OpenMed/multicare-articles huggingface dataset:
Stealing from the Heart: A Rare Case of Chest Pain Post-Coronary Artery Bypass Grafting
Authors: Prasanti A Kotta, Joshua R Hirsch, Umair Khalid, Ali E Denktas
Journal: Methodist Debakey Cardiovasc J (2023)
Keywords: bilateral blood pressure differential, computed tomography angiogram, coronary subclavian steal, subclavian artery angiogram, subclavian artery stenosis
MeSH terms: Subclavian Steal Syndrome / diagnosis, Subclavian Steal Syndrome / surgery, Case Reports, Aged, Chest Pain, Coronary Artery Bypass / adverse effects, Humans, Subclavian Artery, Theft

A 70-year-old veteran with prior triple vessel coronary artery bypass grafting (CABG) presented with exertional chest pain. His work-up revealed > 40 mm Hg bilateral upper extremity blood pressure difference. Chest computed tomography and invasive angiography revealed severe stenosis at the ostium of the left subclavian artery, proximal to the origin of the left internal mammary artery to left anterior descending artery graft (LIMA-LAD). A diagnosis of coronary subclavian steal syndrome (CSSS) was made, and carotid-subclavian bypass was performed. This case outlines when to suspect CSSS, an approach to its diagnosis, and the importance of its timely management.
Successful Treatment of Carcinomatous Central Airway Obstruction with Bronchoscopic Electrocautery Using Hot Biopsy Forceps during Mechanical Ventilation
Authors: Motoi Ugajin, Hisanori Kani
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

We report the case of a 72-year-old man with occlusion of the left main bronchus due to squamous cell carcinoma of the lung. He required tracheal intubation and mechanical ventilation because of the aggravation of atelectasis and obstructive pneumonia. Electrocautery using hot biopsy forceps was performed during mechanical ventilation with a 40% fraction of inspired oxygen. He was extubated following improvement in the atelectasis and obstructive pneumonia and discharged with shrinkage of the tumor after chemotherapy. We describe a safe electrocautery procedure using hot biopsy forceps during mechanical ventilation with reference to previous reports.
The Diagnostic and Therapeutic Challenges of Posttraumatic Iris Implantation Cysts: Illustrative Case Presentations and a Review of the Literature
Authors: Nandini Venkateswaran, Steven S T Ching, William Fischer, Frank Lee, Gabrielle Yeaney, Holly B Hindman
Journal: Case Rep Ophthalmol Med (2015)

Posttraumatic iris implantation cysts are rare ocular findings that are often associated with poor visual outcomes. Iris implantation cysts can present clinicians with diagnostic and therapeutic challenges given their variable presentations and frequently destructive nature. In this paper, we provide descriptions of two unusual cases of posttraumatic iris implantation cysts. The first case is of a recurrent keratin-filled iris implantation cyst that developed after open globe injury and intraocular implantation of cilia and was treated with cyst debulking procedures, injections of 5-Fluorouracil, and iridocyclectomy. The second case is of recurrent posttraumatic serous iris implantation cysts that were treated with laser, cyst aspiration, and injections of 5-Fluorouracil. We use these cases as a platform to discuss the different manifestations of implantation cysts, the roles of anterior segment optical coherence tomography, ultrasound biomicroscopy, and histopathology in facilitating timely and accurate diagnosis and review the range of available therapeutic modalities. We discuss conservative treatment approaches, including the novel use of 5-Fluorouracil therapy as an adjunct therapy, as well as more aggressive surgical excision requiring ocular reconstruction. Through a discussion of these cases and review of the literature, we provide recommendations to assist clinicians in managing this uncommon but vision-threatening condition and minimizing complications.
Case report: Refractory intestinal Behçet's syndrome successfully treated with tofacitinib: A report of four cases
Authors: Na Zhao, Yanchun Tang, Shaokun Wang, Liping Cui, Xuehui Sun, Zhihua Wang, Ying Liu
Journal: Front Immunol (2022)
Keywords: behçet’s syndrome, case report, intestinal diseases, tofacitinib, treatment
MeSH terms: Behcet Syndrome / drug therapy, Janus Kinase Inhibitors / therapeutic use, Piperidines / therapeutic use, Pyrimidines / therapeutic use, Case Reports, Review, Antibodies, Monoclonal / therapeutic use, Biological Factors / therapeutic use, COVID-19 / epidemiology, Humans, Immunosuppressive Agents / therapeutic use, Intestines / pathology, Janus Kinases, Prospective Studies, Tumor Necrosis Factor Inhibitors, Ulcer / drug therapy, Antibodies, Monoclonal, Biological Factors, Immunosuppressive Agents, Janus Kinase Inhibitors, Piperidines, Pyrimidines, Tumor Necrosis Factor Inhibitors, tofacitinib, Janus Kinases

Behçet's syndrome (BS) is a chronic form of relapsing multisystem vasculitis, characterized by recurrent oral and genital ulcers. Intestinal BS is a special type of BS. Volcano-shaped ulcers in the ileocecum are a typical finding of intestinal BS, and punched-out ulcers can be observed in the intestine or esophagus. At present, there is no recognized radical treatment for intestinal BS. Glucocorticoids and immunosuppressants are currently the main drugs used to improve the condition. Although it has been reported that monoclonal anti-TNF antibodies may be effective for some refractory intestinal BS, further randomized, prospective trials are necessary to confirm these findings. Some patients are restricted from using biological agents because of serious allergic reactions of drugs, inconvenient drug injections or the impact of the novel coronavirus epidemic. If endoscopic remission (endoscopic healing) is not achieved for a prolonged period of time, serious complications, such as perforation, fistula formation, and gastrointestinal bleeding can be induced. Therefore, it is necessary to develop new treatment methods for controlling disease progression. We reviewed the relevant literature, combined with the analysis of the correlation between the pathogenesis of BS and the mechanism of Janus kinase (JAK) inhibition, and considered that tofacitinib (TOF) may be effective for managing refractory intestinal BS. We report for the first time that four patients with severe refractory intestinal BS were successfully treated with TOF. We hope to provide valuable information on JAK inhibitors as potential therapeutic targets for the treatment of severe refractory intestinal BS.
Lemierre's syndrome complicating pregnancy
Authors: M Thompson, A O Awonuga, J Bell, C Ray, M T Awonuga, A Helfgott
Journal: Infect Dis Obstet Gynecol (2007)
MeSH terms: Anti-Bacterial Agents / therapeutic use, Jugular Veins, Pregnancy Complications, Infectious / diagnosis, Sepsis / diagnosis, Thrombophlebitis / diagnosis, Case Reports, Acute Disease, Adult, Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Infectious / drug therapy, Pregnancy Outcome, Sepsis / drug therapy, Thrombophlebitis / drug therapy, Anti-Bacterial Agents

Lemierre's syndrome is an anaerobic suppurative thrombophlebitis involving the internal jugular vein secondary to oropharyngeal infection. There is only one previous case report in pregnancy which was complicated by premature delivery of an infant that suffered significant neurological damage. We present an atypical case diagnosed in the second trimester with a live birth at term. By reporting this case, we hope to increase the awareness of obstetricians to the possibility of Lemierre's syndrome when patients present with signs of unabating oropharyngeal infection and pulmonary symptoms.
Coincidental Central Precocious Puberty and Wilms Tumor in a 5-Year-Old Girl
Authors: Laura Kasongo, Patricia Forget, Ramona Corina Nicolescu
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Wilms tumor is the most frequent pediatric renal malignancy, and its usual presentation is an abdominal mass or hematuria. Unusual presentations have also been reported, such as paraneoplastic syndromes (acquired von Willebrand disease, sudden death due to pulmonary embolism, and Cushing syndrome). These conditions can precede, occur concomitantly, or present in a later phase of tumor development. Precocious puberty, as paraneoplastic endocrine syndrome, has already been described in children with malignant tumors (brain, gonadal, adrenal tumors, and hepatoblastoma). However, little is known about central precocious puberty, as paraneoplastic manifestation of nephroblastoma or secondary to its specific chemotherapy. Here, we report a case of Wilms tumor and simultaneous precocious puberty in a 5-year-old girl. The initial diagnosis was premature telarche, but the clinical and biological pubertal progression changed our diagnosis to idiopathic central precocious puberty. Chemotherapy and nephrectomy were well tolerated, and we began treatment with a gonadotropin-releasing hormone agonist which showed favorable outcomes over the short term. We highlight the need for early diagnosis and work-up in all patients of precocious puberty, in order to institute timely management.
Case report: Acute oxalate nephropathy due to traditional medicinal herbs
Authors: Lirui Wang, Zhuxian Zhu, Jiangtao Li
Journal: Front Med (Lausanne) (2022)
Keywords: acute kidney injury, acute oxalate nephropathy, hyperoxaluria, medicinal herbs, renal biopsy
MeSH terms: Case Reports

Acute oxalate nephropathy (AON), defined as the association between acute kidney injury (AKI) and the deposition of oxalate crystals in the renal parenchyma, is a rare complication of hyperoxaluria. We report a rare case of AON in an adult due to medicinal herbs intake leading to crystal-induced AKI. We recommend that a thorough medication history including the use of medicinal herbs, should be obtained for all patients with a rapid loss of kidney function, especially in the absence of known risk factors for AKI. The use of medicinal herbs with unknown oxalate contents would increase the risk of AON and should be avoided.
Atypical Parathyroid Adenoma Complicated with Protracted Hungry Bone Syndrome after Surgery: A Case Report and Literature Review
Authors: Óscar Alfredo Juárez-León, Miguel Ángel Gómez-Sámano, Daniel Cuevas-Ramos, Paloma Almeda-Valdés, Manuel Alejandro López-Flores A La Torre, Alfredo Adolfo Reza-Albarrán, Francisco Javier Gómez-Pérez
Journal: Case Rep Endocrinol (2015)

Hungry Bone Syndrome refers to the severe and prolonged hypocalcemia and hypophosphatemia, following parathyroidectomy in patients with hyperparathyroidism. We present the case of an eighteen-year-old woman with a four-year history of hyporexia, polydipsia, weight loss, growth retardation, and poor academic performance. The diagnostic work-up demonstrated primary hyperparathyroidism with hypercalcemia of 13.36 mg/dL, a PTH level of 2551 pg/mL, bone brown tumors, and microcalcifications within pancreas and kidneys. Neck ultrasonography revealed a parathyroid adenoma of 33 × 14 × 14 mm, also identified on (99)Tc-sestamibi scan. Bone densitometry showed decreased Z-Score values (total lumbar Z-Score of -4.2). A right hemithyroidectomy and right lower parathyroidectomy were performed. Pathological examination showed an atypical parathyroid adenoma, of 3.8 g of weight and 2.8 cm in diameter. After surgery she developed hypocalcemia with tetany and QTc interval prolongation. The patient required 3 months of oral and intravenous calcium supplementation due to Hungry Bone Syndrome (HBS). After 42 months, she is still under oral calcium. Usually HBS lasts less than 12 months. Therefore we propose the term "Protracted HBS" in patients with particularly long recovery of 1 year. We present a literature review of the diagnosis, pathophysiology, and treatment of HBS.
Leiomyosarcoma: Lung Metastasis
Authors: Karim Makhoul, Daniel Miller, Usman Ilyas, Asma Hosna, Muhammad A Baig
Journal: Cureus (2023)
Keywords: hydronephrosis, leiomyosarcoma, lung metastasis, pleural effusion, uterine cancer
MeSH terms: Case Reports

Uterine leiomyosarcoma distant metastasis is common, and lung metastasis has been reported. However, unique cases have been identified either with late onset of metastatic disease or with large size of lung metastasis. A typical approach to avoid metastasis would be a hysterectomy. Nonetheless, metastatic recurrence is common. We encountered a case at our hospital with leiomyosarcoma metastatic to the lungs. Lung metastasis was noted to be 17 cm in diameter. This size has not yet been reported in the literature to the best of our knowledge.
Malignant Deciduoid Mesothelioma: case presentation of an exceptional variant and review of the literature
Authors: Mouna Khmou, Soumiya Echcharif, Rachad Kabbaj, Basma El Khannoussi
Journal: BMC Clin Pathol (2017)
Keywords: deciduoid, immunohistochemistry, mesothelioma, peritoneum
MeSH terms: Case Reports

Background:
Malignant Deciduoid Mesothelioma (MDM) is an extremely rare variant of epithelioid mesothelioma. It was first described in young females, in the peritoneum, and its relation with asbestos was not well defined. Later reports, have shown that this variant may also occur in the pleura, the pericardium and the tunica vaginalis of elderly people, who had been exposed to asbestos.
Case presentation:
We report a case of malignant deciduoid mesothelioma that occurred in the peritoneal cavity, and the omentum of a 35-year-old woman. The patient had never been exposed to asbestos.
Conclusions:
Through this observation, we describe clinical, histopathological, and immunohistochemical findings of deciduoid mesothelioma, and review the literature reports.
Tonic pupil following pars plana vitrectomy and endolaser
Authors: Benyamin Ebrahim, Larry Frohman, Marco Zarbin, Neelakshi Bhagat
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Tonic pupil was observed in a 67 year-old patient following a retinal detachment repair with pars plana vitrectomy, endolaser and silicone oil tamponade performed under retrobulbar anesthesia. The probable location of disturbance is the postganglionic parasympathetic fibers in the short ciliary nerves along their course to the pupil in the suprachoroidal space. A likely explanation for this phenomenon is injury to short ciliary nerves by endolaser treatment.
Euglycemic Diabetic Ketoacidosis Due to Sodium-Glucose Cotransporter 2 Inhibitor Use in Two Patients Undergoing Pancreatectomy
Authors: Devon J Pace, Katerina Dukleska, Samantha Phillips, Vanessa Gleason, Charles J Yeo
Journal: J Pancreat Cancer (2018)
Keywords: sglt-2 inhibitor, canagliflozin, dapagliflozin, distal pancreatectomy, euglycemic dka, pancreatic cancer, pancreaticoduodenectomy
MeSH terms: Case Reports

Background: Euglycemic diabetic ketoacidosis (euDKA) is a potential side effect associated with inhibitors of the sodium-glucose cotransporter 2 (SGLT-2). This effect is most often recognized during physiologic stress (i.e., sepsis) or in patients who undergo surgery. Case presentations: Case 1: A 66-year-old woman underwent distal pancreatectomy with en bloc splenectomy after presenting with a biopsy-proven pancreatic adenocarcinoma in the body of the pancreas noted incidentally on a screening magnetic resonance imaging for an ovarian mass. The patient had a history of type 2 diabetes mellitus (T2DM) and used canagliflozin, which she was instructed to hold 24 h before surgery. Case 2: A 75-year-old man underwent a pylorus-preserving pancreaticoduodenectomy after presenting with obstructive jaundice. This patient also had a history of T2DM and was on dapagliflozin, which he was also instructed to hold 24 h before surgery. Postoperatively, both patients were diagnosed with euDKA, which was suspected primarily because of intraoperative and postoperative polyuria. Conclusions: SGLT-2 inhibitors are associated with euDKA that can be potentiated in patients who undergo surgery. This medication side effect can be easily unrecognized and potentially lead to significant morbidity.
Case Report: Improving Verbal Retrieval Deficits With High Definition Transcranial Direct Current Stimulation Targeting the Pre-Supplementary Motor Area in a Patient With Chronic Traumatic Brain Injury
Authors: Hsueh-Sheng Chiang, Scott Shakal, Sven Vanneste, Michael Kraut, John Hart Jr
Journal: Front Neurol (2021)
Keywords: eeg, hd-tdcs, tbi, case report, tdcs, verbal fluency, verbal retrieval, word finding
MeSH terms: Case Reports

We report a patient who has cognitive sequalae including verbal retrieval deficits after severe traumatic brain injury (TBI). The cortico-caudate-thalamic circuit involving the pre-Supplementary Motor Area (pre-SMA) has been proposed to underlie verbal retrieval functions. We hypothesized that High Definition-transcranial Direct Current Stimulation (HD-tDCS) targeting the pre-SMA would selectively modulate this circuit to remediate verbal retrieval deficits. After the patient underwent 10 sessions of 20 min of 1 mA HD-tDCS targeting the pre-SMA, we documented significant improvements for verbal fluency and naming, and for working memory and executive function tasks that involve the frontal lobes. The effects persisted for up to 14 weeks after completion of HD-tDCS treatment. We also demonstrated normalization of the event-related potentials suggesting modulation of the underlying neural circuit. Our study implicates that region-specific non-invasive brain stimulation, such as HD-tDCS, serves as a potential individualized therapeutic tool to treat cognitive deficits by inducing longer-lasting neuroplasticity even in the chronic phase of TBI.
Novel onset of a posttraumatic superficial temporal artery pseudoaneurysm
Authors: Alexandra A Roman, Andre J Arsenault, Kenneth D Jackson, John M Price
Journal: Case Rep Emerg Med (2013)

Less than 200 cases of posttraumatic superficial temporal artery pseudoaneurysm have been described in the literature. The majority of these cases result from blunt head trauma and are diagnosed an average of three weeks following the inciting traumatic event. In this case report, we describe a superficial temporal artery pseudoaneurysm that developed and was diagnosed the same day of a blunt head trauma in a 54-year-old white male. This is the earliest formation/diagnosis of post-traumatic superficial temporal artery pseudoaneurysm yet reported in the literature. This case report demonstrates that this diagnosis should be kept in the list of differential diagnoses for a post-traumatic soft tissue mass of the face, even immediately following the traumatic event.
Lumbar Spinal Angiolipoma with Expanding Left Neural Foramen Mimicking Lumbar Schwannoma; Case Report and Review of The Literature
Authors: Yener Akyuva, Aylin Gonultas, Numan Karaaslan, Zehra Gulciftci Dagci, Semih Saglik, Mehmet Isyar, Mahir Mahirogullari
Journal: Open Neurol J (2017)
Keywords: lumbar angiolipoma, schwannoma, spinal angiolipoma, spinal canal, spinal cord

Aim:
To describe a patient with lumbar angiolipoma mimicking schwannoma in the posterolateral side of the spinal canal with expansion of the left lumbar foramen and to discuss the clinical, radiologic, and surgical features of these lesions with literature.
Methods:
Without language restriction in this paper, the electronic databases; The Cochrane Collaboration the Cochrane, The Cochrane Library (Issue 2 of 12, Feb. 2011), ProQuest, US National Library of Medicine, National Institutes of Health (NLM) and PubMed dating from 1966 September to January Week 2 2017, were searched for comparative experimental studies using the terms: "OR", "AND". On-line literature searches were conducted using the key words "lumbar angiolipoma", "schwannoma ", "spinal angiolipoma", "spinal cord", and "spinal canal". We compared this research with our patient.
Results:
Bilateral L2 total laminectomy, excision of the tumors and bilateral L2-L3 transpedicular stabilization were performed, and complaints improved prominently. Pathological examination was reported as angiolipoma.
Conclusion:
The research shows that a probable diagnosis in such tumor cases could be made by sufficient pre-op scanning before surgical operations and although angiolipoma has been rarely seen in lumbar posterolateral space, it can be seen in lumbar region and mimic schwannoma as producing symptoms and signs of spinal cord and nerve root compression.
Fregoli syndrome: an underrecognized risk factor for aggression in treatment settings
Authors: Nauman Ashraf, Daniel Antonius, Arthur Sinkman, Karine Kleinhaus, Dolores Malaspina
Journal: Case Rep Psychiatry (2011)
MeSH terms: Case Reports

Fregoli syndrome (FS) is commonly associated with verbal threats and aggressive behavior. We present a case of Fregoli syndrome leading to an assault. We discuss the possible underdiagnosis of FS, associated risk for aggression, and strategies to reduce that risk.
Autosomal Recessive Bestrophinopathy: Clinical and Genetic Characteristics of Twenty-Four Cases
Authors: Hassan Khojasteh, Mohsen Azarmina, Nazanin Ebrahimiadib, Narsis Daftarian, Hamid Riazi-Esfahani, Houra Naraghi, Hamideh Sabbaghi, Alireza Khodabande, Hooshang Faghihi, Afrooz Moghaddasi, Fatemeh Bazvand, Masoud Reza Manaviat, Hamid Ahmadieh, Narges Hassanpoor, Fatemeh Suri
Journal: J Ophthalmol (2021)

Background:
To describe ocular manifestations, imaging characteristics, and genetic test results of autosomal recessive bestrophinopathy (ARB). The study design is an observational case series.
Methods:
Forty-eight eyes of 24 patients diagnosed with ARB underwent complete ophthalmic examinations including refraction, anterior and posterior segment examination, enhanced depth imaging optical coherence tomography (EDI-OCT), fluorescein angiography (FA), electroretinography (ERG), and electrooculography (EOG). Optical coherence tomography angiography (OCTA) and BEST1 gene sequencing were performed in selected patients.
Results:
The age at onset was 4-35 years (mean: 18.6 years). The male-to-female ratio was 0.45. All patients were hyperopic, except one with less than one diopter myopia. EOG was abnormal in 18 cases with near-normal ERGs. Six patients did not undergo EOG due to their young age. Eighteen patients (75%) had a thick choroid on EDI-OCT, of which three had advanced angle-closure glaucoma, 15 patients were hyperopic, and eight of them had more than four diopters hyperopia in both eyes. Macular retinoschisis was observed in 46 eyes of 23 patients (95%) with cysts mostly located in the inner nuclear layer (INL) to the outer nuclear layer (ONL). Of the 18 patients who underwent FA, mild peripheral leakage was seen in eight eyes of four patients (22%). Subfoveal choroidal neovascularization (CNV) was seen in three eyes of two patients (6%) that responded well to intravitreal bevacizumab (IVB). Seven mutations of the bestrophin-1 (BEST1) gene were found in this study; however, only two of them (p.Gly34 = and p.Leu319Pro) had been previously reported as the cause of ARB based on ClinVar and other literature studies.
Conclusions:
ARB can be presented with a wide spectrum of ocular abnormalities that may not be easily diagnosed. Pachychoroid can occur alongside retinal schisis and may be the underlying cause of angle-closure glaucoma in ARB. Our study also expands the pathogenic mutation spectrum of the BEST1 gene associated with ARB.