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American Journal of Case Reports

Rocío Escartín, Nuria Brun, M Nieves García Monforte, Joan Carles Ferreres, Raquel Corripio
BACKGROUND Insulinomas are pancreatic neuroendocrine tumors that cause non-ketotic hypoglycemia due to hyperinsulinism; they are extremely rare, especially in children. CASE REPORT We present a case of a sporadic insulinoma in an 11-year-old boy who had episodes of self-limited drowsiness and behavior changes over a 3-month period, thought to be caused by psychological issues. Non-ketotic hypoglycemia was confirmed at our center. A fasting blood test found inappropriately elevated insulin levels during hypoglycemia, undetectable β-hydroxybutyrate, and increased C-peptide levels in line with insulin levels...
September 21, 2018: American Journal of Case Reports
Bing Xiao, Peng Deng, Hongyu Jin, Han Wang, Yu Cao
BACKGROUND Linezolid (LZD) has been reported to combat several intractable infectious diseases, including multidrug-resistant infections and tuberculosis. Although quite a number of adverse effects of LZD therapy have been abundantly described so far, LZD associated lactic acidosis and thrombocytopenia have rarely been studied. We described a patient dying of lactic acidosis and thrombocytopenia associated with LZD therapy complications. To the best of our knowledge, this is the first report focusing on LZD therapy complications in treating patients with deadly abnormalities in hemogram...
September 20, 2018: American Journal of Case Reports
Daniele Bernardi, Emanuele Asti, Davide Ferrari, Luigi Bonavina
BACKGROUND Perforated gastric cancer accounts for less than 1% of patients who present with an acute abdomen and for up to 16% of all gastric perforations. A two-stage laparoscopic procedure may be the therapeutic strategy of choice in selected patients, and adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) can reduce the incidence of peritoneal recurrence. A rare case of subphrenic abscess and gastric perforation due to carcinoma of the gastric fundus, followed by two-stage gastrectomy and adjuvant HIPEC is presented...
September 19, 2018: American Journal of Case Reports
Tetsuya Nomura, Kenshi Ono, Yu Sakaue, Daisuke Ueno, Yusuke Hori, Kenichi Yoshioka, Masakazu Kikai, Natsuya Keira, Tetsuya Tatsumi
BACKGROUND As primary percutaneous coronary intervention (PCI) has been commonly performed for acute myocardial infarction (AMI), we rarely encounter ventricular septal rupture (VSR), which is one of the mechanical complications of AMI. However, the associated mortality rate is still very high unless treated appropriately. CASE REPORT We encountered a very rare case of VSR that was considered to have occurred during primary PCI for AMI. The manifestation of sudden coronary flow disturbance may correspond with the emergence of VSR...
September 18, 2018: American Journal of Case Reports
Christer Sawaya, Raja Sawaya
BACKGROUND A lumbar puncture is a procedure performed to uncover the state of the central nervous system by analysis of the cerebrospinal fluid. It is done also to infuse medications in the subdural space. A lumbar puncture should not cause central nervous system bleeding, but this complication is still occurring in certain cases. CASE REPORT We present 2 cases where a lumbar puncture was performed in the emergency department. The first patient had severe inflammatory lower back pain and received epidural steroids through a lumbar puncture and the second case presented with the clinical picture of meningitis and a lumbar puncture was performed for diagnostic purposes...
September 17, 2018: American Journal of Case Reports
Valerio Panizzo, Barbara Rubino, Guglielmo Niccolò Piozzi, Paolo Ubiali, Anna Morandi, Marco Nencioni, Giancarlo Micheletto
BACKGROUND Adrenocortical oncocytic neoplasms (AONs) are extremely rare tumors. AONs are classified as: oncocytoma (AO), oncocytic neoplasm of uncertain malignant potential (AONUMP), and oncocytic carcinoma (AOC). Among the 162 reported cases of AONs in the literature, 30 cases were classified as malignant. Adrenalectomy is the treatment of choice for AON. CASE REPORT We report the case of a 48-year-old man with a primitive 12-cm mass affecting the right adrenal gland, detected by ultrasonography during follow-up for alcoholic liver cirrhosis...
September 15, 2018: American Journal of Case Reports
Verajit Chotmongkol, Pewpan M Intapan, Kritsakorn Jingjit
BACKGROUND Spinal sparganosis and racemose (grape-like) neurocysticercosis are rare diseases. Co-infection with spinal sparganosis and racemose neurocysticercosis has never been reported in the English-language literature. CASE REPORT A 41-year-old male presented after having experienced left hip pain with radiation to the leg, progressive weakness and numbness of the left leg, and difficulty urinating for 4 years, all of which was caused by spinal sparganosis. He had also experienced progressive vision and hearing loss on the right side for 3 years, which were caused by racemose neurocysticercosis...
September 14, 2018: American Journal of Case Reports
Sara Mahmoud, Hassan Mitwally, Hani Soliman El Zeer, Ihab El Madhoun, Mohamad Khatib
BACKGROUND Hypercalcemia is a common complication in the intensive care unit (ICU). It can be a result of diverse etiologies, such as malignancy. In this case, bisphosphonates can serve as an effective therapeutic option. However, bisphosphonates are not safe to use in patients with end stage renal disease. CASE REPORT We report a case of severe hypercalcemia possibly secondary to bone metastasis. The patient is known to have end-stage renal disease (ESRD) and undergoing dialysis 3 times a week. She had severe persistent hypercalcemia which did not resolve with regular measures or calcitonin...
September 13, 2018: American Journal of Case Reports
Tetsuya Yumoto, Ryoji Joko, Yasuaki Yamakawa, Taihei Yamada, Hiromichi Naito, Atsunori Nakao
BACKGROUND Subperiosteal hematoma (SPH) of the iliac bone is an extremely uncommon clinical entity that occurs mostly in young patients with a history of a recent fall or sports-related injury. Patients usually complain of severe hip pain after a fall, mimicking femoral neck fracture. CASE REPORT An 18-year-old female was transported to our hospital complaining of pain in her left hip after falling on her buttocks while engaging in martial arts. Ultrasound of her left iliac region revealed a subperiosteal mass on the internal aspect of the iliac bone lifting the iliac muscle...
September 12, 2018: American Journal of Case Reports
Paula Münkler, Alexander Wutzler, Philipp Attanasio, Martin Huemer, Abdul Shokor Parwani, Wilhelm Haverkamp, Christian Meyer, Leif-Hendrik Boldt
BACKGROUND Following catheter ablation of atrial fibrillation, increased incidence of ventricular arrhythmia has been observed. We report a case of sustained ventricular arrhythmia in a patient who underwent cryoballoon-based pulmonary vein isolation for symptomatic persistent atrial fibrillation. CASE REPORT A 57-year-old patient with dilated cardiomyopathy underwent CB-based pulmonary vein isolation for symptomatic persistent AF. On the day following an uneventful procedure, the patient for the first time experienced a sustained ventricular tachycardia that exacerbated into VT storm...
September 11, 2018: American Journal of Case Reports
Chongfei Jin, Hamza Minhas, Amandeep Kaur, Sreenath Kodali, Vladimir Gotlieb
BACKGROUND Ocular Kaposi's sarcoma (KS) involving the conjunctiva and ocular adnexa is uncommon and is usually treated with cryotherapy or surgical excision. We report a case of ocular KS successfully treated with HAART combined with 8 cycles of weekly docetaxel. CASE REPORT Our patient was a 24-year-old, treatment-naïve, HIV-positive (CD4 cell count 198 cells/mm3), homosexual man treated as having atypical hordeolum and subconjunctival hemorrhage, and later confirmed with pathology to have ocular KS with immunohistochemistry study showing KS with positive HHV8, CD34, CD31, and focal positive staining with Factor VIIIRA...
September 10, 2018: American Journal of Case Reports
Sunil Pokharel, Sukhraj Singh, Muhammad Saad Shaukat
BACKGROUND This is a very interesting case of Granulomatosis with Polyangiitis (GPA) presenting with hand ischemia which rapidly evolved into dry gangrene from the involvement of digital arteries. GPA usually affects the small and medium sized blood vessels. GPA affecting muscular artery causing limb ischemia is a rare manifestation. CASE REPORT A 72 years old Caucasian female was sent to our hospital for the evaluation of left hand pain and bluish discoloration, which she noticed for few days. Physical examination was notable for bluish discoloration of left 2nd to 5th fingers, which later evolved, into dry gangrene at the tips...
September 7, 2018: American Journal of Case Reports
Xiaoxue Gong, Min Liu, Yujin Guo, Wenxiu Han, Dehua Liao, Hualin Cai, Pei Jiang
BACKGROUND Depressive patients are considerably more likely to suffer cardiovascular disease (CVD), and in patients with CVD, depression is a predictor of poor outcome. Recent findings suggest higher rates of depression and anxiety in patients with coronary slow flow (CSF). However, there is no research investigating whether the antidepressant treatment can mitigate psychiatric symptoms and cardiac conditions in CSF patients comorbid with depression. CASE REPORT The patient was a 52-year-old Chinese female with frequent chest pain...
September 6, 2018: American Journal of Case Reports
Gregory Nicolas, Haydar Nasser, Juliano Haddad, Elie Zaghrini, Karim Daher, Amal Assef Nasser, Christian Saliba, Nour Gharios, Raja Wakim
BACKGROUND Duodenal and ampullary carcinoids are very rare tumors accounting respectively for 2% and 0.03% of all carcinoid tumors. Clinical findings vary according to the location of the tumor within the periampullary region; with epigastric pain being the most common presenting symptom in duodenal carcinoids and jaundice the most common clinical finding in ampullary carcinoids. Treatment options include pancreaticoduodenectomy, local excision, and endoscopic excision. CASE REPORT In this case report, we present a 60-year-old male who presented with a one-week history of intractable epigastric pain...
September 5, 2018: American Journal of Case Reports
Kaori Amari, Masaki Tago, Naoko E Katsuki, Norio Fukumori, Shu-Ichi Yamashita
BACKGROUND Although diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma in adults, isolated cardiac recurrence of DLBCL which can cause fatal heart failure via various mechanisms is extremely rare. Furthermore, the frequency of recurrence of DLBCL more than 5 years after attaining complete remission is as low as 3.6%. The rate of complete remission and partial remission of DLBCL that have recurred 5 or more years after attaining the initial remission are reported to be 61% and 29%, respectively...
September 4, 2018: American Journal of Case Reports
Horacio di Fonzo, Melina Villegas Gutsch, Augusto Castroagudin, María Victoria Cabrera, Mariano E Mazzei, Darío Rueda
BACKGROUND Vancomycin has been used for decades to treat infections by Gram-positive bacteria, particularly those caused by methicillin-resistant staphylococci. Agranulocytosis is an infrequent complication of this antibiotic, postulated in its genesis a mechanism immune-mediated by antineutrophil antibodies and antineutrophil cytoplasm antibodies (ANCA). Treatment includes discontinuing vancomycin, and granulocyte colony-stimulating factor administration. CASE REPORT We present the case of a patient who developed agranulocytosis secondary to vancomycin during the treatment of an infectious endocarditis, which was reversed when the antibiotic was stopped...
September 3, 2018: American Journal of Case Reports
Upendra Maddineni, Eric F Worrall, Erik A Baker, Madhavi Earasi, Francis Mathieu, Georgi Guruli
BACKGROUND Originally implemented for colorectal surgery, enhanced perioperative protocols have been incorporated into many surgical fields in an effort to improve outcomes. The cornerstone of many strategies includes patient education, liberalized oral intake on the day of surgery, no routine bowel prep, targeted multimodal analgesia, cautious use of IV hydration, early extubation, avoidance of NG tubes and/or surgical drains, and encouraging early postoperative ambulation. CASE REPORT We report on the successful outcome of a single patient with a rare autosomal dominant disorder (hereditary hemorrhagic telangiectasia) with multisystem involvement including pulmonary, cardiac, hematologic, gastrointestinal, renal, oncologic, and hepatic comorbidities, scheduled for open nephrectomy...
September 1, 2018: American Journal of Case Reports
Chelsea Kathleen Varner, Caillin Wyse Marquardt, Peter Vincent Pickens
BACKGROUND Antiphospholipid syndrome (APS) is an autoimmune disease characterized by antibodies directed against phospholipids on plasma membranes. Through unclear mechanisms, APS confers hypercoagulability. APS may cause recurrent thromboses in the arterial and venous vasculature. We report a case of primary APS resulting in cerebral venous thrombosis and ST-elevation myocardial infarction (STEMI) for which only antiphosphatidylserine (aPS) IgM antibody was positive after extensive investigation. CASE REPORT A 48-year-old male was admitted after a witnessed generalized seizure with subsequent confusion...
August 31, 2018: American Journal of Case Reports
Hamza Minhas, Cherif Abdelmalek, Marium Khan, James E O'Donnell, Vladimir Gotlieb, Jen Chin Wang
BACKGROUND Double-hit lymphomas (DHL) belong to a category of very aggressive lymphomas characterized by MYC translocation and either BCL2, or less commonly, BCL6 translocations. Those with BCL6 translocations have a predilection for rare extranodal sites such as the gastrointestinal tract, nasopharynx, and tonsils. Involvement of the skull and adnexal structures is rare. Here we report a case of a young female with both skull and adnexal involvement. CASE REPORT A 20-year-old female who presented with hypercalcemia was found to have adnexal, skull, and jaw masses...
August 30, 2018: American Journal of Case Reports
Qinyi Xu, Junhui Chen, Jun Liu, Chenggguo Sun, Junjie Lu, Dong Wang
BACKGROUND Traumatic torcular herophili epidural hematoma is a rare and specific type of traumatic brain injury that is technically difficult to treat and, more critically, can lead to malignant encephalocele during the operation. CASE REPORT A 40-year-old man presented to our hospital 2 h after a motor vehicle crash. Emergency cranial CT showed a frontotemporal subdural hematoma; 3 h after the patient was admitted, the GCS score decreased to 8 and cranial CT re-examination showed that the frontotemporal subdural hematoma was significantly larger than before...
August 29, 2018: American Journal of Case Reports
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