OpenMed/multicare-articles huggingface dataset:
Tezepelumab improved chronic eosinophilic pneumonia in severe asthma patients with liver cirrhosis
Authors: Mizuki Inaba, Yasuo Shimizu, Yusuke Nakamura, Hiroaki Okutomi, Akihiro Takemasa, Seiji Niho
Journal: Front Med (Lausanne) (2024)
Keywords: asthma, eosinophilia, eosinophilic pneumonia, liver fibrosis, oral corticosteroids, sinusitis, tezepelumab, thymic stromal lymphopoietin
MeSH terms: Case Reports

Systemic administration of corticosteroids is used in the treatment of chronic eosinophilic pneumonia (CEP). However, in patients with CEP as well as other comorbidities, the adverse effects of corticosteroids should be minimized as much as possible. A 71-year-old woman was presented with aggravating asthma with CEP and sinusitis, and she had uncompensated liver cirrhosis (LC) with a Child-Pugh score of 7. Initial treatment with a low dose of oral corticosteroids (OCSs) in combination with tezepelumab, an anti-thymic stromal lymphopoietin (TSLP) antibody, resulted in rapid improvement of asthma and CEP without deteriorating LC. Sinusitis also improved after ceasing OCS. This case suggested that tezepelumab may be useful as a treatment option for patients with CEP, especially those with liver dysfunction.
Early Ciliovitreal Block following Ab Externo XEN Gel Implantation
Authors: Jason Ning
Journal: Case Rep Ophthalmol Med (2023)
MeSH terms: Case Reports

Purpose:
To report a case of ciliovitreal block following ab externo implantation of a XEN gel stent for glaucoma.
Methods:
Case report.
Results:
An 84-year-old African American male underwent ab externo implantation of a XEN gel stent for elevated intraocular pressure. Several days after the surgery, the patient developed severe eye pain and reduced vision. Examination revealed ciliovitreal block (also called aqueous misdirection or malignant glaucoma) which was unresponsive to medical and laser treatment. Pars plana vitrectomy with anterior and posterior synechialysis and anterior chamber reformation were performed. The ciliovitreal block was resolved, and intraocular pressure brought to acceptable levels, but vision in that eye remained poor, likely due to the period of elevated pressure prior to treatment.
Conclusion:
Ciliovitreal block is a rare postsurgical (typically) form of secondary angle closure characterized by narrow or flat central and peripheral anterior chamber, anterior displacement of the lens-iris diaphragm, anterior rotation of ciliary processes, and (usually) elevated intraocular pressure. To our knowledge, this is the first reported case of ciliovitreal block occurring after ab externo XEN implantation. Early diagnosis and treatment are essential for preventing vision loss.
Indocyanine green fluorescence imaging-assisted laparoscopy resection of retroperitoneal tumors in children: case report and literature review
Authors: Yuanyuan Luo, Hong Zhang, Qiang Wu, Yan Chen, Zhihua Ye, Ruiyu Liu, Chengwei Chai
Journal: Front Pediatr (2024)
Keywords: children, indocyanine green, laparoscopy, real-time intraoperative navigation, retroperitoneal tumor
MeSH terms: Case Reports

This study examined the applicability of indocyanine green (ICG) fluorescence imaging to assist the laparoscopic resection of retroperitoneal tumors in pediatric patients via an abdominal approach. Conducted prospectively at the Guangzhou Women and Children's Medical Center from May to September 2023, the research included three pediatric cases, for whom laparoscopic retroperitoneal tumor resections were performed utilizing ICG fluorescence imaging. In each case, ICG was intravenously administered (0.3 mg/kg) prior to surgery, enabling the visualization of vital vascular structures through real-time fluorescence imaging. The trocar's placement was guided by a "four-hole" technique from the healthy side in a 70-degree lateral decubitus position. The operations were accomplished successfully without any complications. Pathological analysis of the patients identified one case of Wilms tumor of the embryonal type, one ganglioneuroblastoma of the mature type without N-MYC gene amplification, and one mature cystic teratoma. The findings suggest that with careful patient selection and skilled surgical execution, the utilization of ICG fluorescence imaging in the laparoscopic resection of retroperitoneal tumors is both safe and effective in children. This approach significantly improves the visualization of critical blood vessels, thus enhancing surgical safety.
One-and-a-Half Syndrome in a Case of Brainstem Bleed
Authors: Balamurugan Nathan, Ajithkumar Rajendran, Ezhilkugan G
Journal: Cureus (2024)
Keywords: brainstem stroke, emergency medicine, gaze palsy, internuclear ophthalmoplegia, one-and-a-half syndrome
MeSH terms: Case Reports

One-and-a-half syndrome (OHS) is a horizontal gaze palsy in one direction with internuclear ophthalmoplegia (INO) in the other. The only eye movement possible is the abduction of the contralateral eye with nystagmus. The usual structures affected are the medial longitudinal fasciculus and paramedian pontine reticular formation or the abducens nucleus. Most commonly, the OHS is caused by ischemia and demyelinating lesions. The other causes include infectious, neoplastic, and rarely traumatic. We report a case of a 42-year-old non-compliant hypertensive female who presented with giddiness, projectile vomiting, and right-sided hemiparesis and was found to have OHS on cranial nerve examination in the emergency department (ED). In the ED, the presence of complete horizontal gaze palsy in one direction with INO in the other direction should raise suspicion of a brainstem pathology.
Necrotizing Pneumonia: A Rare Outcome of a Rare Complication
Authors: Francisco Dá Mesquita Faustino, Catarina Morgado, Inês Palmares, Joana Ferrão, Paulo Freitas
Journal: Cureus (2024)
Keywords: critical care, invasive mechanical ventilation, necrotizing pneumonia, sepsis and shock physiology, ventilation
MeSH terms: Case Reports

Necrotizing pneumonia is a rare complication of community-acquired pneumonia, characterized by lung parenchymal destruction in affected areas. It has been sporadically documented over the years, mostly with insidious progression and a higher incidence among individuals with risk factors. Its diagnosis relies on clinical, analytical, and imaging data, and the treatment encompasses medical and surgical measures. The persistently high morbidity and mortality result from delayed diagnosis and the intricate therapeutic approach. In this report, the authors describe an unusual case of necrotizing pneumonia in a patient without risk factors.
Diagnosing B-cell acute lymphoblastic leukemia in 2 pediatric patients with recent SARS-CoV-2 infection
Authors: Anupam Mitra, Alexander Ladenheim, Ananya Datta-Mitra, Kaitlyn Lauren Honeychurch, Denis M Dwyre, John Paul Graff
Journal: Clin Pathol (2024)
Keywords: acute leukemia, covid-19, fluorescence in situ hybridization, lymphoblastic leukemia, pre-leukemic genes
MeSH terms: Case Reports

COVID-19 infection is still a mystery in terms of its long-term effect on health and its consequences on hematological disorders. Prior studies including ours have shown the abnormal changes in hematopoietic cells in COVID-19 patients. In this article, we are presenting 2 cases of pediatric B-lymphoblastic leukemia (B-ALL) with a previous history of COVID-19 infection. The first case describes a 22-month-old boy presenting with lymphadenopathy, neutropenia, and anemia with concurrent COVID-19 infection without any evidence of a hematolymphoid neoplasm as per bone marrow and lymph node biopsy. However, he presented after 2 months with bone marrow biopsy confirming B-ALL. The second case is that of a 4-year-old girl presenting with B-ALL who has had asymptomatic COVID-19 infection 5 months before this current presentation. Both the cases had complete resolution of COVID-19 infection during the time of presentation with acute leukemia. There were notably 2 rare findings along the course of the patients' illnesses. First, the unusual plasmacytosis in the marrow during active COVID-19 infection in the first patient and the second, is predilection of development of B-ALL following COVID-19. In both the cases the fluorescence in situ hybridization (FISH) studies showed pathologic alteration of the RUNX1 gene. Overall, there are no literature to support a causal association between acute B-ALL and COVID-19. The diagnosis of B-ALL in these patients after COVID-19 infection may be totally unrelated. However, if we consider Greaves proposed 2-hit model for childhood acute leukemia, that an infectious agent can precipitate development of B-ALL in a genetically susceptible individual. Alteration of the RUNX1 gene in both the patients, opens a door for further exploration of the "second-hit" hypothesis regarding an infectious agent precipitating development of B-ALL in a genetically susceptible individual.
Ewing sarcoma of the pancreas: a pediatric case report and narrative literature review
Authors: Zhensheng Liu, Jian Bian, Yong Yang, Decheng Wei, Shiqin Qi
Journal: Front Oncol (2024)
Keywords: ewing sarcoma, child, pancreatic neoplasms, pancreaticoduodenectomy, small round cell malignant tumor
MeSH terms: Case Reports

Ewing's Sarcoma (ES) is an rare, small round-cell sarcoma that predominantly occurs in children and young adults, with both skeletal and extraskeletal manifestations. However, pancreatic ES, due to its rarity, is infrequently featured in scholarly literature, with only a scant 43 reported instances. Our study describes a case of pancreatic ES in an 8-year-old boy who was found to have an abdominal mass. Following an exhaustive examination, the boy was diagnosed with a neoplasm in the pancreatic head and underwent a complex surgical procedure encompassing pancreatoduodenectomy and partial transverse colectomy. Immunohistochemical assays confirmed the neoplastic cells' positivity for Cluster of Differentiation 99(CD99), Vimentin, and NK2 Homeobox 2(NKX2.2), while genomic testing identified an EWSR1-FLI1(Ewing Sarcoma Breakpoint Region 1-Friend Leukemia Integration 1) gene fusion. This led to a conclusive diagnosis of pancreatic Ewing's Sarcoma. The patient underwent seven cycles of adjuvant chemotherapy, alternating between VDC (Vincristine, Doxorubicin, Cyclophosphamide) and IE (Ifosfamide, Etoposide) tri-weekly, but did not undergo radiotherapy. At present, the patient remains neoplasm-free. Through our case analysis and comprehensive review of the existing literature, we aim to underscore th rarity of pancreatic Ewing's sarcoma and to highlight the efficacy of our individualized therapeutic approach.
Sarcinaventriculi in association with gastric ulcer: a case report
Authors: Ankita Simkhada, Pritha Acharya, Shreya Shrivastav
Journal: Access Microbiol (2024)
Keywords: sarcina ventriculi, gastric ulcer, gram-positive bacteria
MeSH terms: Case Reports

Sarcina ventriculi is a species of Gram-positive bacteria which has been reported in patients with delayed gastric emptying as well as in association with cases of gastric ulcer and gastric carcinoma. Although it has been reported frequently in veterinary cases as a cause of fatal diseases, the exact pathogenesis in humans has yet to be identified. We report here a case of an elderly male who presented with haematemesis following which an upper gastrointestinal endoscopy was done and a gastric ulcer was revealed. Histopathological examination revealed S. ventriculi in association with the ulcer.
Bullous Pemphigoid Associated With the Use of Sacubitril/Valsartan: A Case Report and Literature Review
Authors: Daniel A Martin Arsanios, Lina M Gómez-Álvarez, Natalia Muñoz-Angulo, Claudia Montealegre, Elias Quintero Muñoz, Carlos Calderón-Vargas
Journal: Cureus (2024)
Keywords: adverse reactions, blisters, bullous pemphigoid, sacubitril/valsartan, skin lesions
MeSH terms: Case Reports

Bullous pemphigoid (BP) is a complex autoimmune blistering disease with an increased incidence in the comorbid population, particularly among older adults. The occurrence of drug-induced BP is associated with an underlying genetic predisposition, triggering an enhanced immune response, the formation of autoantibodies, and alterations in antigenic properties within the basement membrane zone. With over 90 identified drugs capable of precipitating BP, we present the case of an 87-year-old woman with comorbidities who experienced a medication change from losartan to sacubitril/valsartan. Three months later, erythematous lesions appeared on her lower limbs, progressing to a generalized rash accompanied by itching. Over the following month, these lesions evolved into tense blisters with serous content and intense pain. Suspecting the medication switch to sacubitril/valsartan as the cause, the drug was discontinued, and immunomodulatory treatment was initiated, resulting in a notable improvement in the lesions.
Right-sided iliac vein compression syndrome: when the vein is compressed between the internal and external iliac arteries-a case report
Authors: Tetsuo Yamanaka, Tatsuhiko Ishihara, Toru Hara, Yoshimaro Ichinohe, Toru Fukatsu
Journal: Eur Heart J Case Rep (2024)
Keywords: case report, deep vein thrombosis, iliac vein compression syndrome, right-sided iliac vein compression syndrome, venous thromboembolism
MeSH terms: Case Reports

Background:
In its normal anatomical relationship, the inferior vena cava is located on the right side of the abdominal aorta. Iliac vein compression syndrome (IVCS) is a pathological condition in which a blood clot is formed due to blood flow obstruction when the left common iliac vein is compressed between the right common iliac artery and the vertebral body. Therefore, right-sided IVCS (RIVCS) is rare. The effectiveness of treatment for RIVCS has not been sufficiently investigated.
Case summary:
A 51-year-old man developed deep vein thrombosis in the right lower extremity and non-massive pulmonary embolism during steroid treatment for IgA nephropathy. Magnetic resonance angiography (MRA) suggested iliac compression syndrome. Symptoms improved with the use of direct oral anticoagulants and compression stockings. At the 8-month follow-up, the clinical course was uneventful.
Discussion:
The causes of RIVCS in this case are believed to be the effects of steroids, prolonged sitting, and compression of the right external iliac vein. However, considering that deep vein thrombosis did not form in the left lower limb where there was no venous compression, it can be considered that the compression of the right external iliac vein had a significant impact. This case has been followed up for 8 months with anticoagulants and is progressing well. This is the first case to report the course of RIVCS treated conservatively with anticoagulant therapy for 8 months. This case suggested that conservative treatment is effective for RIVCS.
Case report: A mesenchymal chondrosarcoma with alternative HEY1::NCOA2 fusions in the sella turcica
Authors: Satsuki Kishikawa, Akihide Kondo, Takashi Yao, Tsuyoshi Saito
Journal: Pathol Oncol Res (2024)
Keywords: cns sarcoma, hey1
MeSH terms: Basic Helix-Loop-Helix Transcription Factors / genetics, Cell Cycle Proteins / genetics, Chondrosarcoma, Mesenchymal / genetics, Chondrosarcoma, Mesenchymal / pathology, Chondrosarcoma, Mesenchymal / surgery, Nuclear Receptor Coactivator 2 / genetics, Sella Turcica / pathology, Case Reports, Female, Humans, Middle Aged, HEY1 protein, human, Basic Helix-Loop-Helix Transcription Factors, NCOA2 protein, human, Nuclear Receptor Coactivator 2, Cell Cycle Proteins

Introduction:
Mesenchymal chondrosarcoma (MCS) is a rare subtype of chondrosarcoma that occurs at widespread anatomical locations, such as bone, soft tissue, and intracranial sites. The central nervous system (CNS) is one of the most common origins of extraosseous MCS. However, alternative HEY1::NCOA2 fusions have not been reported in this tumor.
Case report:
We report a case of intracranial MCS with HEY1::NCOA2 rearrangement. A 52-year-old woman presented with a 15-mm calcified mass around the sella turcica. She initially underwent transsphenoidal surgery for tumor resection and then additional resections for five local recurrences over 5 years. Histologically, the tumor was composed of small round to spindle-shaped cells admixed with well-differentiated hyaline cartilaginous islands. A hemangiopericytoma-like vascular pattern and small sinusoid-like vessels were also observed. RNA sequencing using RNA extracted from formalin-fixed paraffin-embedded samples from the last operation revealed two alternative variants of the HEY1::NCOA2 fusion: HEY1(ex4)::NCOA2 (ex13) and HEY1(ex4)::NCOA2(ex14). Both variants were confirmed as in-frame fusions using reverse transcription-polymerase chain reaction.
Discussion:
Cartilaginous components were often not apparent during the recurrences. In addition to the non-typical pathological finding, the correct diagnosis was hampered by the poor RNA quality of the surgical specimens and non-specific STAT6 nuclear staining.
Conclusion:
This is the first reported case of intracranial MCS with an alternative HEY1::NCOA2 fusion.
Migration of an Inferior Vena Cava Tumor Thrombus during Renal Cell Carcinoma Resection
Authors: Roupen Hatzakorzian, Andrea Blotsky, Albert Moore, Julien Vaillancourt, Pattra Mettasittigorn, Armen Aprikian, Steven B Backman
Journal: Case Rep Anesthesiol (2023)
MeSH terms: Case Reports

Approximately 4%-10% of patients with renal cell carcinoma (RCC) have tumoral vascular invasion with resultant thrombi in the renal vein and in the inferior vena cava (IVC). The authors describe an interesting case of IVC tumor thrombus that migrated to the right cardiac chambers during RCC resection. The diagnosis was made by intraoperative transesophageal echocardiography (TEE), which revealed the presence of a free-floating thrombus between the right atrium (RA) and right ventricle (RV). The patient required an urgent sternotomy with cardiopulmonary bypass (CPB) for atrial thrombus removal prior to the completion of the nephrectomy. The patient made a full recovery and was discharged to a rehabilitation facility. These findings illustrate the importance of intraoperative TEE monitoring during nephrectomy and IVC thrombectomy. In this case, TEE allowed for the diagnosis of an unexpected complication necessitating prompt cardiac surgical management.
Concurrent Palmar Lunate Dislocation and Posterior Elbow Dislocation With a Distal Radius Fracture: A Rare Case Report
Authors: Ousama Jelti, Abdelilah Barzouq, Oussama El Alaoui, Najib Abdeljaouad, Hicham Yacoubi
Journal: Cureus (2024)
Keywords: dislocation, elbow joint, floating forearm, surgery, wrist injuries
MeSH terms: Case Reports

We present an unusual case involving the simultaneous dislocation of the trans-scapho-retro-lunate in the right wrist and a posterolateral dislocation in the right elbow joint with a distal radius fracture in a 23-year-old male with no notable medical history. These injuries occurred when he fell from a height of around 12 meters onto his outstretched right hand. The patient presented to the hospital in a normal upper limb trauma position with no discomfort to critical functions. Predominant symptoms at the emergency department were discomfort in the right wrist, hand, and ipsilateral elbow, as well as the entire upper limb functional impairment. Both the wrist and the elbow seemed distorted on examination, with considerable edema and loss of bone landmarks. Passive mobilization was hampered by pain, but peripheral pulses were detectable. The radial, ulnar, and median nerves' autonomous sensory-motor domains were intact, with a cutaneous opening classified as stage 2 by the Cauchoix-Duparc classification. The elbow dislocation was successfully treated using a closed reduction method. External manipulation was employed to reduce the trans-scaphoid perilunate dislocation, which was subsequently stabilized through percutaneous screw fixation of the scaphoid using a triquetrum-lunate pin. Additionally, a styloid pin was utilized to address and manage a distal radius fracture, followed by the implementation of a radiometacarpal external fixator. After one year and three months, the patient reported no pain in his elbow and minimal wrist discomfort during heavy lifting.
Cerebral venous sinus stenting and jugular bulb embolization for pulsatile tinnitus: A case report
Authors: Mengjiao Xu, Xiaobo Dong, Can Zheng, Tao Zheng, Gesheng Wang
Journal: Front Neurol (2024)
Keywords: jugular bulb, pulsatile tinnitus, sigmoid sinus, spring coil embolization, stenting
MeSH terms: Case Reports

Background:
Pulsatile tinnitus (PT) is a rare form of tinnitus that aligns with the heartbeat. It is typically brought on by lesions with significant vascularity, which produce aberrant sound conduction and increase the risk of mental health issues and hearing loss. Venous PT is more prevalent than arterial PT. Open procedures or interventional procedures can be used to treat PT. We present here a case of PT caused by venous luminal stenosis combined with jugular bulb (JB) malformation, which was improved by stenting and JB embolization.
Case presentation:
A 59-year-old woman presented with long-term tinnitus consistent with heart rhythm and hearing loss, accompanied by anxiety, insomnia, and depression. The results of brain MRV, CT, and DSA showed stenosis of the right sigmoid sinus and high jugular bulb (JB) with dehiscence of the JB wall. The patient saw a significant improvement in PT symptoms following sigmoid sinus stenting and spring coil embolization of the high JB, following the diagnosis of PT. The patient had no PT recurrence for the course of the 31-month follow-up period.
Conclusion:
In the present PT case, there was a simultaneous onset of the right sigmoid sinus stenosis and the high JB with the JB wall abnormalities. Sigmoid sinus stenting and spring coil embolization of high JB may be a treatment for the PT, but the prevention of post-stenting complications is still an issue that requires great attention and needs further study.
A rare presentation of rhino-orbital-cutaneous mucormycosis in an immunocompetent patient: a case report
Authors: Ni Putu Ayu Reza Dhiyantari, Delfitri Lutfi, Dwi Hari Susilo, Irwan Kristyono, Alicia Widya
Journal: Pan Afr Med J (2024)
Keywords: mucormycosis, antifungal, case report, communicable, fungal infection
MeSH terms: Amphotericin B / administration & dosage, Amphotericin B / therapeutic use, Antifungal Agents / administration & dosage, Debridement / methods, Mucormycosis / diagnosis, Case Reports, Dermatomycoses / diagnosis, Dermatomycoses / drug therapy, Dermatomycoses / microbiology, Headache / etiology, Humans, Immunocompetence, Male, Middle Aged, Mucorales / isolation & purification, Orbital Cellulitis / diagnosis, Orbital Cellulitis / microbiology, Orbital Diseases / diagnosis, Orbital Diseases / microbiology, Orbital Diseases / therapy, Antifungal Agents, Amphotericin B

Mucormycosis is a rare opportunistic infection caused by Mucorales fungi. Cutaneous mucormycosis typically present as chronic indolent infection, whereas rhino-orbital mucormycosis is rapidly progressive disease often invade the adjacent cerebral tissue associated with high mortality. This case represents the atypical clinical history of rhino-orbital-cutaneous mucormycosis. The patient was presented with a right orbital cellulitis associated with an extensive multiple suppurative deep cutaneous infection and worsening headache. The skin lesion was initiated from a localized abscess at the right periorbital area nine months before admission. Suspicion of fungal infection was raised after weeks of non-responsive antibiotics treatment. Aggressive treatment with exoneration of the right eye and surgical debridement was undertaken. Periodic acid Schiff staining from healthy periorbital tissue revealed ribbon-like hyphae with pauciseptate and 90° branching identified as Mucoraceaefamily. The resolution was seen after four weeks of antifungal treatment with Amphotericin B.