OpenMed/multicare-articles huggingface dataset:
Molecular Guided Therapy Provides Sustained Clinical Response in Refractory Choroid Plexus Carcinoma
Authors: Albert Cornelius, Jessica Foley, Jeffrey Bond, Abhinav B Nagulapally, Julie Steinbrecher, William P D Hendricks, Maria Rich, Sangeeta Yendrembam, Genevieve Bergendahl, Jeffrey M Trent, Giselle S Sholler
Journal: Front Pharmacol (2017)
Keywords: idh2, tp53, choroid plexus carcinoma, mtor, molecular guided therapy
MeSH terms: Case Reports

Choroid plexus carcinomas (CPCs) are rare, aggressive pediatric brain tumors with no established curative therapy for relapsed disease, and poor survival rates. TP53 Mutation or dysfunction correlates with poor or no survival outcome in CPCs. Here, we report the case of a 4 month-old female who presented with disseminated CPC. After initial response to tumor resection and adjuvant-chemotherapy, the tumor recurred and metastasized with no response to aggressive relapse therapy suggesting genetic predisposition. This patient was then enrolled to a Molecular Guided Therapy Clinical Trial. Genomic profiling of patient tumor and normal sample identified a TP53 germline mutation with loss of heterozygosity, somatic mutations including IDH2, and aberrant activation of biological pathways. The mutations were not targetable for therapy. However, targeting the altered biological pathways (mTOR, PDGFRB, FGF2, HDAC) guided identification of possibly beneficial treatment with a combination of sirolimus, thalidomide, sunitinib, and vorinostat. This therapy led to 92% reduction in tumor size with no serious adverse events, excellent quality of life and long term survival.
Idiopathic Isolated Acquired Steroid Dependent SO Palsy: A Rare Case Report
Authors: Isha Agarwal, Mayuresh Naik, HarinderSingh Sethi
Journal: Case Rep Ophthalmol Med (2019)
MeSH terms: Case Reports

15-year-old boy presented with sudden onset, stable, nonprogressive painless diplopia (greatest in right gaze and inferior field of view) and hyperdeviation of left eye for a year. On ophthalmic examination, the patient had uncrossed diplopia with tilt and separation maximum in dextrodepression. On Park's three step test, left eye hypertropia increased on right gaze and left tilt suggestive of left superior oblique (SO) palsy. On prism bar cover test (PBCT), deviation was more than 25 PD base-down over the left eye for both distance and near in all gazes. MRI head and orbit revealed a normal study while the myasthenia and inflammatory work-up was unremarkable. A provisional diagnosis of "Idiopathic Acquired Left Superior Oblique Palsy" was made and the patient was given trial of oral steroids at 1 mg/kg body weight. At 6 weeks, patient's diplopia resolved and PBCT neutralised at 6PD. Oral steroids were gradually tapered off by 10 mg per week with weekly follow-up. Upon decreasing the dose of prednisolone to 5 mg, intermittent diplopia and 18 PD left hypertropia reappeared. When patient was again restarted on oral steroids at 1 mg/kg body weight, diplopia-hypertropia disappeared at 10 mg OD prednisolone only to reappear at 5 mg OD dosage, leading to the final diagnosis of a "Steroid Dependent Isolated Superior Oblique Palsy". Presently, the patient is maintained on a daily dose of 10 mg oral prednisolone.
Concurrent sarcoidal granulomas and melanoma micrometastasis in a sentinel node - a case report
Authors: Hannah Trøstrup, Nille Behrendt, Anne Mellon Mogensen, Iselin Saltvig, Phillipe Claus Bandier, Jørgen Hesselfeldt, Jette B Løvenwald
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: sentinel node, granulomas, melanoma, micrometastasis, sarcoidosis
MeSH terms: Case Reports

Incidental findings of non-caseating granulomas and metastasis in sentinel lymph nodes are rare but cause clinical challenges. We report a case of coinciding unexpected asymptomatic lymphoid sarcoidosis and a micrometastasis in a sentinel node of a patient, who was newly diagnosed with 2.0 mm thick melanoma on the left calf.
Case Report: Dupilumab Successfully Controls Severe Eczema in a Child With Elevated IgE Levels and Recurrent Skin Infections
Authors: Tejas P Joshi, Sara Anvari, Meera R Gupta, Carla M Davis, Joud Hajjar
Journal: Front Pediatr (2021)
Keywords: dupilumab, hyper-ige syndrome, pediatrics-children, primary immunodeficencies, severe eczema
MeSH terms: Case Reports

The efficacy of dupilumab in pediatric patients with severe eczema presenting in the setting of elevated immunoglobulin E (IgE) levels and recurrent bacterial skin infections is not well-understood. Here we present the case of a child with elevated IgE levels in whom dupilumab treatment led to remarkable control of his eczema and recurrent skin infections. We also review the use of dupilumab in other patients with molecularly proven cases of hyper IgE (HIGE) syndrome. Our case supports the notion that dupilumab may have a seminal application in treating severe eczema that occurs in the setting of elevated IgE levels and recurrent bacterial skin infections.
A curious case of cough: Mounier-Kuhn syndrome in a Namibian female patient
Authors: Mercy Juliette Mkandawire, Nobert Makombe Muramira, Ngalawi Mraba
Journal: Pan Afr Med J (2020)
Keywords: hiv, mounier-kuhn syndrome, namibian female, airway dilatation, tracheomalacia
MeSH terms: Chest Pain / etiology, Cough / etiology, Dyspnea / etiology, Tracheobronchomegaly / diagnosis, Case Reports, Adult, Bronchoscopy, Expectorants / administration & dosage, Female, Humans, Namibia, Tomography, X-Ray Computed, Tracheobronchomegaly / therapy, Expectorants

We report a case of a 43-year-old female who presented with a history of recurrent productive cough, since her teenage years. Her associated symptoms included dyspnoea, occasional pleuritic chest pain and rarely, constitutional symptoms. Treated numerous times for lower respiratory tract infections, her symptoms would improve after antimicrobial therapy, but always recurred. She had a background of HIV infection and was virologically suppressed on antiretroviral therapy for nine years. Investigations revealed an active pseudomonas infection and high-resolution computed tomography scan (HRCT) and bronchoscopy confirmed features of Mounier-Kuhn syndrome. The patient was treated accordingly with positive airway pressure, mucolytic agents and chest physiotherapy aimed at aiding mucus clearance and received pneumococcal and influenza vaccines. Mounier-Kuhn syndrome, though rare, should be considered in the differential diagnosis of patients with recurrent lower respiratory tract infections. In Africa, more cases may be identified and treated appropriately with timely investigation and treatment.
Percutaneous mechanical thrombectomy of superior mesenteric artery embolism
Authors: Dimitrij Kuhelj, Pavel Kavcic, Peter Popovic
Journal: Radiol Oncol (2013)
Keywords: aspirex®, rotarex®, acute mesenteric ischemia, percutaneous mechanical thrombectomy, superior mesenteric artery embolism

Background:
The present series present three consecutive cases of successful percutaneous mechanical embolectomy in acute superior mesenteric artery ischemia. Superior mesenteric artery embolism is a rare abdominal emergency that commonly leads to bowel infarction and has a very high mortality rate. Prompt recognition and treatment are crucial for successful outcome. Endovascular therapeutic approach in patients with acute SMA embolism in median portion of its stem is proposed.
Case reports:
Three male patients had experienced a sudden abdominal pain and acute superior mesenteric artery embolism in median portion of its stem was revealed on computed tomography angiography. No signs of intestinal infarction were present. The decision for endovascular treatment was made in concordance with the surgeons. In one patient 6 French gauge Rotarex(®) device was used while in others 6 French gauge Aspirex(®) device were used. All patients experienced sudden relief of pain after the procedure with no signs of intestinal infarction. Minor procedural complication - rupture of a smaller branch of SMA during Aspirex(®) treatment was successfully managed by coiling while transient paralytic ileus presented in one patient resolved spontaneously. All three patients remained symptom-free with patent superior mesenteric artery during the follow-up period.
Conclusions:
Percutaneous mechanical thrombectomy seems to be a rapid and effective treatment of acute superior mesenteric artery embolism in median portion of its stem in absence of bowel necrosis. Follow-up of our patients showed excellent short- and long-term results.
A Rare Case of Midostaurin-Associated Sweet's Syndrome
Authors: Hesham Yasin, Tessa Laytem, Grerk Sutamtewagul, Sabarish Ayyappan
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Acute febrile neutrophilic dermatosis which is referred as Sweet's syndrome (SS) is a dermatological condition characterized by fever, erythematous rash, and leukocytosis. SS can be idiopathic or associated with malignancies or medications. We present a rare case of SS which developed shortly after starting midostaurin in a patient with acute myelogenous leukemia (AML).
Severe retinal hemorrhages at various levels with a serous retinal detachment in a pediatric patient with aplastic anemia-A case report
Authors: Xiaoshuang Jiang, Mengxi Shen, Licong Liang, Philip J Rosenfeld, Fang Lu
Journal: Front Med (Lausanne) (2023)
Keywords: aplastic anemia, retinal atrophy, retinal edema, retinal hemorrhage, serous retinal detachment, vitrectomy
MeSH terms: Case Reports

Background:
Aplastic anemia can cause ophthalmic abnormalities in patients. Vision loss in a child with aplastic anemia due to massive retinal hemorrhages at various levels is rare.
Case presentation:
A pediatric patient with aplastic anemia presented with retinal hemorrhages at multiple levels along with a serous retinal detachment in both eyes and subsequent retinal changes after pars plana vitrectomy.
Conclusion:
Anemia and thrombocytopenia in aplastic anemia could cause severe retinal hemorrhages and result in retinal atrophy and retinal edema. Vitrectomy can be performed to remove vitreous hemorrhage, but risk factors for retinal atrophy and edema need further investigation.
Intravitreal aflibercept for choroidal neovascularization secondary to angioid streaks in a non-responder to intravitreal ranibizumab
Authors: Olga E Makri, Foteini N Tsapardoni, Panagiotis Plotas, Athina Pallikari, Constantine D Georgakopoulos
Journal: Int Med Case Rep J (2018)
Keywords: aflibercept, angioid streaks, choroidal neovascularization, intravitreal, ranibizumab
MeSH terms: Case Reports

Purpose:
To report the 12-month outcomes of a patient switching from intravitreal ranibizumab to aflibercept for choroidal neovascularization (CNV) associated with angioid streaks (AS).
Results:
A 42-year-old Caucasian female with CNV associated with AS underwent intensive treatment with ranibizumab without significant functional or anatomic change. Treatment was then switched to aflibercept and the patient received the proposed age-related macular degeneration treatment regimen. After 3 loading doses of aflibercept, best-corrected visual acuity (BCVA) improved from 3/10 to 6/10, while optical coherence tomography (OCT) demonstrated resolution of the subretinal fluid with a reduction of the intraretinal fluid. After 12 months and 7 intravitreal injections of aflibercept, BCVA returned to 3/10, while OCT had demonstrated further morphologic improvement.
Conclusion:
Our case shows that aflibercept may be an alternative treatment for advanced cases of CNV associated with AS that respond insufficiently to ranibizumab injections. Prospective studies are required to further evaluate the effect of aflibercept and to propose a standardized treatment protocol for this entity.
Case report: Successful medical management of adrenocortical carcinoma with metastasis in a Maltese dog
Authors: Sin-Wook Park, Keon Kim, Ock-Kyu Kim, Woong-Bin Ro, Chang-Min Lee
Journal: Front Vet Sci (2023)
Keywords: adrenal tumor, adrenal-dependent hyperadrenocorticism, canine, metastasis, trilostane
MeSH terms: Case Reports

Introduction:
Adrenocortical carcinoma (ACC) with metastasis has a grave prognosis, and adrenalectomy is associated with a high perioperative mortality rate in dogs. A favorable outcome following trilostane treatment in patients with metastatic ACC confirmed by a decreased size of the adrenal tumor and metastatic lesions has not been reported in dogs.
Case description:
A 12-year-old neutered male Maltese dog was diagnosed with a right adrenal tumor and a hepatic mass. Adrenal-dependent hyperadrenocorticism (ADH) was diagnosed based on clinical signs and an adrenocorticotropic hormone stimulation test (ACTHST). In addition, tests for plasma metanephrine and normetanephrine ruled out a pheochromocytoma. Based on cytology and computed tomography, unresectable metastatic ACC was confirmed. The dog was managed with trilostane due to the presence of distant metastasis. Medical management improved the clinical signs and post-ACTHST cortisol concentrations. One year after the first presentation, the clinical signs and ACTHST test showed a favorable outcome. In addition, computed tomography revealed a decreased size of the right adrenal tumor and resolution of the hepatic mass.
Conclusions:
Trilostane could be considered as a treatment option for unresectable metastatic ACC. A decrease in tumor size following treatment with trilostane has not been reported in dogs. This case report is the first to demonstrate a favorable outcome of metastatic ACC following trilostane mono therapy for >1 year.
Migration of surgical clips through a right lobectomy stump mimicking an asthmatic syndrome
Authors: Vincenzo Di Crescenzo, Paolo Laperuta, Filomena Napolitano, Chiara Carlomagno, Michele Danzi, Bruno Amato, Alfredo Garzi, Mario Vitale
Journal: BMC Surg (2013)
MeSH terms: Asthma / diagnosis, Foreign-Body Migration / diagnosis, Lung / surgery, Pneumonectomy, Postoperative Complications / diagnosis, Sutures, Case Reports, Aged, Bronchoscopy, Diagnosis, Differential, Female, Foreign-Body Migration / surgery, Humans, Postoperative Complications / surgery, Syndrome

The mechanical stapler is routinely used in thoracic surgery practice to attend resection of bronchus and vessels. Herein, we reported a very rare complication as the migration of a titanium surgical clip through a right lobectomy stump. One year after the procedure, the patient complained of persistent cough. A misdiagnosis of asthma was made and she treated for 6 months with bronchodilators, corticosteroid and antihistaminic without success. Thus, patient re-referred of our unit. No clinical signs of infection as fewer, productive cough, dyspnea were present. The laboratory exams were within normal value including white cells. CT scan revealed no abnormalities. Bronchoscopy demonstrated a healed upper bronchus stump without evidence of an actual, open bronchopleural fistula but with clips apparently working their way into the airway, with approximately half of the clip visible within the lumen. The side of the clips that would be open before closure by the surgeon formed the leading edge of the clips visible in the lumen. The clips were successfully removed during flexible bronchoscopy with a forceps usually used for biopsy. After the procedure, the cough disappeared. The endoscopy check after 3 months showed a normal bronchial stump without evidence of fistula.
Delayed Tamponade after Traumatic Wound with Left Ventricular Compression
Authors: Fahad Almehmadi, Mark Chandy, Kim A Connelly, Jeremy Edwards
Journal: Case Rep Cardiol (2016)

Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade causing left ventricular collapse. The pericardial effusion was treated with emergent pericardiocentesis and later required a thoracoscopy guided pericardial window for definitive management.
Proximal Tibiofibular Joint Arthrodesis Due to Recurrent Giant Ganglion Cyst Causing Peroneal Nerve Palsy
Authors: Murat Birinci, Oguzhan Korkmaz, Bilal Bostanci, Tugrul Ormeci, Adnan Kara
Journal: Cureus (2023)
Keywords: arthrodesis, drop foot, ganglion cyst, peroneal nerve palsy, recurrence
MeSH terms: Case Reports

Ganglion cysts are masses that we encounter frequently in our daily practice, usually in the upper extremity, less frequently in the lower extremities, and rarely cause compression symptoms. We present a case of a massive ganglion cyst of the lower limb causing peroneal nerve compression, managed with excision and proximal tibiofibular joint arthrodesis to prevent recurrence. Examination and radiological imaging of a 45-year-old female patient who was admitted to our clinic showed new-onset weakness in right foot movements and numbness on the dorsum of the foot and lateral cruris, a mass consistent with a ganglion cyst expanding the muscle was detected in the peroneus longus muscle. In the first surgery, the cyst was carefully resected. After three months, the patient came with a repeated mass on the lateral side of the knee. After confirmation of the ganglion cyst with clinical examination and MRI, a second surgery was planned for the patient. In this stage, we performed a proximal tibiofibular arthrodesis for the patient. Her symptoms recovered during the early follow-up period and no recurrence occurred during the two years of the follow-up period. Although the treatment of ganglion cysts seems easy, it can sometimes be challenging. We think that arthrodesis may be a good treatment option in recurrent cases.
Improving Employment Through Interpersonal Psychotherapy: A Case Series of Patients With Treatment-Refractory Depression
Authors: Takeshi Katagiri, Yoshikazu Takaesu, Mariko Kurihara, Yuki Oe, Miho Ishii, Naoko Onoda, Tomonari Hayasaka, Yuta Kanda, Yayoi Imamura, Koichiro Watanabe
Journal: Front Psychiatry (2021)
Keywords: employment, interpersonal psychotherapy, major depressive disorder, psychotherapy, treatment-refractory depression

Patients with treatment-refractory depression (TRD) have significantly great losses in work productivity and employment. Interpersonal psychotherapy (IPT) is considered an approach for the treatment of TRD. However, the effectiveness of IPT in patients with TRD remains unclear. In this study, we report cases of TRD patients who underwent IPT after a detailed evaluation, along with their employment status. Of 112 patients who experienced 1-week examination administration for TRD at Kyorin University Hospital, which aimed to determine appropriate diagnosis and treatment approaches for each patient, four patients who met the criteria for major depressive disorder according to DSM-IV-TR and were determined suitable for IPT were included in this report. Two patients had moderate, one had mild, and one had remission levels of depressive symptoms according to the Montgomery-Asberg Depression Rating Scale at the time of admission. All four patients completed the scheduled sessions of IPT (6-16 sessions) in the outpatient clinic and achieved remission. All four patients attained full-time employment within 6 months after receiving IPT. This study suggests that the appropriate selection of IPT might be effective for TRD patients, possibly leading to positive outcomes, including work productivity and employment status.
Delayed Neuropsychiatric Sequel Following Pediatric Carbon Monoxide Poisoning: A Case Report and Literature Review
Authors: Hila Gavrieli, Iris Noyman, Eli Hershkovitz, Benjamin Taragin, Guy Hazan
Journal: Front Pediatr (2022)
Keywords: carbon monoxide poisoning, delayed neurological sequel, delayed neuropsychiatric sequel, encephalopathy, neurological disorders, seizure
MeSH terms: Case Reports

Carbon monoxide (CO) poisoning is a serious health problem. The main pathophysiological mechanism of acute CO poisoning is hypoxia due to the formation of carboxyhemoglobin (COHb). Delayed neuropsychiatric sequel (DNPS) occurs following an interval of several days to several weeks post-CO exposure and can present in many different manifestations, ranging from behavioral and mood disorders to encephalopathy and seizures and cause long-term neuropsychiatric sequel. The pathogenesis of DNPS following CO poisoning is a complex one that encompasses hypoxia-induced encephalopathy as well as inflammation, direct cellular changes and damage. The incidence varies and treatment is debated. We display a case of a previously healthy 13-year-old boy suffering from DNPS, presenting with seizures and encephalopathy and later developing optic nerve damage. Increased awareness to this condition might help diagnose future patients and aid in the understanding of the pathogenesis and treatment options for this poorly understood condition.
Risperidone-Induced Neutropenia in a Schizophrenic Patient: A Case Report and Literature Review
Authors: Ayodele Atolagbe, Stanley Nkemjika, Olusegun Popoola, Oluwatoyin Oladeji, Irina Kogan, Haroon Saeed, Tolulope Olupona
Journal: Case Rep Psychiatry (2021)
MeSH terms: Case Reports

Neutropenia is an adverse effect of various pharmacological therapies, including antipsychotics. Among the second-generation antipsychotic (SGA) medications, clozapine is most notable for neutropenic adverse effect. Risperidone, another SGA drug, is linked mainly with metabolic adverse effects, but rarely, blood dyscrasia adverse reactions have been reported. Hence, we report the case of a 56-year-old African American woman who developed severe neutropenia following two weeks of oral risperidone treatment. Her neutrophil levels returned to normal limits following discontinuation of risperidone and switching to haloperidol.