OpenMed/multicare-articles huggingface dataset:
A South African Breast Implant-Associated Anaplastic Large Cell Lymphoma: Clinical Presentation and Six-Year Follow-Up
Authors: Alexandra Grubnik, Yastira Ramdas, Barend Van der Bergh, Simon Nayler, Carol-Ann Benn, Bernardo L Rapoport
Journal: Case Rep Oncol Med (2022)
MeSH terms: Case Reports

Breast augmentation is the most common surgical procedure for women globally, with 1,795,551 cases performed in 2019. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is highly uncommon, with 733 reported cases as of January 2020. In South Africa, there are less than 4000 breast augmentation surgeries annually. This case presents the first case report documentation of a South African woman diagnosed with BIA-ALCL. The patient was a 61-year-old woman who consulted the Breast Care Centre of Excellence in Johannesburg in 2015. She had a prior history of bilateral augmentation mammoplasty with subsequent implant exchange. The patient presented with periprosthetic fluid with a mass-like enhancement on the left breast. Aspiration of the mass-like fluid was positive for CD45, CD30, and CD68 and negative for CD20 and ALK-1, indicative of BIA-ALCL. Surgical treatment included bilateral explantation, complete capsulectomies, and bilateral mastopexy. Macroscopic examination of the left breast capsulectomy demonstrated fibrous connective tissue. The histological examination of the tumor showed extensive areas of broad coagulative necrosis with foamy histiocytes. Immunohistochemistry examination of this tumor showed CD3-, CD20-, and ALK-1-negative and CD30- and CD68-positive stains. PCR analysis for T-cell clonality showed monoclonal T-cell expansion. These findings confirm the presence of BIA-ALCL. The patient recovered well after surgery and did not require adjuvant therapy. A patient with a confirmed diagnosis of BIA-ALCL was successfully treated with explantation and complete capsulectomy. She was followed up regularly for six years, and the patient remains well and in remission.
Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade
Authors: Avantika Chenna, Venu Madhav Konala, Subhasish Bose, Sasmit Roy, Bhaskar Reddy Madhira, Vijay Gayam, Srikanth Naramala, Sreedhar Adapa
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

The renin-angiotensin system plays a very critical role in hypertension, diabetes, and kidney and heart diseases. The blockade of the renin-angiotensin system results in the prevention of progression of renal and cardiac damage. There have been controversial hypotheses raised regarding the safety of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in COVID-19 (coronavirus disease 2019). We present the case series of four patients (2 men and 2 women; 1 Caucasian and 3 African Americans; two survived and two died) with confirmed COVID-19, presenting with respiratory symptoms and acute kidney injury, who have been on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Membrane-bound angiotensin-converting enzyme 2 (ACE2) has been implicated as the gateway for viral entry into the human cell in causing the infection. The factors contributing to acute kidney injury are diuretics, iodinated contrast administration, hemodynamic instability apart from ACE inhibitors, and angiotensin receptor blockers. The ACE inhibitors and ARBs were stopped in these patients due to acute kidney injury. We also discussed the role of ACE2 and the renin-angiotensin system (RAS) blockade in patients with COVID-19 infection along with pathogenesis.
Indeterminate cell histiocytosis in association with acute myeloid leukemia
Authors: Filipa Ventura, Teresa Pereira, Maria da Luz Duarte, Herlander Marques, Fernando Pardal, Celeste Brito
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

Indeterminate cell histiocytosis (ICH) is a rare proliferative disorder, in which the predominant cells share morphologic and immunophenotypic features from both Langerhans and non-Langerhans cell histiocytosis. We describe a 62-year-old man presenting a 2-month history of firm nodular lesions on the upper lip. Histopathology, immunohistochemical, and ultrastructural analysis showed typical findings of ICH. The patient was treated with thalidomide and almost complete regression of the lesions was reached within 7 months. Nevertheless, one month after remission, he developed an acute myeloid leukemia of the subtype monocytic leukemia (M5). The patient's condition rapidly worsened and he died due to a respiratory failure four weeks later. We present this case because apart of being rare it joins the effectiveness of thalidomide and the association with an acute monocytic leukemia. A review of the literature is made.
Endometriosis-Associated Massive Ascites in an Asian Woman: A Case Report of a Rare Clinical Entity
Authors: Nuntasiri Eamudomkarn, Naratassapol Likitdee, Pilaiwan Kleebkaow, Chumnan Kietpeerakool
Journal: Case Rep Obstet Gynecol (2020)
MeSH terms: Case Reports

Massive ascites as a presentation of endometriosis is a rare clinical entity that is most commonly seen in black nulliparous females. Herein, we describe a case of a 32-year-old multiparous Thai woman who presented with a two-year history of abdominal distension. Computerized tomography of the abdominopelvic region showed an infiltrative enhancing lesion involving the cul-de-sac and perirectal region with massive loculated ascites, suggesting carcinomatosis peritonei. Abdominal paracentesis was performed to yield fluid samples for evaluation, which revealed no malignant cells, and polymerase chain reaction (PCR) was negative for tuberculosis. The patient underwent exploratory laparotomy which revealed a large amount of serosanguinous ascites, thickened matted bowel loops, and necrotic debris covering the entire surface of the peritoneum and visceral organs. The surgical procedures included drainage of 6.5 liters of ascites, lysis adhesion, biopsy of the peritoneum, and right salpingo-oophorectomy. Histologic examination revealed benign endometrial glands with stroma at the peritoneum tissue and broad ligament. Other causes of ascites were excluded. The ascites responded to drainage and hormonal suppression. A final diagnosis of endometriosis was made based on these findings. Endometriosis should therefore be considered in differential diagnosis in women of childbearing age who present with ascites.
Proximal Femoral Fracture in Hip Arthrodesis Treated with Double Reconstruction Plates
Authors: Shunsuke Asakawa, Takeo Mammoto, Atsushi Hirano
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

We present a rare clinical case of a 90-year-old female who sustained a proximal femoral neck fracture following long-standing hip arthrodesis. Since the fracture occurred relatively proximally and involved the pelvis, double-plate fixation was chosen to achieve rigid fixation. The reconstruction plate was placed at the posterior and anterior columns individually through single vertical incision. She was treated successfully, and she attained preinjury activity level. Proximal femoral fractures in arthrodesed hips need to be recognized as a fracture between the pelvis and femur. Rotational stress from the trunk and lower extremity requires rigid fixation to minimize the increase of displacement and the risk for nonunion.
A New Twist on an Old Technique: Lawson Retrograde Endoscopic-Guided Nephrostomy Access for Percutaneous Nephrolithotomy in Prone Split-Leg Position
Authors: Kamaljot S Kaler, Egor Parkhomenko, Cyrus Y Lin, Zachary A Valley, William K Kim, Zhamshid Okhunov, Roshan M Patel, Jaime Landman
Journal: J Endourol Case Rep (2018)
Keywords: lawson catheter, nephrolithiasis, percutaneous nephrolithotomy, percutaneous nephrostomy, renal calculi, retrograde nephrostomy
MeSH terms: Case Reports

Background: A minority of urologists performing percutaneous nephrolithotomy (PCNL) achieve their own nephrostomy access. In an effort to simplify the access part of PCNL, we herein describe our initial experience with endoscopic-guided retrograde percutaneous access in the prone split-leg position. Case Presentation(s): After informed consent, a confirmed negative urine culture, and 1 week pretreatment with tamsulosin, four carefully selected PCNL patients underwent endoscopic-guided retrograde access in a prone split-leg position using the Lawson catheter. In all the four patients, we achieved endoscopic-guided retrograde upper pole access in the prone split-leg position. A single Clavien 3B complication occurred. Total fluoroscopy time for the PCNL averaged 162 seconds (51-283). Complete stone-free rate at 1 week based on CT scan was 25%, and a stone-free rate defined as <4 mm was 100%. Conclusion: Endoscopic-guided retrograde percutaneous upper pole access can be established efficiently with a modified Lawson technique in the prone split-leg position.
Treatment of chronic hepatitis C in a patient affected by systemic sclerosis
Authors: Guido Poggi, Laura Villani, Federico Sottotetti, Barbara Tagliaferri, Benedetta Montagna, Alessio Amatu, Giovanni Bernardo
Journal: Gastroenterol Res Pract (2009)
MeSH terms: Case Reports

The currently recommended treatment for patients infected with hepatitis C virus (HCV) is pegilated interferon alpha (IFN alpha) plus ribavirin. Despite the numerous benefits of this therapy, there is an increasing concern regarding his tolerance. Among the most common side effects, interferon may trigger the onset or exacerbation of autoimmune diseases. When chronic hepatitis C coexists with an autoimmune disorder, it is not clear whether using interferon is better than avoiding it. We evaluated the disease state of a 55-year old female affected by sistemic sclerosis (SSc), during and after therapy with IFNalpha pegilated plus ribavirin for chronic HCV infection. We were worried about the potential worsening of the autoimmune disease during the therapy, but we were confident that we would give our patient a short course of peginterferon and ribavirin. A mild, asymptomatic worsening of lung SSc was observed during IFN administration, without life threatening symptoms. After 24 months follow up we observed the maintenance of the virological response and a good control of the rheumatological disease. Thus, in liver disease at high risk of progression and concomitant SSc, the antiviral therapy with IFNalpha is a feasible approach.
Case Report: Abnormally Low Glycosylated Hemoglobin A1c Caused by Clinically Silent Rare β-Thalassemia in a Tujia Chinese Woman
Authors: Wei Gao, Yanwen Jin, Minjin Wang, Yan Huang, Huairong Tang
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: hb j-bangkok, hba1c, hemoglobinopathy, high-pressure liquid chromatography (hplc), β-thalassemia
MeSH terms: Glucose Intolerance, Hemoglobinopathies, Hemoglobins, Abnormal / analysis, Hemoglobins, Abnormal / chemistry, Hemoglobins, Abnormal / genetics, Insulin Resistance, beta-Thalassemia / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Adult, Blood Glucose, China, Female, Glycated Hemoglobin / analysis, Hematologic Tests, Humans, Thailand, Blood Glucose, Glycated Hemoglobin A, Hemoglobins, Abnormal

Background:
Glycosylated hemoglobin A1c (HbA1c) is an important means of monitoring blood glucose and diagnosing diabetes. High-performance liquid chromatography (HPLC) is the most widely used method to detect HbA1c in clinical practice. However, the results of HbA1c by HPLC are susceptible to hemoglobinopathy. Here, we report a case of discordantly low HbA1c with an abnormal chromatogram caused by rare β-thalassemia.
Case description:
A 36-year-old Tujia Chinese woman presented with an abnormally low HbA1c level of 3.4% by HPLC in a health check-up. The chromatogram of HbA1c showed an abnormal peak. Fasting blood glucose, routine blood tests and serum bilirubin were normal. Her body mass index was 27.86 kg/m2. Hemoglobin electrophoresis showed low hemoglobin A and abnormal hemoglobin β-chain variants. The thalassemia gene test suggested a rare type of β-thalassemia (gene sequencing HBB: c.170G>A, Hb J-Bangkok (GGC->GAC at codon 56) in a beta heterozygous mutation). Glycated albumin (GA) was slightly increased. Oral glucose tolerance tests (OGTT) and insulin release tests indicated impaired glucose tolerance and insulin resistance. The hematologist advised follow-up visits. The endocrinologist recommended that the patient adopt lifestyle intervention. Three months later, GA returned to normal, and impaired glucose tolerance and insulin resistance improved.
Conclusions:
Clinically silent β-thalassemia may lead to low HbA1c values and abnormal chromatograms by HPLC. In these circumstances, differential diagnosis is important. Checking the chromatogram may be helpful in interpreting HbA1c as well as identifying hemoglobinopathy. Further tests, such as GA, OGTT, hemoglobin electrophoresis and genetic tests, are needed for differential diagnosis.
Multisystem inflammatory syndrome in children (MIS-C) secondary to COVID-19 mRNA vaccination - A case report from Qatar
Authors: Manoj Varghese, Hussam Abdel Rahman S Alsoub, Junais Koleri, Reem Hasan Mustafa El Ajez, Ziad Mohamad Alsehli, Yaman Ismael Gh Alkailani, Muna A Rahman S Al Maslamani
Journal: IDCases (2022)
Keywords: covid-19, covid-19 vaccine adverse effect, mis-a, mis-c, multisystem inflammatory syndrome
MeSH terms: Case Reports

COVID-19 vaccines are generally proven safe in all population and are highly recommended. However, rare adverse events have been reported. We hereby present a case of an 18-year-old man who presented to emergency department with fever, meningitis like symptoms, shortness of breath, chest pain, skin rash, and extreme fatigue. He had cardiac manifestations including hypotension, elevated troponin, and reduced ejection fraction. High inflammatory markers were also noted. He was initially worked up for and treated as a possible infectious etiology, but the microbiological studies were negative and there was no response to treatment. Since he had recently received booster dose of Pfizer-BioNTech COVID-19 vaccination three weeks prior to onset of symptoms, a possibility of Multisystem inflammatory syndrome in children (MIS-C) was made. His presentation fulfilled all the diagnostic criteria. The possibility for MIS-C being related to vaccination was proposed after relevant serological tests showed that the antibodies, he had were due to COVID-19 vaccine, not to a prior infection. After he received appropriate immunomodulatory treatment (IVIG and methylprednisolone) as per the guideline, he showed marked clinical improvement. Our case report highlights the need to consider MIS-C as a potential differential in young patients who present with unexplained multisystem illness with increased inflammatory markers and negative microbiologic work-up. MIS-C can be secondary to COVID-19 vaccination as well as to prior COVID-19 infection.
High-resolution melting analysis coupled with next-generation sequencing as a simple tool for the identification of a novel somatic BRCA2 variant: a case report
Authors: Alessandra Costella, Rossella De Leo, Donatella Guarino, Marco D'Indinosante, Paola Concolino, Giorgia Mazzuccato, Andrea Urbani, Giovanni Scambia, Ettore Capoluongo, Anna Fagotti, Angelo Minucci
Journal: Hum Genome Var (2018)
Keywords: high-resolution melting analysis, next-generation sequencing, novel somatic brca2 variant
MeSH terms: Case Reports

In a 72-year-old woman with no associated personal or family history of breast and/or ovarian cancers, we identified a novel somatic pathogenic BRCA2 variant (c.18_28delAGAGAGGCCAA, p.Lys6Asnfs*4) using next-generation sequencing (NGS). The variant allele frequency (VAF) was 16%, and Sanger sequencing was unable to identify this variant. Adopting a high-resolution melting analysis strategy coupled with NGS, we successfully highlighted the presence of the c.18_28delAGAGAGGCCAA allele.
Diagnose and treatment of traumatic pleural-subarachnoid fistula in children: A case report and systematic review
Authors: Wei Yang, Ming Ge, Chenghao Chen, Qi Zeng
Journal: Chin Neurosurg J (2020)
Keywords: complications, intracranial hypertension, pleural-subarachnoid fistula, treatment
MeSH terms: Case Reports

Background:
Pleural-subarachnoid fistula (PSF) is a rare disease that is difficult to diagnose and treat. Secondary intracranial hypertension and the treatment are seldom mentioned previously among PSF.
Case presentation:
A 1-year-old boy diagnosed PSF developed into secondary intracranial hypertension after conservative treatment. He was finally cured by down-step treatment of mannitol, avoiding form ventricle-peritoneal shunt. Then, we reviewed the literature of pleural-subarachnoid fistula. Fifty-six cases have been reported so far. Most of the cases (51.8%) were caused by surgery; only 17.9% were caused by car accidents. Regarding the treatment, half of the cases cured by surgery and the other by conservative measures. Our case is the first one involving secondary intracranial hypertension and cured by down-step treatment of mannitol.
Conclusions:
A comprehensive examination should be performed before the treatment to avoid any inappropriate medical strategies. Secondary acute intracranial hypertension may be cured by down step treatment of mannitol, evading from the long-term ventriculoperitoneal shunt.
Acute symptomatic hyponatremia in setting of SIADH as an isolated presentation of COVID-19
Authors: Mhd Baraa Habib, Sundus Sardar, Jamal Sajid
Journal: IDCases (2020)
Keywords: atypical presentation, covid-19, covid-19, coronavirus disease 2019, ecg, electrocardiogram, hyponatremia, novel coronavirus, sars-cov-2 infection, sars-cov-2, severe acute respiratory syndrome coronavirus 2, siadh, siadh, syndrome of inappropriate antidiuretic hormone secretion
MeSH terms: Case Reports

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is one of the most common causes of hyponatremia in hospitalized patients. Wide spectrum of etiologies associated with hyponatremia pose significant challenges in detecting and treating this disorder. Several infectious causes of SIADH have been reported; however, hyponatremia associated with SIADH and Coronavirus disease 2019 (COVID-19) was only recently mentioned in a few case reports. We discuss a unique presentation of COVID-19, in which the patient presented with acute severe symptomatic hyponatremia thought to be the initial and isolated presentation of SARS-CoV-2 infection.
Treatment of second to third-degree burns in a 2-day-old infant: A case report
Authors: Thomas Ziegler, Thomas Cakl, Johannes Schauer, Dieter Pögl, Tomas Kempny
Journal: Int J Surg Case Rep (2019)
Keywords: iatrogenic burn, infant, mesenchymal stem cells, neonatal burn, non-surgical treatment, tissue regeneration

Introduction:
Burn injuries in newborns are particularly complex cases. Since these patients are rare, there is little experience and no existing standardized treatment.
Presentation of case:
This report examines a case of accidental second to third-degree burning of the heel and toes on the left foot in a new-born girl. The burns covered an estimated 1% of the total body surface area (TBSA). After an initial debridement and 32 days of non-surgical wound therapy with Adaptic® fat gauze dressings, we were able to achieve an aesthetically and functionally satisfactory result including the complete preservation of all toes. In order to eliminate a scar contracture, we carried out a Z-plasty one year later.
Discussion:
Modern wound treatment following the principle of less frequent dressing changes allows the burn wound to have better re-epithelialization. New findings in stem cell research indicate that the high proportion of mesenchymal stem cells (MSC) in postnatal blood is also involved in the regeneration and healing of burns. To our knowledge, this is the first case report dealing with initial non-surgical combustion therapy in a newborn.
Conclusion:
There is evidence that newborns have a much higher potential for wound healing than adults. Proper position in long-term immobilization of toes is important to prevent scar contracture and deformity.
Application of Immediate Dentoalveolar Restoration in Alveolus Compromised with Loss of Immediate Implant in Esthetic Area
Authors: Rafael de Lima Franceschi, Luciano Drechsel, Guenther Schuldt Filho
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

In the reported clinical case, the immediate dentoalveolar restoration (IDR) technique was applied to reconstruct the buccal bone wall, with autogenous graft of the maxillary tuberosity, which had been lost due to a root fracture, and to provide the necessary bone substrate for the installation of an implant and its provisioning. One of the greatest risks inherent in the survival of immediate implants is the maintenance of their stability during the healing period. In this case, due to a mechanical trauma in sports activity in the first postoperative month, there was a total failure in the osseointegration process, confirmed by tomographic examination of both the implant and the bone graft. The deleterious effects of this accident were compensated with a new approach and reapplication of IDR technique using a smaller-diameter implant and with conical macrogeometry in conjunction with the new bone reconstruction under the same compromised alveolus; associated, after the period of osseointegration, with the maneuvers of volume increase of the gingival tissue by subepithelial connective tissue graft. The tomographic result demonstrated the success of the surgical procedures, and the clinical/photographic analysis obtained showed the stability of the gingival margin without compromising the esthetic result of the prosthetic restoration.
Clonally Related Plasmablastic Lymphoma Simultaneously Occurring with Diffuse Large B-Cell Lymphoma
Authors: Norisato Hashimoto, Tomoki Ueda, Shinichiro Hiraiwa, Takuma Tajiri, Naoya Nakamura, Kenji Yokoyama
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma. Although it was first described in HIV- (human immunodeficiency virus-) infected patients, PBL has been diagnosed in patients with other immunodeficiencies as well as in immunocompetent patients. PBL immunohistochemically expresses plasmacytic markers and lacks pan B-cell markers. The cells of origin of PBL are considered to be plasmablasts. MYC gene rearrangement and MYC overexpression are frequently found in PBL, but the pathogenesis of PBL is yet to be elucidated. Here, we report a case of composite lymphoma of PBL and diffuse large B-cell lymphoma (DLBCL); that is, PBL in the urinary bladder and DLBCL in the nasal cavity occurred simultaneously. We extracted DNA from the two lymphomas for polymerase chain reaction and sequenced the amplified immunoglobulin heavy variable genes and the complementarity-determining region- (CDR-) 3. The sequence of the CDR3 region of both tumors matched. MYC rearrangement was found in the bladder tumor but not in the nasal tumor. The patient was treated with R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone), and durable remission had been obtained. The results of the DNA analysis indicated that both PBL and DLBCL emerged from common postgerminal B cells. This case may help to elucidate the pathogenesis of PBL.