OpenMed/multicare-articles huggingface dataset:
Hypertension secondary to renal hypoplasia presenting as acute heart failure in a newborn
Authors: Jena Deitrick, Kayle Stevenson, Daniel Nguyen, William Sessions, Vijay Linga, Tetyana Vasylyeva
Journal: Clin Hypertens (2019)
Keywords: acute heart failure, neonatal hypertension, renal hypoplasia
MeSH terms: Case Reports

Introduction:
Neonatal hypertension is defined as persistent systolic and/or diastolic blood pressures above the 95th percentile compared to other infants of similar gestational age and size. Neonatal hypertension is a rare condition, occurring in only 0.2-3.0% of neonates. The most common etiology of neonatal hypertension is renal vascular or parenchymal disease, and it is usually detected on routine examination in an asymptomatic child. However, it may present in a variety of manners, including acute heart failure, renal dysfunction, feeding difficulties, failure to thrive, tachypnea, apnea, lethargy, irritability, or seizures.
Case presentation:
A term female was born via repeat caesarean section with vacuum extraction. On day of life (DOL) 3, the baby presented to the emergency department with poor feeding and lethargy. Initial laboratory tests indicated severe metabolic acidosis and the patient was transferred to our neonatal intensive care unit (NICU). During the hospital stay, the patient had intermittently high blood pressures. An echocardiogram was ordered, which demonstrated a severely decreased ejection fraction of 33%, but no signs of coarctation of the aorta. The low ejection fraction and constellation of symptoms were consistent with the diagnosis of acute heart failure, so treatment with milrinone was initiated. Further labs demonstrated elevated renin and aldosterone, and a computed tomography scan showed right kidney hypoplasia with reduced perfusion. This suggested a renovascular etiology of hypertension causing the initial presentation of acute heart failure. The patient was started on enalapril and clonidine for blood pressure control and was discharged with a home blood pressure monitoring system. At 5 months of life, this patient was still on enalapril and amlodipine as well as home blood pressure monitoring.
Conclusions:
Acute heart failure is a rare presentation of neonatal hypertension, and prompt recognition and treatment for the underlying systemic hypertension is necessary to provide the best possible outcomes for patients. Due to the lack of sufficient evidence, treatment of hypertension in newborns is often anecdotal in nature. Further awareness of neonatal hypertension and research determining ideal methods of diagnosis and treatment would benefit physicians and their affected patients.
Vanishing Bone Metastases in Superior Vena Cava Obstruction
Authors: Mimoun Mimoun Mazlin, Wim Verwimp, Stephane Dechambre
Journal: J Belg Soc Radiol (2022)
Keywords: intravertebral venous collateral, vanishing bone metastases
MeSH terms: Case Reports

Teaching Point: Intravertebral venous collateral formation can occur in thoracic venous obstruction syndrome and mimic metastatic bone lesions on contrast-enhanced imaging: vanishing bone metastases.
Langerhans cell histiocytosis in adults is associated with a high prevalence of hematologic and solid malignancies
Authors: Jennifer Ma, James H Laird, Karen W Chau, Monica R Chelius, Benjamin H Lok, Joachim Yahalom
Journal: Cancer Med (2019)
Keywords: langerhans, langerhans cell histiocytosis, eosinophilic granuloma, histiocytosis, second malignancies
MeSH terms: Histiocytosis, Langerhans-Cell / epidemiology, Neoplasms / epidemiology, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Adult, Aged, Aged, 80 and over, Female, Humans, Incidence, Kaplan-Meier Estimate, Male, Middle Aged, Prevalence

Background:
Langerhans cell histiocytosis (LCH) is a rare disorder of histiocyte proliferation. Previous case studies suggest a higher prevalence of hematologic and solid malignancies among LCH patients, possibly due to treatment with tumorigenic agents such as etoposide. We report the first large, single-institution experience of adult LCH patients with additional malignancies to study the characteristics of these patients.
Methods:
We identified 132 consecutive patients >18 years of age with histologically confirmed LCH at our center between 1990 and 2015. Demographics and detailed oncologic history were recorded to identify patients with additional malignancies.
Results:
Of 132 adult LCH patients, 42 (32%) patients had an additional malignancy. There were 53 malignancies among the 42 patients, with 31 (58%) preceding LCH diagnosis, 11 concurrent (≤3 months; 21%) with LCH diagnosis, and 11 (21%) after. Median age was 54 years (range 28-89) with a median follow-up of 3.7 years (0.1-22.2) for this cohort. OS at 3 years was 98% in patients with LCH alone and 82% among patients with additional malignancies, with 30 (71%) alive at last follow-up. Solid tumors, lymphomas, and other hematologic malignancies were observed as follows: 39 (74%), 9 (17%), and 5 (9%).
Conclusion:
Our cohort of adult LCH patients demonstrates an unusually high number of additional malignancies. Our study includes predominantly malignancies diagnosed preceding or concurrent with LCH, suggesting a cause of malignancy independent of LCH treatment. Further exploration of the biology of this rare disease may elucidate the mechanism of frequent additional malignancies.
Curious vascular tumor
Authors: Faissal Jghaimi, Hasna Baallal, Anas Fakhri, Hanane Rais, Noama Karbout, Nadia Akhdari, Said Amal, Badia Belaabidia
Journal: Case Rep Dermatol Med (2012)

Introduction. Sinusoidal hemangioma is a rare variant of acquired cavernous hemangioma predominantly occurring in females. Very few case reports have been described in the literature. Case Report. We present a case of a 46-year-old woman who noticed a slowly growing, cutaneous nodule on the left breast. Local excision of the lesion was performed and histology allowed to find a sinusoidal hemangioma. No recurrence was noticed. Conclusion. The very few reports of such a lesion in the literature reflect either rarity of such lesions or unfamiliarity of this subset among the pathologists.
Prevention preferable to treatment: 3 case reports of patients experiencing right-sided heart failure after Ebstein anomaly correction
Authors: Ming Luo, Jing Lin, Zhen Qin, Lei Du
Journal: Medicine (Baltimore) (2017)
MeSH terms: Cardiac Surgical Procedures / adverse effects, Cardiac Surgical Procedures / methods, Ebstein Anomaly / surgery, Heart Failure / diagnosis, Heart Failure / etiology, Heart Failure / physiopathology, Perioperative Care / methods, Postoperative Complications / prevention & control, Tricuspid Valve Insufficiency / diagnosis, Tricuspid Valve Insufficiency / etiology, Tricuspid Valve Insufficiency / physiopathology, Case Reports, Adult, Echocardiography, Transesophageal / methods, Female, Heart Ventricles / diagnostic imaging, Heart Ventricles / physiopathology, Humans, Middle Aged, Prognosis, Treatment Outcome, Tricuspid Valve / diagnostic imaging, Tricuspid Valve / physiopathology

Rationale:
Ebstein anomaly is a common congenital heart disease that may induce severe tricuspid regurgitation and dilation of the "atrialized" portion of the right ventricle. Patients who undergo surgery to correct Ebstein anomaly are at high risk of postoperative right-sided heart failure, yet little is known about what pre-, peri-, or postoperative procedures may help reduce this risk.
Patient concerns:
Here, we describe 3 cases of adults with Ebstein anomaly who underwent corrective surgery and in whom right-sided heart failure occurred with severe tricuspid regurgitation detected by transesophageal echocardiography.
Diagnoses:
Ebstein anomaly.
Intervention:
Various approaches were applied to prevent right heart failure: perioperative control of atrial and ventricle arrhythmia, protection of myocardium, reduction of right-side cardiac workload after cardiopulmonary bypass, and mechanical support for right heart.
Outcomes:
One of the 3 patients died, another experienced kidney failure despite postoperative support on extracorporeal membrane oxygenation, and the third patient survived without complications.
Lessons:
Our case series suggests that surgical prognosis can be improved through aggressive preoperative treatment, vasoactive and anti-arrhythmia medications, and comprehensive measures designed to reduce myocardial injury, prevent myocardial edema, and reduce pre- and afterload on the right ventricle.
COVID-19-Associated Coagulopathy: A Case Report of Thrombosis despite Therapeutic Anticoagulation
Authors: Habiba Hussain, Matthew Sehring, Bhagat Singh Aulakh
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

The Coronavirus disease (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has led to tremendous morbidity and mortality. Various inflammatory markers have been monitored and considered to be associated with disease prognosis. One of the major sources of comorbidity involved has been development of thrombosis alongside the infection. This prothrombotic phenomenon considered, COVID-19-associated coagulopathy (CAC), has been the center of discussion in dealing with this infection. There still remains ambiguity regarding management guidelines for thromboprophylaxis dosing and therapeutic anticoagulation. We present a case of severe SARS-CoV-2 infection complicated by thrombosis despite therapeutic anticoagulation contributing to prolonged intensive care unit and hospital stay.
Jejunal Intussusception Secondary to a Large Inflammatory Fibroid Polyp: A Case Report and Discussion of Differential Diagnosis
Authors: Asma Khalid Abu-Salah, Eric Brocken, Hector Mesa, Katrina Collins
Journal: Case Rep Pathol (2023)
MeSH terms: Case Reports

Inflammatory fibroid polyp (IFP), initially considered a reactive process, is now recognized as a benign mesenchymal neoplasm of the gastrointestinal tract. We report a case of a 68-year-old woman with medically refractory Crohn disease that presented with intussusception requiring surgical intervention. The resection revealed a jejunal mass consisting of a submucosal proliferation of bland spindle cells in a fibrous stroma infiltrated by numerous eosinophils. By immunohistochemistry, the lesion was positive for vimentin and negative for desmin, smooth muscle actin (SMA), S-100, CD117, DOG1, ALK (D5F3), Melan-A, HMB-45, CD34, and STAT6. Ki-67 proliferative index was low (<1%). The mass was classified as IFP by its characteristic morphology and associated eosinophilia. IFP should be considered in the differential diagnosis of adults with intussusception or bowel obstruction. Definitive treatment typically requires surgical resection of the involved bowel segment.
Critical Care Admission of an HIV Patient with Diabetic Ketoacidosis Secondary to Pembrolizumab
Authors: John A Cuenca, Andres Laserna, María P Reyes, Joseph L Nates, Gregory H Botz
Journal: Case Rep Crit Care (2020)
MeSH terms: Case Reports

Background:
Pembrolizumab is a checkpoint inhibitor that targets the programmed cell death-1 receptor (PD-1) and has shown to be effective against several malignancies, including lung cancer. However, life-threatening immune-related adverse events can result from these immunotherapy treatments. Case presentation. A 62-year-old man with HIV, metastatic adenocarcinoma of the lung, and no previous history of diabetes presented to the emergency department with new-onset nausea, vomiting, and generalized weakness. Glucose was 1191 mg/dl, hemoglobin A1c 11%, and potassium 6.9 mEq/L. He had metabolic acidosis with a lactate of 6.6 mmol/L and anion gap of 38 mEq/L, and ketones were detected on the urinalysis. Severe diabetic ketoacidosis was diagnosed, and the patient was admitted to the intensive care unit. Additional investigations showed low C-peptide and negative anti-glutamic acid decarboxylase antibody, anti-insulin antibody, and anti-islet-antigen 2Ab antibody. After ruling out other possible etiologies, pembrolizumab was considered to be the cause of the diabetes and ketoacidosis.
Conclusions:
Life-threatening adverse drug events associated with checkpoint inhibitors such as pembrolizumab are on the rise. We recommend to closely follow and monitor patients receiving these immunotherapies. This strategy could lead to early detection and prevention, as well as reduction of more serious life-threatening complications requiring intensive care.
Agenesis of the infra-hepatic segment of the inferior vena cava associated with recurrent deep venous thrombosis: case report
Authors: Vinicius Tadeu Ramos da Silva Grillo, Pedro Luciano Mellucci, Rodrigo Gibin Jaldin, Matheus Bertanha, Rafael Elias Fares Pimenta, Marcone Lima Sobreira
Journal: J Vasc Bras (2021)
Keywords: cardiovascular abnormalities, deep venous thrombosis, inferior vena cava
MeSH terms: Case Reports

Agenesis of the inferior vena cava (IVC) has been described in less than 1% of the population; a rare occurrence caused by embryonic abnormalities. Its correlation with deep vein thrombosis (DVT) is certainly underestimated, since this change is hard to detect using ultrasound. The aim of the article is to report the case of a 41-year-old female patient with pain and edema up to the top of the right thigh after plastic surgery. Bilateral venous duplex ultrasound revealed bilateral DVT involving iliac-femoral-popliteal and distal segments. Venous angiotomography was requested because the IVC was not visible on ultrasound, revealing thrombosis of the right lumbar plexus and iliofemoral segment bilaterally and agenesis of the infrahepatic segment of the inferior vena cava, with ectasia and compensatory tortuosity of paravertebral veins and the azygos-hemiazygos system, and bilateral pelvic varices. Systemic and oral anticoagulation were administered, with a satisfactory clinical response.
Positron emission tomography detected thyroid incidentaloma
Authors: J Goddard, A Gaunt, D H Markham
Journal: Ann R Coll Surg Engl (2013)
MeSH terms: Incidental Findings, Multimodal Imaging, Positron-Emission Tomography, Thyroid Neoplasms / diagnostic imaging, Tomography, X-Ray Computed, Case Reports, Female, Humans, Lung Neoplasms / diagnostic imaging, Middle Aged, Solitary Pulmonary Nodule / diagnostic imaging, Thyroid Neoplasms / surgery, Thyroidectomy / methods

We describe the case of a 48-year-old woman who presented with a thyroid lesion incidentally detected on positron emission tomography/computed tomography for a suspicious lung lesion. Subsequent clinical examination and investigations revealed a 3 cm nodule in the left lower pole of the thyroid. Fine needle aspiration was indeterminate for malignancy. A left hemithyroidectomy was performed and histology confirmed a benign thyroid adenoma with an incidental micropapillary carcinoma. The literature regarding the best management for thyroid incidentalomas remains uncertain and, as such, each patient must be managed on an individual basis.
Case report: post-stroke interventional BCI rehabilitation in an individual with preexisting sensorineural disability
Authors: Brittany M Young, Zack Nigogosyan, Veena A Nair, Léo M Walton, Jie Song, Mitchell E Tyler, Dorothy F Edwards, Kristin Caldera, Justin A Sattin, Justin C Williams, Vivek Prabhakaran
Journal: Front Neuroeng (2014)
Keywords: bci therapy, bci-fes-tdu, ue motor rehabilitation, brain-computer interface, case study, disability, stroke rehabilitation

Therapies involving new technologies such as brain-computer interfaces (BCI) are being studied to determine their potential for interventional rehabilitation after acute events such as stroke produce lasting impairments. While studies have examined the use of BCI devices by individuals with disabilities, many such devices are intended to address a specific limitation and have been studied when this limitation or disability is present in isolation. Little is known about the therapeutic potential of these devices for individuals with multiple disabilities with an acquired impairment overlaid on a secondary long-standing disability. We describe a case in which a male patient with congenital deafness suffered a right pontine ischemic stroke, resulting in persistent weakness of his left hand and arm. This patient volunteer completed four baseline assessments beginning at 4 months after stroke onset and subsequently underwent 6 weeks of interventional rehabilitation therapy using a closed-loop neurofeedback BCI device with visual, functional electrical stimulation, and tongue stimulation feedback modalities. Additional assessments were conducted at the midpoint of therapy, upon completion of therapy, and 1 month after completing all BCI therapy. Anatomical and functional MRI scans were obtained at each assessment, along with behavioral measures including the Stroke Impact Scale (SIS) and the Action Research Arm Test (ARAT). Clinically significant improvements in behavioral measures were noted over the course of BCI therapy, with more than 10 point gains in both the ARAT scores and scores for the SIS hand function domain. Neuroimaging during finger tapping of the impaired hand also showed changes in brain activation patterns associated with BCI therapy. This case study demonstrates the potential for individuals who have preexisting disability or possible atypical brain organization to learn to use a BCI system that may confer some rehabilitative benefit.
Case Report: Recurrent pericardial tamponade in a child with COVID-19
Authors: Ádám Győri, Tamás Decsi, József Stankovics, Zoltán Nyul, Mária Környei, György Masszi, Evelin Leibinger, Bernadett Mosdósi
Journal: Front Pediatr (2022)
Keywords: covid-19 in children, anakinra, cardiac tamponade, haemorrhagic pericardial effusion, interleukin-1 antagonist
MeSH terms: Case Reports

Background:
Pericarditis is rare in Coronavirus disease 2019 (Covid-19) infection and only a few cases were reported in children.
Case presentation:
We present the case of a 15-year-old boy with symptoms of high fever and worsening chest pain during COVID-19 infection. Chest computer tomography (CT) and echocardiography confirmed pericardial tamponade requiring urgent drainage. Despite antiviral drug treatment, after 18 days severe attack developed requiring repeated pericardiocentesis. High dose ibuprofen, colchicin and the interleukin-1 antagonist, anakinra were given. Clinical symptoms and laboratory parameters improved after seven days of treatment. Autoinflammatory diseases were also suspected in the background the severe pericarditis, but genetic analysis ruled out any mutations.
Conclusion:
Pericarditis associated with COVID-19 infection may present in the acute phase or later as MIS-C. Though pericardial tamponade related to ongoing Covid-19 infection is rare in children, even biological treatment with interleukin-1 antagonist may be needed to control the inflammation.
Splenic Abscess after Sleeve Gastrectomy
Authors: Rany Aoun, Michel Gabriel, Elias El Haddad, Roger Noun, Ghassan Chakhtoura
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

Splenic abscess is a very rare complication of laparoscopic sleeve gastrectomy (LSG). Clinical presentation includes fever, leucocystosis, and abdominal pain. CT SCAN is a must for diagnosis. The preferred treatment is either conservative, with intravenous antibiotics and percutaneous drainage, or splenectomy. We report the thirteen case of a splenic abscess after LSG. In our patient, the abscess occurred three weeks after LSG in a 21-year-old man, and it was successfully treated conservatively.
A Case of Septicemia due to Nonocclusive Mesenteric Ischemia Occurring in Induction Chemotherapy
Authors: Hideki Tanaka, Kiyoaki Tsukahara, Isaku Okamoto, Rio Kojima, Kazuhiro Hirasawa, Hiroki Sato
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

In nonocclusive mesenteric ischemia (NOMI), mesenteric ischemia and intestinal necrosis occur despite the absence of organic blockage in mesenteric blood vessels. As abdominal pain is often absent and few characteristic findings are seen in blood biochemistry, imaging diagnosis or other examinations, discovery is often delayed. With a mortality rate of 56-79%, NOMI is a very serious disease. However, few reports have described this pathology in association with chemotherapy regimens such as those used for malignant head and neck tumors. We encountered a case of NOMI during induction therapy combining cisplatin, docetaxel, and 5-fluorouracil. The patient was a 74-year-old man receiving chemotherapy for T2N2bM0 stage IVA oropharyngeal carcinoma. Febrile neutropenia appeared on treatment day 8. An antibacterial agent and a granulocyte colony-stimulating factor were administered, but septic shock developed and he was transferred to the intensive care unit. Abdominal distension was present and contrast-enhanced computed tomography of the abdomen suggested NOMI. Emergency surgery on day 9 resected the necrotized small intestine and created a single-hole ileostomy. The patient subsequently recovered with 2 weeks of continuous hemodiafiltration and other intensive therapies. Otolaryngological surgeons seldom encounter intestinal diseases, which are thus easily overlooked. The present case report may help in achieving early diagnosis.
NF-κB Essential Modulator Deficiency Leading to Disseminated Cutaneous Atypical Mycobacteria
Authors: Jonathan Braue, Vagishwari Murugesan, Steven Holland, Nishit Patel, Eknath Naik, Jennifer Leiding, Abraham Tareq Yacoub, Carlos N Prieto-Granada, John Norman Greene
Journal: Mediterr J Hematol Infect Dis (2015)
MeSH terms: Case Reports

NF-κB essential modulator (NEMO) is a kinase integral to the macrophage TNF-α pathway, which leads to the intracellular destruction of Mycobacteria species. Defects in the NEMO pathway result in spectrum of diseases, including but not limited to ectodermal dysplasia, Mendelian susceptibility to mycobacterial diseases, and incontinentia pigmenti. In addition, paucity of NEMO can lead to the inability to mount a proper immune response against opportunistic pyogenic and mycobacterial infections, leading to dissemination to various organ systems. This manuscript will discuss the numerous clinical manifestations of NEMO deficiency, the differential diagnosis of atypical mycobacterial infections in immunocompetent adults, and feature a case report of rare isolated susceptibility to disseminated atypical mycobacteria due to a mutation in the first exon of the NEMO gene.
Co-infection by Streptococcus anginosus and Mycobacterium tuberculosis: three case reports
Authors: Ramón Rabuñal, Juan Corredoira, Rafael Monte, Amparo Coira
Journal: J Med Case Rep (2009)

Introduction:
Bacterial infections may appear as sequelae of remote tuberculous infections, especially thoracic infections. The simultaneous appearance of tuberculosis and bacterial infection is not common, and, to our knowledge, the association of infection by Streptococcus anginosus and Mycobacterium tuberculosis has not been reported previously in the literature.
Case presentation:
We report three cases of dual infection with Streptococcus anginosus and Mycobacterium tuberculosis that were first diagnosed as pyogenic abscesses because of an isolation of Streptococcus anginosus. Despite a course of antibiotics and drainage, the outcome of this initial treatment was unfavourable. A re-evaluation yielded a diagnosis of mixed infection with Streptococcus anginosus and Mycobacterium tuberculosis.
Conclusion:
In a geographical area with a high prevalence of tuberculous disease, the rare possibility of dual infection with Streptococcus anginosus and Mycobacterium tuberculosis should be considered.