OpenMed/multicare-articles huggingface dataset:
Bilateral Wrist Tenosynovitis owing to Acute Conversion of Adult T-Cell Leukemia-Lymphoma in a Patient with Rheumatoid Arthritis
Authors: Akira Hashimoto, Motoki Sonohata, Satomi Nagamine, Hiromu Yoshizato, Masaaki Mawatari
Journal: Case Rep Orthop (2020)
MeSH terms: Case Reports

Human T-cell leukemia virus type 1- (HTLV-1-) associated arthritis is a relatively common disease. However, tenosynovitis owing to adult T-cell leukemia-lymphoma (ATL) is a rare condition. To the best of our knowledge, there have been no reports of tenosynovitis caused by conversion to acute ATL from one of the other ATL types. We present the case of a 60-year-old woman with rheumatoid arthritis (RA) with bilateral wrist tenosynovitis owing to the conversion to acute ATL from one of the other ATL types. She had swelling around the bilateral wrist joint under well controlled RA inflammation. She had no symptoms, physical findings, or laboratory findings indicative of conversion to acute ATL from one of the other ATL types. She underwent tenosynovectomy on the volar and dorsal sides of the left wrist joint to diagnose the cause of swelling around the bilateral wrist joint. Pathological analysis revealed diffuse proliferation of medium-sized atypical CD4(+) lymphocytes. Interestingly, she was diagnosed with wrist tenosynovitis caused by an acute ATL type. This diagnosis suggested that clinicians must consider ATL in connection with atypical wrist tenosynovitis in HTLV-1-endemic areas.
Neurosyphilis versus Herpes Encephalitis in a Patient with Confusion, Memory Loss, and T2-Weighted Mesiotemporal Hyperintensity
Authors: Elisa Vedes, Ana Filipa Geraldo, Rita Rodrigues, Sofia Reimão, Alice Ribeiro, Francisco Antunes
Journal: Case Rep Infect Dis (2012)
MeSH terms: Case Reports

Acute confusion and memory loss associated with asymmetrical mesiotemporal hyperintensity on T2-weighted MRI are characteristic of herpes encephalitis. The authors report the case of a patient with these symptoms and MRI presentation who had neurosyphilis. Recently clinical and imaging patterns usually associated with herpes simplex encephalitis have been seen in patients with neurosyphilis. Because syphilis is "The Great Pretender" not only clinically but also in imaging and because its numbers are rising, it must be sought as a differential diagnosis.
Heparin-induced thrombocytopenia associated with massive intracardiac thrombosis: a case report
Authors: Atheer Ahmed, Hamid Al-Mondhiry, Truman J Milling Jr, David Campbell
Journal: Case Rep Hematol (2012)
MeSH terms: Case Reports

A 60-years old patient was admitted to a community hospital with septic arthritis. He was treated with antibiotics and subcutaneous unfractionated heparin (UH) was used for venous thromboprophylaxis. After three days, he developed leg deep venous thrombosis and was treated with IV heparin. One day later, the patient developed pulmonary emboli, which was found using ventilation/perfusion scan. He was transferred to the University Hospital for further management. Upon arrival, antibiotic and intravenous UH were continued. Trans-Esophageal Echocardiogram showed a thrombus in the right atrium, a small portion of which extended to the left atrium through a patent foramen ovale. Another large thrombus was noted in the right ventricle, which extended to the pulmonary artery. Review of the patient's medical records revealed a halving of his platelet count three days following the heparin administration. Therefore, HIT seemed very likely. Intravenous UH was stopped and an emergency thrombectomy was performed. ELISA testing of HIT antibodies came negative. This made HIT diagnosis unlikely and the patient received dalteparin. A week later, as the platelet count declined again, HIT antibodies' testing using ELISA and C-14 serotonin release was repeated, and both assays were positive. Argatroban was restarted and the platelet count normalized.
Appendiceal GIST: report of an exceptional case and review of the literature
Authors: Mahdi Bouassida, Mohamed Fadhel Chtourou, Emna Chalbi, Fathi Chebbi, Lamine Hamzaoui, Selim Sassi, Lamia Charfi, Mohamed Mongi Mighri, Hassen Touinsi, Adok Sassi
Journal: Pan Afr Med J (2013)
Keywords: appendiceal gist, cd34, peritonitis, surgery
MeSH terms: Appendiceal Neoplasms / pathology, Gastrointestinal Stromal Tumors / pathology, Rare Diseases / pathology, Case Reports, Review, Abdominal Pain / etiology, Aged, Appendectomy, Appendiceal Neoplasms / surgery, Gastrointestinal Stromal Tumors / surgery, Humans, Male, Peritoneal Lavage, Peritonitis / etiology, Rare Diseases / surgery

Gastro-intestinal stromal tumors (GISTs) of the appendix are a rare entity. To date, only eight cases has been described in the literature, most of which have been of the benign type. We report a new case of an appendiceal GIST in a 75-year-old man. The tumor was discovered when the patient presented with acute appendiceacal peritonitis. Preoperative diagnosis of appendiceal GIST was rarely done as tumors were usually associated with appendicitis-like symptoms.
A Case of Lymphangioma of the Anal Canal
Authors: Kyriacos Karapashis, Maria Isaia, Antonia Fotiou, Theodora Kalli, Ioannis Michaelides, Nikolaos Nikolaou
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Lymphangiomas are unusual benign malformations, which can often be misdiagnosed due to their relatively mild and nonspecific symptomatology. Their appearance in the anal canal is extremely rare. Correct diagnosis is necessary for formulating appropriate management. We present the case of a 42-year-old man, with a medical history of ulcerative colitis and mild symptomatology, who was diagnosed with lymphangioma of the anal canal after undergoing a colonoscopy.
Novel TBC1D24 Mutations in a Case of Nonconvulsive Status Epilepticus
Authors: Jingjing Li, Ruihong Liu, Huiyu Feng, Jian Zhang, Dilong Wang, Yiming Wang, Jinsheng Zeng, Yuhua Fan
Journal: Front Neurol (2018)
Keywords: tbc1d24, cerebellar ataxia, mutation, nonconvulsive status epilepticus, novel mutation
MeSH terms: Case Reports

Objective: Nonconvulsive status epilepticus (NCSE) is an uncommon clinical manifestation in patients with TBC1D24 mutations. In addition, NCSE has not been reported as a syndrome together with cerebellar ataxia and ophthalmoplegia. Methods: We herein report the clinical and genetic features of a four-year-old patient with NCSE, cerebellar ataxia, and ophthalmoplegia caused by hitherto unidentified TBC1D24 mutations. We performed 24-h video electroencephalogram (EEG), magnetic resonance imaging, and gene sequencing on the patient and her parents to determine the diagnosis. Results: We identified a novel c.1416_1437del (p.Ser473Argfs*43) mutation, as well as the previously identified c.1499C>T (p.Ala500Val) mutation in TBC1D24, by using targeted next-generation sequencing. The novel mutation (inherited from the mother) is the first reported deletion mutation longer than 20 bp in TBC1D24. The p.Ala500Val mutation inherited from father has been reported in a German patient with infantile myoclonic, for whom results from the EEG and neuroimaging were normal. These two mutations resulted in the severe phenotypes observed in our patient Conclusions: The identification of the novel TBC1D24 mutation and consequent complicated clinical manifestations suggest that patients with NCSE and ataxia demand more attention. We further recommend that genetic test should be administered to these patients to avoid genetic inheritance of this mutation.
Early Gastric Cancer with Purely Enteroblastic Differentiation and No Conventional Adenocarcinoma Component
Authors: Rin Yamada, Shin-Ichiro Horiguchi, Tomoko Onishi, Toru Motoi, Tsunekazu Hishima
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Gastric carcinoma with enteroblastic differentiation (GCED) is a rare variant of gastric carcinoma, and a part of GCED produces alpha-fetoprotein. GCED is characterized by cells with clear cytoplasm and a tubulopapillary and solid growth pattern resembling those in the primitive gut. GCED is typically overlaid by a conventional adenocarcinoma (CA) component, implying that CA in the mucosa differentiates into GCED during tumor invasion and proliferation. We present the case of a 73-year-old woman with a 10-mm superficial elevated lesion and a slight central depression at the anterior wall of the lower gastric body. Endoscopic submucosal dissection revealed tumor cells having clear cytoplasm and severely atypical nuclei characteristic of GCED. The growth pattern was predominantly solid and trabecular but included submucosal layer invasion and limited tubular growth. Atrophic pyloric mucosa without intestinal metaplasia surrounded the tumor. Immunohistochemically, the tumor cells were positive for AFP, GPC3, and SALL4. The present patient showed a purely enteroblastic differentiation without a CA component despite the presence of early cancer, indicating that few cases of GCED may arise de novo in the gastric mucosa. GCED is more aggressive compared with CA; therefore, pathologists should be aware that GCED without CA can appear in biopsy specimens of early cancer while making an accurate diagnosis.
Long-term survival and PSA control with radiation and immunotherapy for node positive prostate cancer
Authors: M Kamrava, Kwong Y Tsang, R A Madan, A Kaushal, C N Coleman, J Gulley
Journal: Clin Dev Immunol (2009)
MeSH terms: Adenocarcinoma / therapy, B7-1 Antigen / metabolism, Cancer Vaccines, Prostate-Specific Antigen / metabolism, Prostatic Neoplasms / therapy, Case Reports, Adenocarcinoma / diagnosis, Adenocarcinoma / pathology, Adenocarcinoma / physiopathology, Anilides / administration & dosage, Antineoplastic Agents, Hormonal / administration & dosage, B7-1 Antigen / genetics, B7-1 Antigen / immunology, Goserelin / administration & dosage, Humans, Lymphatic Metastasis, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Staging, Nitriles / administration & dosage, Prostate-Specific Antigen / genetics, Prostate-Specific Antigen / immunology, Prostatic Neoplasms / diagnosis, Prostatic Neoplasms / pathology, Prostatic Neoplasms / physiopathology, Protein Engineering, Radiography, Abdominal, Radiotherapy, T-Lymphocytes / drug effects, T-Lymphocytes / immunology, T-Lymphocytes / metabolism, T-Lymphocytes / pathology, Tosyl Compounds / administration & dosage, Ultrasound, High-Intensity Focused, Transrectal, Vaccines, Synthetic / administration & dosage, Vaccines, Synthetic / genetics, Vaccines, Synthetic / metabolism, Anilides, Antineoplastic Agents, Hormonal, B7-1 Antigen, Cancer Vaccines, Nitriles, Tosyl Compounds, Vaccines, Synthetic, Goserelin, bicalutamide, Prostate-Specific Antigen

We describe a patient with node positive prostate cancer treated with radiation, androgen deprivation, and immunotherapy with long-term overall survival and PSA control. ELISPOT immunoassay studies demonstrated PSA specific T-cells prior to starting vaccine therapy suggesting that this positive response may be related to an improved antitumor immune response of the patient, increased immunogenicity of the tumor, or decreased activation of immune escape pathways. Further evaluation of therapeutic cancer vaccines in combination with radiation and hormonal therapy in the definitive management of prostate cancer is warranted.
Plasmapheresis for treatment of immune complex-mediated glomerulonephritis in infective endocarditis: a case report and literature review
Authors: Meredith Halpin, Olga Kozyreva, Vanesa Bijol, Bertrand L Jaber
Journal: Clin Nephrol Case Stud (2017)
Keywords: streptococcus mutans, immune complex, plasma exchange, proliferative glomerulonephritis, subacute endocarditis
MeSH terms: Case Reports

We report the case of a 57-year-old man who presented with subacute bacterial endocarditis secondary to Streptococcus mutans complicated by biopsy-proven immune complex-mediated glomerulonephritis (ICGN). Despite initial treatment with antibiotics and a short course of corticosteroids, the kidney function further deteriorated, and plasmapheresis was introduced as third-line therapy to remove circulating immune complexes. Following 7 treatment sessions, the patient recovered kidney function. We discuss the potential merit of plasmapheresis for patients with subacute bacterial endocarditis who develop ICGN.
TAFRO Syndrome Associated with EBV and Successful Triple Therapy Treatment: Case Report and Review of the Literature
Authors: Malorie Simons, Emmanuel Apor, James N Butera, Diana O Treaba
Journal: Case Rep Hematol (2016)

TAFRO syndrome is a rare constellation of symptoms: thrombocytopenia, anasarca, reticulin fibrosis of the bone marrow, renal dysfunction, and organomegaly. Its pathogenesis involves an excessive and inappropriate cytokine storm, most notably from IL-6, causing multiorgan failure; however, its etiology is undetermined. Starting in 2012, TAFRO syndrome was first identified in Japan as an atypical variant of Castleman's disease. Previous reports include various different treatment protocols with inconsistent survival outcomes. Here we report the first known American, EBV positive but HIV and HHV-8 negative, male with TAFRO syndrome. He was successfully treated with an unusual three-drug regimen including tocilizumab, etoposide, and rituximab. We review the literature of TAFRO syndrome, discuss its possible viral etiology, and propose an original treatment regimen.
Severe Insomnia Induced by Isotretinoin Use for the Management of Acne Vulgaris: A Rare Side Effect
Authors: Sultan H Assiri, Ashwaq K Alosaimi, Emad A Alharbi
Journal: Cureus (2023)
Keywords: acne, depression, insomnia, isotretinoin, sleep-disorder
MeSH terms: Case Reports

Isotretinoin has been widely prescribed for the management of moderate to severe acne vulgaris worldwide. It has been associated with different sleep disorders, mainly sleep apnea and hypersomnia. To our knowledge, only one study has found an association between isotretinoin use and insomnia. In addition, psychiatric disorders, such as psychosis and depression, have been linked to the use of isotretinoin previously. Here, we present a case of a 21-year-old male patient with severe acne vulgaris that underwent a therapeutic course of isotretinoin. During the course of treatment, he developed severe insomnia and depression. By reducing the daily dose, his insomnia was treated, as well as his depression. This case led to the conclusion that isotretinoin is associated with severe insomnia, and the severity of insomnia is dose-dependent.
Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection
Authors: Mathew P Doyle, Annette Li, Claudia I Villanueva, Sheen C S Peeceeyen, Michael G Cooper, Kevin C Hanel, Gary G Fermanis, Greg Robertson
Journal: Int J Vasc Med (2015)
MeSH terms: Review

Aim. Intravenous leiomyomatosis (IVL) with cardiac extension (CE) is a rare variant of benign uterine leiomyoma. Incomplete resection has a recurrence rate of over 30%. Different hormonal treatments have been described following incomplete resection; however no standard therapy currently exists. We review the literature for medical treatments options following incomplete resection of IVL with CE. Methods. Electronic databases were searched for all studies reporting IVL with CE. These studies were then searched for reports of patients with inoperable or incomplete resection and any further medical treatments. Our database was searched for patients with medical therapy following incomplete resection of IVL with CE and their results were included. Results. All studies were either case reports or case series. Five literature reviews confirm that surgery is the only treatment to achieve cure. The uses of progesterone, estrogen modulation, gonadotropin-releasing hormone antagonism, and aromatase inhibition have been described following incomplete resection. Currently no studies have reviewed the outcomes of these treatments. Conclusions. Complete surgical resection is the only means of cure for IVL with CE, while multiple hormonal therapies have been used with varying results following incomplete resection. Aromatase inhibitors are the only reported treatment to prevent tumor progression or recurrence in patients with incompletely resected IVL with CE.
The First Registered Type 0 Spinal Muscular Atrophy Patient in Latvia: Call for Change in Prenatal Diagnostic Procedures
Authors: Tīna Luīze Čupāne, Mikus Dīriks, Gita Tauriņa, Liene Korņejeva, Linda Gailīte, Ieva Mālniece, Madara Auzenbaha
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

This case report presents the first registered patient in Latvia with type 0 spinal muscular atrophy (SMA). During the first-trimester ultrasonography of the unborn patient, an increased thickness of the nuchal fold was detected. The mother reported decreased foetal movements during the pregnancy. After the boy was born, his general condition was extremely severe. The clinical signs indicated a suspected neuromuscular disorder. A precise diagnosis, type 0 SMA, was determined 7 days after birth through a newborn pilot-screening for SMA, which was conducted for all newborns whose parents consented to participate. The condition of the infant deteriorated. He had severe respiratory distress followed by multiple events leading to his death. Currently, there are only a few published case reports detailing an increased nuchal translucency (NT) measurement in association with a diagnosis of SMA in the foetus. However, an increased NT measurement is a clinically relevant sign as it can be related to genetic syndromes, foetal malformations, disruptions, and dysplasias. Since there is no cure for infants with type 0 SMA at present, it is crucial to be able to detect this disease prenatally in order to provide the best possible care for the patient and parents. This includes the provision of palliative care for the patient, among other measures. This case report highlights the prenatal signs and symptoms in relation to type 0 SMA.
Challenges of Diagnosing Viral Myocarditis in Adolescents in the Era of COVID-19 and MIS-C
Authors: Hemali P Shah, Richard Frye, Sunny Chang, Erin Faherty, Jeremy Steele, Ruchika Karnik
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Myocarditis has a wide array of clinical presentations ranging from asymptomatic to sudden cardiac death. Pediatric myocarditis is a rare disease, with an estimated annual incidence of 1 to 2 per 100,000 children though its true prevalence remains unknown due to its variable and often subclinical presentation. The diagnosis of myocarditis is challenging in the era of COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C), which can have overlapping clinical conundrum. Here, we present a case of a 17-year-old male presenting with chest tightness, shortness of breath, and electrocardiogram (EKG) findings concerning for myocardial injury along with elevated inflammatory markers such as D-dimer, ESR (Erythrocyte Sedimentation Rate), and CRP (C-Reactive Protein). We discuss the key elements of our clinical experience with this case and review the literature for pediatric myocarditis, with a focus on differentiating it from MIS-C in the current COVID-19 pandemic era.
Acquired Factor XI Deficiency with Lupus Anticoagulant in a Pregnant Woman Diagnosed by the Eruptions and Pain in Fingers
Authors: Rie Nakajima, Atsuko Togo, Yasuhira Kanno, Masaru Hayashi, Kanako Mitsuzuka, Hitoshi Ishimoto
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

We report a case of acquired factor XI deficiency with lupus anticoagulant (LA) in a 28-year-old primigravida who presented with finger pain and eruptions on her palms and fingers during the 3rd trimester of pregnancy. The patient complained of pain and reddening of the fingers at 30 weeks of gestation. She was referred to our tertiary center with a diagnosis of preeclampsia and suspected collagen disease at 35 weeks of gestation. Erythema was seen on the fingers and palms, and she presented with pain and cryesthesia on the fingers. Laboratory investigations revealed an activated partial thromboplastin time of 51 s (normal, 23-40 s), although it was normal during the 30th and 34th gestational weeks, LA with an anticardiolipin-beta2-glycoprotein I complex antibody, and low level of clotting XI activity (25 U/mL). On week 37 day 0 of gestation, the patient presented with severe hypertension. An urgent Cesarean section was performed after transfusion of two units of fresh frozen plasma. There was no excessive bleeding during the surgery or the postpartum period. The symptoms on her fingers and palms gradually improved after surgery. Our case indicates that dermatoses of pregnancy may become a starting point for the diagnosis of autoimmune diseases and coagulation abnormalities. When a patient presents with an atypical symptom, as in our case, the possibility of various diseases should be considered.
A case of treatable hypertension: fibromuscular dysplasia of renal arteries
Authors: Dissanayake Mudiyanselage Priyantha Udaya Kumara Ralapanawa, Kushalee Poornima Jayawickreme, Ekanayake Mudiyanselage Madhushanka Ekanayake
Journal: BMC Res Notes (2016)
MeSH terms: Fibromuscular Dysplasia / pathology, Fibromuscular Dysplasia / surgery, Hypertension, Renovascular / surgery, Renal Artery / pathology, Renal Artery / surgery, Case Reports, Adult, Female, Fibromuscular Dysplasia / diagnostic imaging, Humans, Hypertension, Renovascular / diagnostic imaging, Renal Artery / diagnostic imaging, Tomography, X-Ray Computed

Background:
Renovascular hypertension accounts for 51-52% of all cases of hypertension in the general population, but plays a major role in treatable causes for hypertension in the young. This entity consists of renal vascular atherosclerosis (90%), commonly seen among the elderly population, and renal fibro muscular dysplasia (FMD) (10%), predominantly seen in the young. The prevalence of clinically significant renal artery fibromuscular dysplasia is 0.4%.
Case presentation:
We present a case of treatable young hypertension in a 29 year old female, who was diagnosed with renovascular hypertension due to fibromuscular dysplasia of the left renal artery. Computed tomographic angiogram revealed significant stenosis of the left main renal artery. Diethylene triamine penta acetic acid renogram showed a small left kidney due to renal artery stenosis. She underwent left sided nephrectomy, and histology revealed features of FMD, after which she achieved full recovery with normalization of blood pressure, and did not require antihypertensive drug treatment.
Conclusions:
Fibromuscular dysplasia causing renal artery stenosis, though a rare cause of renovascular hypertension, is essential to be considered in young hypertensives, even in the absence of family history of hypertension. A high index of suspicion is necessary in early diagnosis and prompt treatment, which can result in rapid and complete recovery.