OpenMed/multicare-articles huggingface dataset:
Encephalopathy in COVID-19 Presenting With Acute Aphasia Mimicking Stroke
Authors: Umberto Pensato, Lorenzo Muccioli, Elena Pasini, Maria Tappatà, Lorenzo Ferri, Lilia Volpi, Laura Licchetta, Stella Battaglia, Giada Rossini, Isabella Bon, Maria Carla Re, Luigi Cirillo, Luigi Simonetti, Laura Ludovica Gramegna, Roberto Michelucci, Pietro Cortelli, Andrea Zini, Francesca Bisulli
Journal: Front Neurol (2020)
Keywords: icans, sars-cov-2, car-t, cytokine release syndrome, delirium, encephalitis, neurology
MeSH terms: Case Reports

Introduction: Neurological manifestations are emerging as relatively frequent complications of corona virus disease 2019 (COVID-19), including stroke and encephalopathy. Clinical characteristics of the latter are heterogeneous and not yet fully elucidated, while the pathogenesis appears related to neuroinflammation in a subset of patients. Case: A middle-aged man presented with acute language disturbance at the emergency department. Examination revealed expressive aphasia, mild ideomotor slowing, and severe hypocapnic hypoxemia. Multimodal CT assessment and electroencephalogram (EEG) did not reveal any abnormalities. COVID-19 was diagnosed based on chest CT findings and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription PCR (RT-PCR) on nasopharyngeal swab. The following day, neurological symptoms progressed to agitated delirium and respiratory status worsened, requiring admission to the ICU and mechanical ventilation. Brain MRI and cerebrospinal fluid (CSF) studies were unremarkable. RT-PCR for SARS-CoV-2 on CSF was negative. He received supportive treatment and intravenous low-dose steroids. His neurological and respiratory status resolved completely within 2 weeks. Conclusions: We report a patient with reversible COVID-19-related encephalopathy presenting as acute aphasia, mimicking stroke or status epilepticus, eventually evolving into delirium. Although large-vessel stroke is frequently encountered in COVID-19, our case suggests that focal neurological deficits may occur as the earliest feature of encephalopathy. Neurological status reversibility and the absence of abnormalities on brain MRI are consistent with a functional rather than a structural neuronal network impairment.
Delusional infestation in a patient with renal failure, metabolic syndrome, and chronic cerebrovascular disease treated with aripiprazole: a case report
Authors: Bernardo Carpiniello, Federica Pinna, Raffaella Tuveri
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Delusional infestation is an aspecific psychiatric condition manifested either as a primary psychotic disorder or a secondary disorder induced by a wide range of very different medical conditions. Both primary and secondary delusional infestations seem to respond to typical and atypical antipsychotics. The latter are considered the first-line treatment although the use of second-generation antipsychotics featuring a higher metabolic, cardiovascular, and renal tolerability is preferable in secondary cases, which often occur in patients with multiple, severe medical conditions. We report a case of a 72-year-old patient affected by delusional infestation associated with severe renal failure, metabolic syndrome, hypertensive cardiopathy, and chronic cerebrovascular disease.
Remarkable response to alectinib for metastatic papillary thyroid cancer with STRN-ALK fusion: A case report
Authors: Lucheng Zhu, Shenglin Ma, Bing Xia
Journal: Front Oncol (2022)
Keywords: alk inhibitor, strn-alk fusion, alectinib, case report, thyroid cancer
MeSH terms: Case Reports

Little is known about the efficacy of alectinib for papillary thyroid cancer with STRN-ALK fusion. A 64-year-old female presented with metastatic papillary thyroid cancer, widespread to lungs, mediastinal lymph nodes and brain 20 years after surgery. Disease progression still occurred after radioactive iodine therapy, chemotherapy, and radiotherapy. Tissue obtained from left cervical lymph node confirmed metastatic papillary thyroid cancer. Molecular profiling from re-biopsy tissue identified an STRN-ALK fusion rearrangement. After multidisciplinary discussion, alectinib was administered to the patient. Treatment was well tolerated, and follow-up images confirmed a partial response. ALK occurs rarely, with limited data suggesting the efficacy of ALK inhibitors in thyroid cancer. We presented the first case of a patient with PTC and STRN-ALK fusion to be treat effectively with alectinib.
Two cases of male patients followed for a classical form of congenital adrenal hyperplasia (CAH), presenting an azoospermia: analysis and review of the literature
Authors: Clélia Fouques, Imène Fatfouta, Sylvie Hieronimus, Jean-Louis Sadoul, André Bongain
Journal: Basic Clin Androl (2019)
Keywords: 21-hydroxylase deficiency- azoospermia - male infertility, congenital adrenal hyperplasia, testicular adrenal inclusions, “tart” lesions
MeSH terms: Case Reports

Background:
Congenital hyperplasia of the adrenal glands is a rare pathology, which can have an impact on male fertility. We report 2 cases of azoospermia in patients followed for a classical form of congenital adrenal hyperplasia.
Cases presentation:
1st case: After 18 months of infertility of the couple, explorations showed a high level of ACTH on the hormonal biological analysis. A therapeutic strategy combining hydrocortisone with dexamethasone induced a normal semen analysis, and the female partner of the patient subsequently had three spontaneous pregnancies.2nd case: After two years of infertility of the couple, explorations showed adrenal testicular inclusions invading the 4/5th of the testis with a hypergonadotropic hypogonadism, the therapeutic reinforcement did not allow the improvement of semen analysis.
Discussion:
Sertolian deficiency can be explained by: gonadotropic deficiency by excess of adrenal androgens and adrenal testicular lesions (risk of major spermatic alteration).
Conclusion:
Congenital hyperplasia of the adrenal glands is a rare pathology in the context of male infertility. A semen analysis could be performed after puberty and a semen preservation may be proposed.
Localized Pigmented Villonodular Synovitis of the Posterior Knee Compartment with Popliteal Vessel Compression: A Case Report of Arthroscopic Resection Using Only Anterior Knee Portals
Authors: Jack Daoud, Dany Aouad, Youssef Hassan, Georges El Rassi
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Background:
Pigmented villonodular synovitis is a rare pathology causing hyperplasia of the synovium. It mostly affects young populations and most commonly the knee joint. It rarely affects the posterior compartment of the knee as the case presented in this study. Open surgery is usually used to treat this condition; however, in our case it was excised arthroscopically despite the anatomical challenges of the posterior knee compartment.
Case presentation:
This case presents a female patient with a complaint of posterior-region pain of her left knee post direct trauma post fall. This was directly followed by knee joint blockage for 1-week duration before presentation to the hospital. On MRI, she was found to have a multiloculated hemosiderin-containing structure of synovial origin within the femoral notch, extending beyond the joint capsule displacing the popliteal vessels. The patient underwent arthroscopic resection of the lesion, which was found to be pigmented villonodular synovitis on anatomopathological examination. On 6-month follow-up, the patient showed good clinical evolution with the absence of symptoms and back-to-normal daily activities.
Conclusion:
This is a rare case of PVNS affecting the posterior knee joint compartment of a middle-aged woman, which was successfully excised arthroscopically, with no residual affected tissue or recurrence on 6-month follow-up.
Case report: Intra-atrial course of right coronary artery: Evaluation by dual-source CT
Authors: Johann Christopher, Chary Duraikannu
Journal: Indian J Radiol Imaging (2011)
Keywords: dual-source ct, intra-atrial, right coronary artery
MeSH terms: Case Reports

We report a case of an anomalous course of the right coronary artery (RCA) through the right atrium, which was evaluated using dual-source CT angiography. There have been a few cases described previously in literature, but most of them were found either during surgery or at autopsy. Although this variant is clinically benign, it has significant consequences during interventional procedures or bypass surgery.
Spontaneous reactivation of hepatitis B virus replication in an HIV coinfected patient with isolated anti-Hepatitis B core antibodies
Authors: Rongjuan Pei, Sebastian Grund, Jens Verheyen, Stefan Esser, Xinwen Chen, Mengji Lu
Journal: Virol J (2014)
MeSH terms: Coinfection / immunology, Coinfection / virology, HIV Infections / immunology, Hepatitis B virus / physiology, Hepatitis B, Chronic / immunology, Hepatitis B, Chronic / virology, Virus Activation, Case Reports, Research Support, Non-U.S. Gov't, Antiviral Agents / therapeutic use, DNA, Viral / blood, HIV Infections / complications, HIV Infections / drug therapy, Hepatitis B Antibodies / blood, Hepatitis B Core Antigens / blood, Hepatitis B Core Antigens / genetics, Hepatitis B, Chronic / complications, Hepatitis B, Chronic / drug therapy, Humans, Male, Middle Aged, Mutant Proteins / blood, Mutant Proteins / genetics, Mutation, Missense, Viral Load, Antiviral Agents, DNA, Viral, Hepatitis B Antibodies, Hepatitis B Core Antigens, Mutant Proteins

Co-infections with HBV (hepatitis B virus) occur in HIV (human immunodeficiency virus) patients frequently. It has been reported that an effective treatment of HIV can also lead to a suppression of HBV and to anti-HBs seroconversion in HBV-infected patients. Here, we report a spontaneous reactivation of HBV replication in an HIV-infected patient with anti-HBc as the only marker of chronic HBV infection. The patient was known to be coinfected with HIV and HBV for years and the HBV DNA was measured repeatedly at low levels. A significant increase of HBV DNA up to 1.7 x 10⁷ IU/ml was found accompanied with clinical symptoms of hepatitis. Multiple mutations occurred in the S gene during the flare-up of HBV as shown by sequencing, including I103T, K122R, M133I, F134V, D144E, V164E and L175S. Anti-HIV/HBV treatment led to a resolution of symptoms and to a decrease in the HIV RNA and HBV DNA viral load. It is possible that the accumulated mutations during HBV replication were selected and responsible for the reactivation.
Metastatic renal clear cell carcinoma to the rectum, lungs, ilium, and lymph nodes: A case report
Authors: Guoyang Zheng, Hanzhong Li, Ji Li, Xuebin Zhang, Yushi Zhang, Xingcheng Wu
Journal: Medicine (Baltimore) (2017)
MeSH terms: Bone Neoplasms / secondary, Carcinoma, Renal Cell / secondary, Ilium, Kidney Neoplasms / pathology, Lung Neoplasms / secondary, Lymph Nodes / pathology, Rectal Neoplasms / secondary, Case Reports, Aged, Antineoplastic Agents / therapeutic use, Bone Neoplasms / drug therapy, Carcinoma, Renal Cell / drug therapy, Carcinoma, Renal Cell / surgery, Humans, Indoles / therapeutic use, Kidney Neoplasms / drug therapy, Kidney Neoplasms / surgery, Lung Neoplasms / drug therapy, Lymphatic Metastasis, Male, Nephrectomy, Pyrroles / therapeutic use, Rectal Neoplasms / drug therapy, Sunitinib, Antineoplastic Agents, Indoles, Pyrroles, Sunitinib

Background:
Renal cell carcinoma metastasizing to rectum is very rare, and the unusual metastatic sites should be paid attention to during the follow-up of renal cell carcinoma.
Case summary:
We describe a case of a 65-year-old male who was diagnosed with metastatic renal cell carcinoma to rectum 10 years after the right radical nephrectomy. Histopathology and immunohistochemical examinations contribute to making differential diagnosis between rectal metastasis of renal cell carcinoma and primary rectal clear cell carcinoma. Positron emission tomography-computed tomography with fluorodeoxyglucose shows hypermetabolic activity in upper rectum and other sites of metastasis at the same time.
Conclusion:
Possibility of unusual metastatic sites of renal cell carcinoma such as rectum indeed exists, which should not be ignored in the surveillance after resection of the primary tumor.
Surgical Alternative for Treatment of Vertical Root fracture: A Case Report
Authors: Emmanuel João Nogueira Leal da Silva, Gustavo Romão Dos Santos, Renato Liess Krebs, Tauby de Souza Coutinho-Filho
Journal: Iran Endod J (2012)
Keywords: diagnosis, surgical endodontic, tooth fracture, treatment
MeSH terms: Case Reports

Vertical root fracture (VRF) has been a great challenge in dentistry; most fractures often result in tooth extraction. Inflammation of tissues around the fractured root is the main reason for tooth extraction. Based on the strategic importance of some fractured teeth, treatment may be necessary and often complicated. However, performing a proper repair or even splinting the fractured segments may result in tooth preservation. Accordingly, in this case we report a new method for fractured tooth preservation. The surgical exposition of the fracture tooth was carried out through the radicular portion of the element via ultrasonic preparation, filling with composed resin and a synthetic hydroxyapatite graft. All these were performed around the tooth which received five sections of low-power laser. The patient was followed for two years with no signs or symptoms of inflammation and gingival recession. In conclusion, the used treatment protocol could be considered as a promising approach for VRF treatment, especially in cases where there is advanced or moderate bone loss in the surrounding sites of the fractured tooth.
False Positive Findings on I-131 WBS and SPECT/CT in Patients with History of Thyroid Cancer: Case Series
Authors: Zeina C Hannoush, Juan D Palacios, Russ A Kuker, Sabina Casula
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Introduction. Although whole body scan (WBS) with I-131 is a highly sensitive tool for detecting normal thyroid tissue and metastasis of differentiated thyroid cancer (DTC), it is not specific. Additional information, provided by single photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) and by the serum thyroglobulin level, is extremely useful for the interpretation of findings. Case Presentation. We report four cases of false positive WBS in patients with DTC: ovarian uptake corresponding to an endometrioma, scrotal uptake due to a spermatocele, rib-cage uptake due to an old fracture, and hepatic and renal uptake secondary to a granuloma and simple cyst, respectively. Conclusions. Trapping, organification, and storage of iodine are more prominent in thyroid tissue but not specific. Physiologic sodium-iodine symporter expression in other tissues explains some, but not all, of the WBS false positive cases. Other proposed etiologies are accumulation of radioiodine in inflamed organs, metabolism of radiodinated thyroid hormone, presence of radioiodine in body fluids, and contamination. In our cases nonthyroidal pathologies were suspected since the imaging findings were not corroborated by an elevated thyroglobulin level, which is considered a reliable tumor marker for most well-differentiated thyroid cancers. Clinicians should be aware of the potential pitfalls of WBS in DTC to avoid incorrect management.
Rehabilitation of a Child with Denari Prosthesis after Dental Avulsion
Authors: César Sebastián Arcos-López, Juan Marcos Parise-Vasco, Ana Armas-Vega, Yecenia Carrillo-Azuero
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Prosthetic rehabilitation in cases of premature loss of temporary teeth always is a procedure that must be carried out in a planned and integral manner. The avoidance of opposing tooth extrusion, loss of horizontal space, and acquisition of bad oral habits are fundamental to not trigger alterations in the child's occlusal development and psychological development. The purpose of this document is to report the clinical case of a 4-year-old patient with avulsion of the anterior primary teeth secondary to severe automobile trauma. In this case, we describe the use of a Denari-type fixed partial prosthesis. This prosthesis can recover the function and aesthetics of the superior anterior sector of the oral cavity, thus preventing lingual interposition. The treatment with the Denari prosthesis allowed satisfactory results relating to the transverse growth of the maxillary bone in this case report.
A Rare Twist of the Forgotten Disease: A Case of Fusobacterium necrophorum Sepsis with Portomesenteric Thrombosis and a Review of the Literature
Authors: Nicholas Lazar, Kamil Sardarli, Zaid Imam, Majd Khasawneh, Ismail Hader
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Abdominal variants of Lemierre's syndrome presenting with pylephlebitis are rare, and the role of anticoagulation in treatment is controversial. We hereby report a case of pylephlebitis secondary to F. necrophorum bacteremia in a 57-year-old female originating from bacterial translocation secondary to colitis, who developed a favorable outcome with prompt treatment with antibiotics and anticoagulation. We also perform a literature review on similar cases in the literature and discuss management options of this rare but potentially fatal complication.
Concurrent B Cell Acute Lymphoblastic Lymphoma/Leukemia and Monoclonal B Cell Lymphocytosis: A Case Report with Extensive Molecular Analysis
Authors: Maryam Mehdipour Dalivand, Parastou Tizro, Julie Partain, Anita Aggarwal, Jack Lichy, Francisco Mot Ara, Victor E Nava
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Although acute lymphoblastic leukemia (ALL) and monoclonal B cell lymphocytosis (MBL) are common neoplasia, a simultaneous presentation is very unusual. Here, we present two different B cell clones, MBL and B-ALL, cocirculating in a 78-year-old African American male. Detailed molecular characterization revealed an unusual MPL (T487I) point mutation and unmutated VH4-39. After nonstandard chemotherapy, the patient remains in morphologic remission. These findings may stimulate further research to clarify the pathogenesis of hematologic neoplasms.
A case report of hepatitis B virus reactivation 19 months after cessation of chemotherapy with rituximab
Authors: Xiangjuan Guo, Tongtong Ji, Shengliang Xin, Jinghang Xu, Yanyan Yu
Journal: Front Immunol (2022)
Keywords: cd20 monoclonal antibody, hepatitis b virus, hepatitis b virus reactivation, lymphoma, rituximab
MeSH terms: DNA, Viral, Hepatitis B virus, Case Reports, Aged, Antibodies, Monoclonal, Murine-Derived, Female, Humans, Rituximab / adverse effects, Transaminases, Virus Activation, Rituximab, DNA, Viral, Antibodies, Monoclonal, Murine-Derived, Transaminases

A 72-year-old woman presented to our hospital with elevation of serum transaminases. Her blood tests showed the hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) negative. Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) were given for the diffuse large B-cell lymphoma. She didn't receive anti- hepatitis B virus (HBV) drug for the isolated HBcAb positive. HBV reactivation confirmed based on the serum HBV DNA detectable until 19 months after stopping R-CHOP regimen. HBV DNA became undetectable after 4 weeks therapy with Tenofovir alafenamide fumarate (TAF). Serum transaminases went down to normal 3 months later after receiving TAF. HBV reactivation is a substantial risk for patients with isolated HBcAb positive receiving rituximab-containing chemotherapy without anti- HBV drug. Regular monitoring with a frequency of 1-3 months is the basis for timely diagnosis and treatment of HBV reactivation. Serum transaminases abnormalities may be the initial manifestation of HBV reactivation.
The Cushing Reflex: Oliguria as a Reflection of an Elevated Intracranial Pressure
Authors: K Leyssens, T Mortelmans, T Menovsky, D Abramowicz, Marcel Th B Twickler, L Van Gaal
Journal: Case Rep Nephrol (2017)
MeSH terms: Case Reports

Oliguria is one of the clinical hallmarks of renal failure. The broad differential diagnosis is well known, but a rare cause of oliguria is intracranial hypertension (ICH). The actual knowledge to explain this relationship is scarce. Almost all literature is about animals where authors describe the Cushing reflex in response to ICH. We hypothesize that the Cushing reflex is translated towards the sympathetic nervous system and renin-angiotensin-aldosterone system with a subsequent reduction in medullary blood flow and oliguria. Recently, we were confronted with a patient who had complicated pituitary surgery and displayed multiple times an oliguria while he developed ICH.
Case report: Eosinophilic pneumonia associated with vedolizumab therapy in a patient with ulcerative colitis
Authors: Wanwan Zhu, Tianhao Zhao, Jun Wei, Damin Chai, Cancan Zhao, Yu Zhu, Min Deng
Journal: Front Med (Lausanne) (2022)
Keywords: adverse drug reactions, case report, eosinophilic pneumonia, ulcerative colitis, vedolizumab
MeSH terms: Case Reports

Extraintestinal manifestations are common in patients with inflammatory bowel disease, while respiratory involvement is less common. Vedolizumab is a new class of anti-integrin biological agents approved for treating inflammatory bowel disease. In this report, we present the case of a 38-year-old patient with ulcerative colitis for 7 years who developed cough, fever, and pulmonary infiltrates after taking vedolizumab. There was a spontaneous improvement in clinical symptoms and radiological abnormalities after discontinuing vedolizumab and introducing steroids. Despite the rarity of vedolizumab-induced eosinophilic pneumonia, the case reports indicate that patients with unexplained respiratory symptoms that are taking vedolizumab should be fully contemplated.