OpenMed/multicare-articles huggingface dataset:
Recurrent Migratory Transient Bone Marrow Edema of the Knees Associated with Low Vitamin D and Systemic Low Bone Mineral Density: A Case Report and Literature Review
Authors: Omar Alsaed, Mohammad Hammoudeh
Journal: Case Rep Rheumatol (2018)
MeSH terms: Case Reports

Transient bone marrow edema (TBME) is a self-limiting disease characterized by joint pain with localized bone marrow edema by MRI and has been reported in many case series and case reports. It is well known that joints of the lower extremity including hips, knees, ankles, and feet are the classical sites for TBME. Many theories have been proposed for the pathogenesis of TBME. Systemic osteopenia and vitamin D deficiency is one of the theories that have been suggested in the last few years. In this case report, we present a middle-aged male patient, who presented with 4 attacks of TBME in both knees between September 2016 and August 2017. The patient was found to have persistently low vitamin D and osteopenic T score in DXA scan of the lumbar spine and hips. Patients of TBME usually present with joint pain that is provoked by weight-bearing physical activity. The aim of this case report is to raise the awareness that TBME can be the initial presentation of systemic loss of bone mineral density.
Failure to Treat Torsades de Pointes
Authors: Payam Yazdan-Ashoori, Genevieve Digby, Adrian Baranchuk
Journal: Cardiol Res (2012)
Keywords: qt prolongation, temporary pacemaker, torsades de pointes
MeSH terms: Case Reports

A healthy 22 year old male with no history of cardiac disease was admitted with severe community acquired pneumonia that was initially treated with moxifloxacin and azithromycin. At admission, he was found to be hypokalemic and hypomagnesemic. Two days after admission, he experienced several episodes of Torsades de Pointes (TdP). He was initially treated with isoproterenol. A temporary transvenous pacemaker was inserted and set at a rate of 100 bpm. After correction of electrolytes, withdrawal of QT-prolonging medications and ventricular pacing at the mentioned heart rate, another episode of TdP ensued.We report and discuss a case of recurrent TdP in spite of conventional acute management for this condition.
Delayed diaphragmatic hernia after open trauma with unusual content: Case report
Authors: Ketlen Gomes da Costa, Rafaelle Taynah Soares da Silva, Marineide Santos de Melo, Jade Thays Saldanha Pereira, Juan Eduardo Rios Rodriguez, Renato Carvalho Amaral de Souza, Izabela Augusta de Oliveira Medeiros
Journal: Int J Surg Case Rep (2019)
Keywords: case report, diaphragmatic hernia, laparotomy, thoracic cavity, thoracotomy

Introduction:
Post-traumatic diaphragmatic hernias are not commonly diagnosed immediately after the initial trauma. There is a greater prevalence of left hernias due to the fragility or injury in diaphragm muscle and the lack of solid and fixed structures on the left side.
Presentation of case:
A male patient, 30 years old, he was admitted to the emergency department presenting diffuse abdominal pain, vomiting, dyspnea, pain in the left hemithorax with worsening during forced inspiration. After performing X-ray and computed tomography (CT), the presence of organs in the abdominal cavity outside the usual position was evidenced and with discrete deviation. Immediate surgery was performed with posterolateral thoracic access through the sixth left intercostal space combined with left subcostal access. Initially, it was found jejunum, ileum and left colonic flexure and accessory spleen filling the hernial sac.
Discussion:
This report is the first case to report two accessory spleens in manual reduction of herniation between thoracic and abdominal cavities after trauma and percutaneous perforation. The splenectomy performed in both organs occurred due to their advanced ischemia that was due to reduced vascularity.
Conclusion:
The presence of the reported accessory spleen inside the thoracic cavity is only a possible variation within the possibilities in cases of diaphragmatic hernias, which does not modify the surgical procedure in a relevant way.
The left gastro-omental vessels are able to maintain the entire spleen blood supply
Authors: Andy Petroianu
Journal: J Vasc Bras (2022)
Keywords: blood supply, gastro-omental vessels, inferior polar vessels, splenomegaly, wandering spleen
MeSH terms: Case Reports

The spleen is supplied by blood flow through the splenic artery and vein. The purpose of this communication is to report an ectopic spleen supplied only by reverse flow through the left gastro-omental vessels. A 14-year-old boy presented with pelvic splenomegaly supplied only by the left gastro-omental artery and veins connected to the inferior polar vessels, which were the only vessels communicating with the spleen. After detorsion of the spleen and splenopexy, the spleen returned to normal dimensions. The patient had uneventful follow-up. In conclusion, the left gastroepiploic vessels are able to maintain the entire spleen blood supply.
Lyme neuroborreliosis with encephalitis: A rare case
Authors: Simone Bruhn Rosendahl, Pernille Ravn, Anne-Mette Lebech, Christian Peter Midtgaard Stenør
Journal: IDCases (2023)
Keywords: encephalitis, immunosuppression, lyme neuroborreliosis, mri, neuroinfection
MeSH terms: Case Reports

Encephalitis caused by Borrelia burgdorferi sensu lato is a rare clinical manifestation of Lyme neuroborreliosis and only in few cases have brain parenchymal inflammation been documented. Here, we present a case of Lyme neuroborreliosis with encephalitis with significant parenchymal inflammation on magnetic resonance imaging (MRI) in an immunosuppressed patient.
Importance of Continuous Pulse Oximetry of the Ipsilateral Thumb/Index Finger during Transradial Angiography
Authors: Ross C Puffer, David F Kallmes
Journal: Case Rep Anesthesiol (2011)
MeSH terms: Case Reports

We present a case of a 63-year-old male undergoing attempted basilar artery embolization using a right transradial artery approach in which continuous pulse oximetry of the ipsilateral thumb uncovered unanticipated hand ischemia during the procedure. A preprocedural evaluation using pulse oximetry of the right thumb demonstrated normal waveform and maintenance of normal oxygen saturation during manual compression of the right radial artery. This normal waveform and oxygen saturation was maintained after insertion of a 6Fr sheath into the radial artery. After insertion of a 6Fr guiding catheter into the right vertebral artery, near-complete dampening of the pulse oximetry waveform and precipitous decline in oxygen saturation were noted. Examination of the right hand demonstrated poor tissue perfusion. Immediate removal of the guiding catheter led to return of a normal waveform, oxygen saturation, and tissue perfusion. This case demonstrates the importance of continuous, intraprocedural monitoring of oxygenation of the ipsilateral hand during transradial angiography in order to avoid unanticipated perfusion abnormalities.
Dose-dependence of protection from systemic reactions to venom immunotherapy by omalizumab
Authors: Elisa Boni, Cristoforo Incorvaia, Marina Mauro
Journal: Clin Mol Allergy (2016)
Keywords: honeybee, omalizumab, systemic reactions, venom immunotherapy
MeSH terms: Case Reports

Background:
Systemic reactions (SR) to venom immunotherapy (VIT) are rare but may occur, with a rate significantly higher for honeybee than for vespid VIT. In patients with repeated SRs to VIT it is difficult to reach the maintenance dose of venom and pre-treatment with omalizumab is indicated, as shown by some studies reporting its preventative capacity, when antihistamines and corticosteroids are ineffective.
Case presentation:
We present the case of a 47 years old woman allergic to bee venom who experienced two severe SRs after bee stings and several SRs to VIT with bee venom. Pre-treatment with antihistamines and corticosteroids as well as omalizumab at doses up to 300 mg was unsuccessful, while an omalizumab dose of 450 mg finally achieved in our patient the protection from SRs to VIT with 200 mcg of bee venom.
Conclusions:
The search of the dose of omalizumab able to protect a patient with repeated SRs to VIT may be demanding, but this search is warranted by the need to provide to this kind of patient, by an adequate VIT, the protection from potentially life-threatening reactions.
Case report: A heterozygous mutation in ZNF462 leads to growth hormone deficiency
Authors: Yikun Zhou, Jianmei Liu, Shuai Wu, Wanran Li, Yun Zheng
Journal: Front Genet (2022)
Keywords: weiss–kruszka syndrome (wska), znf462, case report, growth hormone deficiency (ghd), mutation
MeSH terms: Case Reports

Weiss-Kruszka syndrome (WSKA) is a rare disease most often caused by mutations in the ZNF462 gene. To screen for hereditary diseases, exons from the patient's genome were sequenced. Genomic PCR experiments followed by Sanger sequencing were used to confirm the mutated genomic regions in the patient and his parents. We report a new mutation site, a heterozygous mutation (NM_021224.6:c.6311dup) in ZNF462 in a male patient of 8 years old. The mutation in the ZNF462 gene caused WSKA. This patient is the first case with WSKA characterized by attention-deficit hyperactivity disorder and complete growth hormone deficiency without pituitary lesions. Our results suggest that the heterozygous mutation in ZNF462 is the direct cause of WSKA in this patient. Mutations in other genes interacting with ZNF462 result in similar symptoms of WSKA. Furthermore, ZNF462 and its interacting proteins ASXL2 and VPS13B may form a protein complex that is important for normal development but awaits more studies to reveal its detailed functions.
Patellar Tendon Avulsion with Tibial Tuberosity Sleeve Fragment
Authors: Akira Isaka, Satoshi Ichihara, Yasuhiro Homma, Tomohiko Hirose, Hajime Kajihara
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Rupture of the patellar tendon is relatively rare. We report a case of patellar tendon avulsion with a tibial tuberosity sleeve fragment in pediatric patient. In pediatric patient, diagnosis is sometimes difficult due to uncompleted ossification. In the present case, which involved the presence of a small fleck of bone from tibia, we were able to attain a diagnosis using the Koshino-Sugimoto index and MRI and easily determine the optimal treatment with the use of the suture anchor and tension band wiring method.
Annexin A2 Expression in Aerogenous Metastasis of Pulmonary Invasive Mucinous Adenocarcinoma: A Case Report including Immunohistochemical Analysis
Authors: Kazumori Arai, Masahide Hirose
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Aerogenous metastasis (AM) is a form of lung cancer that spreads in a unique fashion, but its mechanisms are still unclear. Annexin A2 (ANX A2), a membrane-binding protein, promotes cancer invasion and is involved in cell adhesion and polarity. The relationship between ANX A2 and cancers with poor stromal invasion capacity has not been studied. We immunohistochemically analyzed ANX A2 expression in AM observed in a patient with pulmonary invasive mucinous adenocarcinoma. In the primary site, ANX A2 immunopositivity on the cell-cell borders weakened as tumor cells projected and separated into alveolar spaces. In AM, tumor cell aggregates with ANX A2 immunopositivity near the surface and within the cytoplasm attached to alveolar epithelial cells, then engulfed them and formed a protrusion. As tumor cell aggregates adhered to the alveolar wall and formed a single layer, cytoplasmic ANX A2-positive products accumulated in the lateral sides of the tumor cells and exhibited distinct membranous positivity. These results indicated that ANX A2 near the tumor cell surface was related to alveolar wall attachment. Furthermore, the translocation of cytoplasmic ANX A2 to cell-cell borders changed cell morphology, adhesion, and polarity restoration.
Case report: A rare case of imiquimod-induced atypical pemphigus vulgaris
Authors: Francesco Moro, Davide Ciccone, Luca Fania, Feliciana Mariotti, Adele Salemme, Siavash Rahimi, Sabatino Pallotta, Giovanni Di Zenzo
Journal: Front Med (Lausanne) (2022)
Keywords: dsg1, dsg3, adverse events, imiquimod, non-desmoglein antigen, pemphigus vulgaris
MeSH terms: Case Reports

Background:
Pemphigus vulgaris is an autoimmune intraepithelial bullous disease involving the skin and the mucous membranes. Imiquimod, a topical therapy for skin basal cell carcinoma, is an amine that induces the production of tumor necrosis factor alfa, interleukin-1 and other cytokines. Pemphigus induced by drugs has been frequently reported, mostly after systemic therapy.
Case presentation:
We present the case of a 50-year-old man who developed skin, intraoral, and genital mucosae lesions 3 days after a treatment with Imiquimod for multiple superficial basal cell carcinoma of the trunk. Direct and indirect immunofluorescence results were compatible with the diagnosis of pemphigus vulgaris. Enzyme-linked immunosorbent assay was negative for desmoglein 1 and 3, but interestingly, by immunoblotting on keratinocyte extracts a band of 170 kDa was obtained by IgG. The patient, after interrupting Imiquimod application, started a treatment with prednisolone and in 4 weeks showed a complete remission.
Conclusion:
Topical Imiquimod therapy might induce atypical pemphigus vulgaris in some patients.
Solitary CNS Metastasis on Initial Presentation of High Grade Serous Carcinoma of the Fallopian Tube
Authors: Felicity Harl, Cassandra Niemi, Lori Mankowski Gettle, Paul Weisman, Stephen Rose
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

A 68-year-old woman presented with a three-week history of confusion and anomic aphasia. Imaging of her head demonstrated a single large left frontal mass. Pathology revealed metastatic adenocarcinoma of Müllerian origin. Subsequent surgery revealed a small primary site in a fallopian tube, high left para-aortic lymphadenopathy, and no disseminated intraperitoneal disease. This case was remarkable in that CNS metastasis was her presenting symptom and was restricted to a solitary brain lesion, and other disease sites were limited to retroperitoneal lymphadenopathy and a small fallopian tube primary.
Improving the therapist's metacognition and capacity to intersubjectively attune with a patient with psychosis through the exploration of the therapist's developmental history: a case report
Authors: Gianpaolo Salvatore, Tania Di Somma, Luisa Buonocore, Maria Conza, Nadia Di Sturco, Gerardina Fimiani, Nicoletta Manfredi, Raffaella Marciano, Antonella Pallotta, Maria Grazia Proto, Anna Sateriale
Journal: Front Psychiatry (2023)
Keywords: clinical supervision, developmental trauma, intersubjective attunement, mentalization, metacognition, psychosis, therapeutic relationship
MeSH terms: Case Reports

Clinical literature emphasizes how symptoms of psychosis can be efficiently targeted by psychological treatments. The most well-known approach to these symptoms is cognitive-behavioral therapy; but in the last few decades also other approaches are enriching the landscape, focusing on the dysfunctions in mentalization or metacognition, a spectrum of mental activities involving thinking about one's own and others' mental states. This huge amount of theoretical reflection and empirical research focused on the implementation of treatments does not seem to be associated with an attention to the inner world of the therapist who relates to the patient with psychosis; for example, to the impact of the therapist's developmental history on the therapeutic relationship. In this paper the authors are inspired by an intersubjective perspective, according to which although the treatment is for the patient's benefit, both the patient's and the therapist's developmental history and psychological organization are equally relevant for understanding the clinical exchange. On this basis, the authors make a "parallel" analysis of the clinical case of a young woman with symptoms of psychosis (i.e., persecutory delusions, auditory verbal hallucinations, social withdrawal) and its supervision process. They show how the therapeutic relationship can be significantly conditioned by the therapist's developmental history; and how a process of supervision focused on the exploration of the traumatic elements of this history can effectively promote the therapist's metacognitive capabilities, a functional patient-therapist intersubjective attunement, and a good clinical outcome.
New Variant of Esophageal Atresia
Authors: Swapnil Harne, Manish Pathak, Kamal Nayan Rattan
Journal: J Neonatal Surg (2017)
Keywords: esophageal atresia, esophageal stenosis, tracheoesophageal fistula
MeSH terms: Case Reports

Esophageal atresia with tracheoesophageal fistula (EA/TEF) associated with distal congenital esophageal stenosis (CES) is a well-known entity. We encountered three patients of EA/TEF associated with long and unusual CES.
Laparoscopic Treatment of an Incarcerated Meckel's Diverticulum in a Femoral Hernia
Authors: Christoph Paasch, Gianluca De Santo, Peter Look, Katherina Boettge, Michael Hünerbein
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Meckel's diverticulum (MD) is the persistence of the omphalomesenteric duct. It is usually asymptomatic but may present with bleeding, infections, and intestinal obstruction. It also may be a content of a hernia sac, a so-called Littre hernia. Herein, we will present the case of a 75-year-old female, who suffered from a painful swelling of the right inguinal region. Ultrasound imaging detected an inguinal hernia with incarcerated blind ending small bowel. Immediately, a laparoscopy was conducted. We diagnosed a right femoral hernia with an incarcerated MD. A TAPP (transabdominal preperitoneal) procedure was performed and the MD tangential stapled. Due to an uneventful postoperative course, the patient left the hospital after two days. An incarceration of a MD in a femoral hernia is rare. Tangential resection of the MD with simultaneous hernia repair in a TAPP technique seems to be a sufficient approach, when it is conducted by an experienced surgeon.
Fungal Infection following Total Elbow Arthroplasty
Authors: Samuel S Ornell, Khang H Dang, Aaron J Bois, Anil K Dutta
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

A specific treatment protocol for managing fungal infections after total elbow arthroplasty (TEA) does not currently exist. The purpose of this report is to describe our experience and outline our treatment algorithm for a rare case of prosthetic joint infection (PJI) following a TEA. We present a case of a PJI due to Candida parapsilosis after TEA in a 57 year-old Caucasian woman with a history of hypertension, depression, and three previous surgical procedures to the affected limb. A fungal PJI by the organism C. parapsilosis following TEA has not been previously reported. Successful eradication of the fungal infection was achieved utilizing resection arthroplasty; placement of an amphotericin, vancomycin, and tobramycin-impregnated cement spacer; and 6 months of organism-specific antifungal medication. Although the patient was clinically ready for reimplantation, she passed away due to unrelated issues before reimplantation could be performed. While PJI is a devastating complication following TEA, a fungal infection is a rare complication that imposes difficult challenges to the treating surgeon. With our case report, we hope to contribute to the overall knowledge of fungal infections associated with TEA and describe our successful treatment of this complex case.
A Novel Multimodal Therapy for Anaplastic Thyroid Carcinoma: 125 I Seed Implantation Plus Apatinib After Surgery
Authors: Yiqi Niu, Zheng Ding, Xianzhao Deng, Bomin Guo, Jie Kang, Bo Wu, Youben Fan
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: 125i seed implantation, anaplastic thyroid cancer, apatinib, brachytherapy, multimodal therapy
MeSH terms: Antineoplastic Agents / therapeutic use, Brachytherapy / methods, Iodine Radioisotopes / therapeutic use, Pyridines / therapeutic use, Thyroid Carcinoma, Anaplastic / therapy, Thyroidectomy / methods, Case Reports, Combined Modality Therapy, Female, Humans, Middle Aged, Prognosis, Thyroid Carcinoma, Anaplastic / pathology, Antineoplastic Agents, Iodine Radioisotopes, Pyridines, apatinib, Iodine-125

Anaplastic thyroid cancer is known to be the most lethal malignancy among endocrine tumors for its extremely limited survival rate after diagnosis. As a result of this poor survival prognosis, multimodal therapy is currently under investigation to address this global concern. In this reported case, the 125I seed implantation and vascular endothelial growth factor receptor-2 (VEGFR-2) inhibitor apatinib were co-applied to treat a 49-year-old woman with anaplastic thyroid cancer. After the patient began apatinib administration and underwent 125I seed implantation twice, the tumor size shrank successfully. After a follow-up of 13 months since the initial diagnosis of anaplastic thyroid cancer, the patient survived with a stable disease pathology. In conclusion, this study supports 125I seed implantation and apatinib as effective therapeutic alternatives for inoperable anaplastic thyroid cancer patients.
Case report: A case of giant accessory hepatic lobe torsion combined with left hepatic vein branch thrombosis in a child
Authors: Xiangang Xiong, Yonghua Lou, Teng Zhou, Zebing Zheng, Yuanmei Liu, Rui Liu, Kaizhi Zhang, Yuan Gong, Chengyan Tang, Zhu Jin
Journal: Front Pediatr (2022)
Keywords: accessory hepatic lobe, accessory hepatic lobe torsion, child, left hepatic vein branch thrombosis, liver
MeSH terms: Case Reports

The accessory hepatic lobe (AHL) is a rare congenital malformation of the hepatic tissue, among which the giant AHL is the rarest in children. Patients without complications are usually asymptomatic, and most auxiliary examinations cannot provide a definitive preoperative diagnosis. Surgical procedure is the only recommended management for patients who suffered from the complications of AHL. We report the case of a rare pediatric giant AHL torsion combined with left hepatic vein branch thrombosis which was successfully treated by laparoscopic lobectomy followed by excision of AHL.
Delayed bowel perforation following suprapubic catheter insertion
Authors: Shwan J Ahmed, Ajay Mehta, Peter Rimington
Journal: BMC Urol (2004)
MeSH terms: Catheterization / adverse effects, Intestinal Perforation / etiology, Intestine, Small / injuries, Case Reports, Aged, 80 and over, Humans, Male, Time Factors

Background:
Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion.
Case presentation:
A gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter.
Conclusion:
Bowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with lower abdominal scar. The risk may be reduced with the use of ultrasound scan guidance.