Sathish Muthukumar Ramalingam, Daya Srinivasan, Sandhya ArunKumar, Joe Louis ChiriyanKandath, Sriram Kaliamoorthy
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Morquio syndrome or MPS IVA is a rare type of lysosomal storage disease associated with highly specific dental abnormalities. We present two siblings with enamel hypoplasia and skeletal abnormalities. A diagnosis of mucopolysaccharidosis type IVA was reached based on the clinical, radiographic, and dental findings of the patients. The dental findings are useful diagnostic aid for the early diagnosis of this debilitating disorder.
Lymphocyte-Predominant Hodgkin's Disease in Children: A Case Study and Review of the Literature
Authors: James R Stier, Robert J Vasquez
Journal: Case Rep Oncol Med (2015)

A three-year-old boy presented with an enlarging neck mass. Biopsy demonstrated IgD-positive nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), which was staged as IIa. The patient received cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with rituximab and had excellent results. NLPHL is a relatively rare disease that is biologically distinct from classic Hodgkin lymphoma (cHL). NLPHL is a B-cell malignancy likely of germinal center origin that has an overall good prognosis and favorable response to treatment. Unlike cHL, NLPHL is ubiquitously CD20-positive. Recent evidence supports the efficacy of targeted anti-CD20 therapy in NLPHL, though prospective data is limited. This case demonstrates several unique features of NLPHL and further supports the use of rituximab in front-line therapy. The clinical characteristics among patients at various ages are discussed with a special focus on the IgD-positive subtype. A thorough literature search demonstrates this to be the youngest patient with NLPHL yet described.
CACNA1A-Linked Hemiplegic Migraine in GLUT 1 Deficiency Syndrome: A Case Report
Authors: Chiara Scoppola, Giorgio Magli, Marta Conti, Maria Fadda, Giovanni M Luzzu, Delia M Simula, Alessandra Carta, Stefano Sotgiu, Susanna Casellato
Journal: Front Neurol (2021)
Keywords: cacna1a, glut1 deficiency syndrome, slc2a1, epilepsy, headache, hemiplegic migraine
MeSH terms: Case Reports

Background: Glucose-transporter-1 deficiency syndrome (GLUT1-DS), due to SLC2A1 gene mutation, is characterized by early-onset seizures, which are often drug-resistant, developmental delay, and hypotonia. Hemiplegic migraine (HM) is a rare form of migraine, defined by headache associated with transient hemiplegia, and can be caused by mutations in either CACNA1A, ATP1A2, or SCN1A. Paroxysmal movements, other transient neurological disorders, or hemiplegic events can occur in GLUT1-DS patients with a mild phenotype. Case: We report on a girl with GLUT1-DS, due to SLC2A1 mutation, with a mild phenotype. In early childhood, she developed epilepsy and mild cognitive impairment, balance disorders, and clumsiness. At the age of 9, the patient reported a first hemiplegic episode, which regressed spontaneously. Over the next 3 years, two similar episodes occurred, accompanied by headache. Therefore, in the hypothesis of HM, genetic testing was performed and CACNA1A mutation was identified. The treatment with Lamotrigine avoided the recurrence of HM episodes. Discussion: To our knowledge, among the several cases of GLUT1-DS with HM symptoms described in the literature, genetic testing was only performed in two of them, which eventually proved to be negative. In all other cases, no other genes except for SLC2A1 were examined. Consequently, our patient would be the first description of GLUT1-DS with HM due to CACNA1A mutation. We would emphasize the importance of performing specific genetic testing in patients with GLUT1-DS with symptoms evocative of HM, which may allow clinicians to use specific pharmacotherapy.
Geyser Sign: An Eruption of Fluid through the Acromioclavicular Joint in Chronic Rotator Cuff Degeneration
Authors: Matthias Lembrechts
Journal: J Belg Soc Radiol (2023)
Keywords: mr arthrogram, rotator cuff degeneration, acromioclavicular joint degeneration
MeSH terms: Case Reports

Teaching Point: Leakage of fluid or intra-articular contrast from the subacromial bursa through the acromioclavicular joint, also known as the 'geyser sign', is an uncommon presentation of chronic rotator cuff injury and acromioclavicular joint degeneration.
Pain sensitivity and observer perception of pain in individuals with autistic spectrum disorder
Authors: C S Allely
Journal: ScientificWorldJournal (2013)
MeSH terms: Child Development Disorders, Pervasive / diagnosis, Child Development Disorders, Pervasive / physiopathology, Pain / diagnosis, Pain / physiopathology, Pain Perception, Pain Threshold, Meta-Analysis, Review, Child, Child Development Disorders, Pervasive / epidemiology, Child, Preschool, Comorbidity, Female, Humans, Infant, Infant, Newborn, Male, Pain / epidemiology, Prevalence, Risk Factors

The peer-reviewed literature investigating the relationship between pain expression and perception of pain in individuals with ASD is sparse. The aim of the present systematic PRIMSA review was twofold: first, to see what evidence there is for the widely held belief that individuals with ASD are insensitive to pain or have a high pain threshold in the peer-reviewed literature and, second, to examine whether individuals with ASD react or express pain differently. Fifteen studies investigating pain in individuals with ASD were identified. The case studies all reported pain insensitivity in individuals with ASD. However, the majority of the ten experimental studies reviewed indicate that the idea that individuals with ASD are pain insensitive needs to be challenged. The findings also highlight the strong possibility that not all children with ASD express their physical discomfort in the same way as a neurotypical child would (i.e., cry, moan, seek comfort, etc.) which may lead caregivers and the medical profession to interpret this as pain insensitivity or incorrectly lead them to believe that the child is in no pain. These results have important implications for the assessment and management of pain in children with ASD.
Case-Mix, Care Processes, and Outcomes in Medically-Ill Patients Receiving Mechanical Ventilation in a Low-Resource Setting from Southern India: A Prospective Clinical Case Series
Authors: Balasubramanian Karthikeyan, Tamilarasu Kadhiravan, Surendran Deepanjali, Rathinam Palamalai Swaminathan
Journal: PLoS One (2015)
MeSH terms: Critical Illness / epidemiology, Outcome Assessment, Health Care, Respiration, Artificial / adverse effects, Adult, Critical Illness / mortality, Critical Illness / therapy, Female, Humans, India / epidemiology, Intensive Care Units, Kaplan-Meier Estimate, Length of Stay, Male, Middle Aged, Prospective Studies, Young Adult

Background:
Mechanical ventilation is a resource intensive organ support treatment, and historical studies from low-resource settings had reported a high mortality. We aimed to study the outcomes in patients receiving mechanical ventilation in a contemporary low-resource setting.
Methods:
We prospectively studied the characteristics and outcomes (disease-related, mechanical ventilation-related, and process of care-related) in 237 adults mechanically ventilated for a medical illness at a teaching hospital in southern India during February 2011 to August 2012. Vital status of patients discharged from hospital was ascertained on Day 90 or later.
Results:
Mean age of the patients was 40 ± 17 years; 140 (51%) were men. Poisoning and envenomation accounted for 98 (41%) of 237 admissions. In total, 87 (37%) patients died in-hospital; 16 (7%) died after discharge; 115 (49%) were alive at 90-day assessment; and 19 (8%) were lost to follow-up. Weaning was attempted in 171 (72%) patients; most patients (78 of 99 [79%]) failing the first attempt could be weaned off. Prolonged mechanical ventilation was required in 20 (8%) patients. Adherence to head-end elevation and deep vein thrombosis prophylaxis were 164 (69%) and 147 (62%) respectively. Risk of nosocomial infections particularly ventilator-associated pneumonia was high (57.2 per 1,000 ventilator-days). Higher APACHE II score quartiles (adjusted HR [95% CI] quartile 2, 2.65 [1.19-5.89]; quartile 3, 2.98 [1.24-7.15]; quartile 4, 5.78 [2.45-13.60]), and new-onset organ failure (2.98 [1.94-4.56]) were independently associated with the risk of death. Patients with poisoning had higher risk of reintubation (43% vs. 20%; P = 0.001) and ventilator-associated pneumonia (75% vs. 53%; P = 0.001). But, their mortality was significantly lower compared to the rest (24% vs. 44%; P = 0.002).
Conclusions:
The case-mix considerably differs from other settings. Mortality in this low-resource setting is similar to high-resource settings. But, further improvements in care processes and prevention of nosocomial infections are required.
Extracranial metastases of anaplastic meningioma
Authors: Robbin Zachery Thomas, Ishani Dalal
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Anaplastic meningioma is a World Health Organization (WHO) Class III lesion representing 2-3% of all meningiomas, with more aggressive spread, increased mortality and increased likelihood of recurrence. Metastases outside the blood-brain barrier are uncommon but can occur to the lungs, liver, bone and skin.Definitive diagnosis is obtained with pathological analysis. The World Health Organization classifies meningiomas into benign (Grade I), atypical (Grade II) and anaplastic/malignant (Grade III) based on histological findings including number of mitoses, cellularity, nucleus to cytoplasm etc. This case presents a 58-year-old female with history of treated anaplastic meningioma with new onset headache, nausea and vomiting. Workup demonstrated multiple new bilateral pulmonary nodules, which subsequent biopsy proved to be metastasis from recurrent anaplastic meningioma, with extensive intrathoracic involvement.
Gastrointestinal stromal tumor of the anal wall in a Nigerian
Authors: Aderemi Oluyemi, Samuel Keshinro, Abimbola Jimoh, Philip Oshun
Journal: Pan Afr Med J (2015)
Keywords: gastrointestinal stromal tumors (gist), nigeria, anal wall, immunohistochemistry
MeSH terms: Anal Canal / pathology, Anus Neoplasms / pathology, Gastrointestinal Hemorrhage / etiology, Gastrointestinal Stromal Tumors / pathology, Case Reports, Anus Neoplasms / diagnosis, Biopsy, Gastrointestinal Stromal Tumors / diagnosis, Humans, Immunohistochemistry, Male, Middle Aged, Nigeria

Documented reports of gastrointestinal stromal tumors (GIST) are relatively few in the sub-Saharan continent. The body of evidence points towards anal wall involvement being a rarity indeed. In this article we document a 61 year old Nigerian man who presented with bleeding per rectum and in whom the histological features (including immunohistochemistry) of the biopsied anal lesion was GIST.
Fatal toxic epidermal necrolysis associated with sinomenine in a patient with primary membranous nephropathy
Authors: Xue-Xia Li, Jun-Tao Zhang, Xiao-Ying Ding
Journal: Clin Nephrol Case Stud (2023)
Keywords: primary membranous nephropathy, sinomenine, toxic epidermal necrolysis
MeSH terms: Case Reports

Sinomenine (SIN), the alkaloid monomer extracted from Sinomenium acutum, is a kind of non-steroidal anti-inflammatory drug widely used in China to treat rheumatoid arthritis (RA) and various glomerular diseases. It has various pharmacological effects such as anti-inflammatory, analgesic, and anti-tumor. As a strong histamine-releasing agent, SIN has drawn increasing attention in regards to its side effects such as allergic, gastrointestinal, and circulatory systemic reactions. In this report, we first described a patient with primary membranous nephropathy (PMN) who was treated with oral intake of SIN and developed medicine-induced toxic epidermal necrolysis (TEN) and subsequently died of septic multi-organ failure. The present case report intends to demonstrate the underestimated side effects of SIN that can eventually lead to death.
Primary breast lymphoma in males-a report of two cases with a review of the literature
Authors: Kn Lokesh, Vishwanath Sathyanarayanan, Kc Lakshmaiah, Tm Suresh, D Lokanatha, K Govinda Babu, Linu Abraham Jacob, Suresh Babu
Journal: Ecancermedicalscience (2013)
Keywords: breast, diffuse large b cell lymphoma, small lymphocytic lymphoma
MeSH terms: Case Reports

Primary breast lymphoma (PBL) in males is a rare clinical entity and has been reported in anecdotal case reports up until now. We report two cases of PBL from a tertiary care centre in Southern India. A 46-year-old male presented with a lump in the right breast with right axillary lymphadenopathy; a biopsy with immunohistochemistry showed neoplastic cells positive for CD 20 and negative for CD 30, epithelial membrane antigen, anaplastic lymphoma kinase, suggestive of diffuse large B cell lymphoma stage IIEA. He received three cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone) chemotherapy, then developed a cerebrovascular accident, and died. The other patient was a 60-year-old male with a left breast lump with left axillary lymphadenopathy. The biopsy with immunohistochemistry showed neoplastic cells positive for CD 23 and CD 5, suggestive of small lymphocytic lymphoma stage IIEA. Initially he received three cycles of cyclophosphamide, vincristine, and prednisolone (COP) and defaulted. One year later, he received six cycles of COP chemotherapy, developed progressive disease, and was lost to follow-up. The literature on PBL in males was reviewed. To conclude, PBL in males is an extremely rare disease and can mimic breast cancer. A strong index of suspicion with early diagnosis by biopsy with immunohistochemistry and treatment with rituximab- and anthracycline-based chemotherapy followed by radiotherapy will improve overall survival.
Paediatric Posttraumatic Cyst-Like Lesions: A Report of Two Cases and Review of the Literature
Authors: R Jansen, F van Rooijen, J P Toirkens, A T Besselaar, J J Tolk
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Posttraumatic cyst-like lesions are a rare finding after greenstick fractures in children. These asymptomatic, cystic lesions become radiologically apparent 2-4 months after the initial trauma. Conventional radiographs typically show nonexpansile, well-circumscribed lesions in the cortex, proximal to the fracture site. It is important to recognize them as benign to prevent unnecessary concern and additional imaging or invasive diagnostic procedures. No treatment is indicated, as they eventually resolve spontaneously in 1 to 3 years. The two cases of posttraumatic cyst-like lesions after paediatric forearm fractures are presented.
Case report: Successful combination therapy with double-filtration plasmapheresis and rituximab under the condition of the use of a sensor-augmented pump for type B insulin resistance syndrome
Authors: Arata Osanami, Masatoshi Kanda, Tatsuya Sato, Chikako Akazawa, Shuhei Baba, Hiroaki Komatsu, Kazuyuki Murase, Tomohisa Yamashita, Toshiyuki Yano
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: sjögren’s syndrome, catabolism, double-filtration plasma apheresis, ketosis, rituximab, sensor-augmented pump (sap), systemic lupus erythematosus, type b insulin resistance (tbir)
MeSH terms: Autoimmune Diseases, Diabetes Mellitus / drug therapy, Hyperglycemia / complications, Insulin Resistance, Lupus Erythematosus, Systemic / complications, Case Reports, Research Support, Non-U.S. Gov't, Aged, Antibodies, Monoclonal / therapeutic use, Autoantibodies, Glucocorticoids / therapeutic use, Humans, Hypoglycemic Agents / therapeutic use, Immunosuppressive Agents / therapeutic use, Male, Plasmapheresis, Rituximab / therapeutic use, Antibodies, Monoclonal, Autoantibodies, Glucocorticoids, Hypoglycemic Agents, Immunosuppressive Agents, Rituximab

Type B insulin resistance syndrome (TBIR) is a rare disease characterized by refractory diabetes due to severe insulin resistance caused by anti-insulin receptor autoantibodies, and a standard treatment regimen for TBIR has not been established, leading to therapeutic difficulties and high mortality. Since TBIR is known to be associated with autoimmune diseases such as systemic lupus erythematosus (SLE), glucocorticoids are often used as key immunosuppressive agents. However, glucocorticoids have the potential to exacerbate the pathophysiology of TBIR by worsening insulin sensitivity, which leads to hyperglycemia and muscle wasting. Here, we report a case history of a 66-year-old man who was diagnosed as having TBIR in combination with SLE and Sjögren's syndrome with marked hyperglycemia, ketosis, and muscle wasting. He was successfully treated with combination therapy of double-filtration plasmapheresis (DFPP) and administration of the anti-CD20 monoclonal antibody rituximab without induction of glucocorticoid therapy while using a sensor-augmented insulin pump (SAP) to prevent hypoglycemia. Remission of diabetes was achieved without severe hypoglycemic events and his circulating insulin receptor antibodies became negative after seven months of initiation of these treatments. Based on the successful clinical courses of this case, our report suggests the possibility of an effective therapeutic regimen with DFPP and rituximab under the condition of the use of an SAP for a patient with TBIR without induction of glucocorticoids.
Managing an Acute and Chronic Periprosthetic Infection
Authors: Cristian Barrientos, Maximiliano Barahona, Rodrigo Olivares
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

A case report of a 65-year-old female with a history of right total hip arthroplasty (THA) in 2007 and left THA in 2009 was presented. She consulted with our institution for the first time, on December 2013, for right hip pain and fistula on the THA incision. It was managed as a chronic infection, so a two-stage revision was performed. First-time intraoperative cultures were positive for Staphylococcus aureus (3/5) and Proteus mirabilis (2/5). Three weeks after the second half of the review, it evolved with acute fever and pain in relation to right hip. No antibiotics were used, arthrocentesis was performed, and a coagulase-negative staphylococci multisensible was isolated at the 5th day. Since the germ was different from the first revision, it was decided to perform a one-stage revision. One year after the first review, the patient has no local signs of infection and presents ESV and RPC in normal limits. The indication and management of periprosthetic infections are discussed.
Unusual anatomic variant of the axillary nerve challenging the deltopectoral approach to the shoulder: a case report
Authors: Richard A Pizzo, Jeffrey Lynch, Donald M Adams, Richard S Yoon, Frank A Liporace
Journal: Patient Saf Surg (2019)
Keywords: anatomic variant, axillary nerve, reverse total shoulder arthroplasty
MeSH terms: Case Reports

Background:
The deltopectoral approach is a well-described surgical approach to the proximal humerus and glenohumeral joint. One of the structures at risk during this approach is the axillary nerve. Typically, the axillary nerve arises off the posterior cord of the brachial plexus and courses lateral to the proximal humerus and inferior to the glenohumeral joint, exiting the axilla through the quadrangular space. We describe a case of an aberrant axillary nerve, coursing anteriorly across the glenohumeral joint within the deltopectoral groove encountered during a reverse total shoulder arthroplasty.
Case presentation:
A 73-year-old female presented complaining of atraumatic progressive right shoulder pain of several months duration. Clinical and radiographic findings were consistent with advanced rotator cuff arthropathy. After failing appropriate non-operative treatment, the patient elected to undergo reverse total shoulder arthroplasty. During the deltopectoral approach to the glenohumeral joint, the axillary nerve was found to be coursing deep to the cephalic vein within the deltopectoral interval. The nerve was isolated and protected, and the glenohumeral joint was accessed via a small window in the anterior deltoid muscle. The remainder of the procedure was performed without complication. The patient was found to be healing well and with normal axillary nerve function at 4-month follow-up.
Conclusions:
Neurologic lesions are well-documented complications of reverse total shoulder arthroplasty. The integrity of the axillary nerve is of particular importance to reverse total shoulder arthroplasty as it innervates the deltoid and post-operative function of the extremity is dependent upon a functioning deltoid muscle. Extreme care must be taken to avoid insult to the axillary nerve and any aberrant paths it may course around the glenohumeral joint.
Case Report: Management of a Multidrug-Resistant CMV-Strain in a Renal Transplant Recipient by High-Dose CMV-Specific Immunoglobulins, Modulation in Immunosuppression, and Induction of CMV-Specific Cellular Immunity
Authors: Vanessa Wiening, Tina Schmidt, Maximilian Dahmen, Sami Siam, Stefan Reuter, Hermann-Joseph Pavenstädt, Martina Sester, Barbara Suwelack
Journal: Front Immunol (2021)
Keywords: case report, cytomegalovirus-specific cellular immunity, high dose immunoglobulins, multidrug-resistant cytomegalovirus, renal transplant
MeSH terms: Cytomegalovirus / immunology, Cytomegalovirus Infections / drug therapy, Cytomegalovirus Infections / immunology, Cytomegalovirus Infections / pathology, Drug Resistance, Multiple, Viral / immunology, Immunity, Cellular, Immunoglobulins, Intravenous / administration & dosage, Immunosuppression Therapy, Kidney Transplantation, Case Reports, Humans, Male, Middle Aged, Immunoglobulins, Intravenous, cytomegalovirus-specific hyperimmune globulin

The management of multidrug-resistant strains of cytomegalovirus after solid organ transplantation is challenging. This case report demonstrates the successful treatment of a multidrug-resistant strain of cytomegalovirus that may represent a valuable option for problematic cases. This report illustrates the emergence of a multidrug-resistant cytomegalovirus (CMV) UL54 mutant strain in a renal transplant recipient with severe lymphopenia and thrombocytopenia. We show that the combined treatment with high-dose intravenous cytomegalovirus-specific immunoglobulins (CMV-IVIG) after the switch to a mammalian target of rapamycin (mTOR)-inhibitor and cyclosporine A was a successful treatment alternative to direct antiviral treatment with high-dose ganciclovir and foscarnet. This treatment was associated with a quantitative induction of CMV-specific CD4 and CD8 T cells that showed maturation in phenotype and functionality with decreasing viral load. Our case report illustrates that high-dose CMV-IVIG and conversion of immunosuppressive drugs to mTOR inhibitors and cyclosporine A can be a successful treatment in a situation where the use of direct antiviral drugs was considered insufficient.