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American Journal of Case Reports

Andreas Panagopoulos, Ioannis Vrachnis, Stavros Balasis, Antonis Kouzelis, Giorgos Karpetas, Minos Tyllianakis, Panagiotis Megas
BACKGROUND Renal cell carcinoma (RCC) is the most common malignancy of the kidney, with clear cell (ccRCC) subtype identified in 85% of the cases; one-third of these patients experience synchronous metastatic disease, while 20-30% of the remaining patients develop metachronous metastatic RCC. The axial skeleton (pelvis and sacrum) is the second most common location (following the lungs), with a reported incidence of 35%. Diaphysis of the long bones is rarely involved, with the tibia being an even rarer site of metastasis...
November 14, 2018: American Journal of Case Reports
Ahlam Alghamdi, Deanne Tabb, Laura Hagan
BACKGROUND Actinomyces species are normal flora of the upper respiratory, female genital, and gastrointestinal tract. Actinomyces species are generally considered to have a low virulence potential. Here we report one case of Actinomyces viscosus isolated from a neonatal blood culture as a consequence of extreme prematurity in the presence of HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome. CASE REPORT A 23-week gestational age female infant was born to a 32-year-old mother. The pregnancy was complicated by severe HELLP syndrome leading to cesarean section at 23-week gestation...
November 13, 2018: American Journal of Case Reports
Marcelo Augusto Duarte Silveira, Antônio Carlos Seguro, Jukelson Barbosa da Silva, Marcia Fernanda Arantes de Oliveira, Victor Faria Seabra, Bernardo Vergara Reichert, Camila Eleutério Rodrigues, Lucia Andrade
BACKGROUND Corpus callosum agenesis (CCA) is one of the most common congenital brain abnormalities, and is associated with neurodevelopmental and neuropsychiatric disorders. In CCA, defects in osmoregulation have been reported. This report presents a rare case of chronic hyponatremia associated with the syndrome of inappropriate antidiuresis (SIAD) in a woman with CCA. CASE REPORT A 41-year-old woman presented to the renal unit with symptomatic hyponatremia. In her past medical history, she had a four-year history of systemic arterial hypertension and Sjögren's syndrome, and a three-year history of systemic lupus erythematosus (SLE), which was treated with cyclophosphamide...
November 12, 2018: American Journal of Case Reports
Bilal H Shaikh, Muneebah Sohaib, Raeda Alshantti, Francisco Barrera, Farah S Faridi, Natia Murvelashvili
BACKGROUND Severe hypertriglyceridemia is a well-known cause of acute pancreatitis. Mild elevations of triglyceride levels are common in patients presenting with diabetic ketoacidosis (DKA). Rarely, DKA can be accompanied by an elevation of serum triglyceride level severe enough to lead to AP. CASE REPORT We report one such case of a young diabetic male who presented with DKA that was complicated by hypertriglyceridemia-induced acute pancreatitis (HTGAP). We were able to treat the condition with a slightly prolonged infusion of intravenous (IV) regular insulin in an efficient and cost-effective manner with a good outcome...
November 10, 2018: American Journal of Case Reports
Eduardo de Souza Martins Fernandes, Felipe Pedreira Tavares de Mello, Ronaldo Oliveira Andrade, Camila Liberato Girao, Leandro Savattone Pimentel, Camilla Cesar, Claudia Cristina Sousa, Anderson Brito-Azevedo, Samanta Teixeira Basto, Orlando Jorge Martins Torres
BACKGROUND The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is an important tool to induce fast liver hypertrophy. The degree of hepatic fibrosis/cirrhosis in patients with HCC negatively impacts their health, and the risk of liver failure is always present. In these cases, liver transplantation may be necessary as a rescue procedure. We present the case of a patient with HCC who underwent ALPPS and developed liver failure. A living donor liver transplant was performed as a rescue procedure...
November 9, 2018: American Journal of Case Reports
Ioannis Mantzoros, Despoina Kyriakidou, Konstantinos Galanos-Demiris, Christos Chatzakis, Styliani Parpoudi, Nikolaos Sapidis, Lydia Loutzidou, Orestis Ioannidis, Stamatis Angelopoulos, Konstantinos G Tsalis
BACKGROUND Solitary parathyroid adenomas are the leading cause of primary hyperparathyroidism in 0% to 85% of cases. Diagnosis of parathyroid adenoma is based on typical clinical presentation of hypercalcemia, biochemical profile, and modern imaging studies. The purpose of this article is to present the diagnostic and therapeutic approach used for a 73-year-old female patient with a giant parathyroid adenoma measuring 5×2.5×2.5 cm and weighing 30 grams. CASE REPORT A 73-year-old female was referred to the outpatient clinic of our Surgical Department with the diagnosis of primary hyperparathyroidism...
November 8, 2018: American Journal of Case Reports
Juan Manuel Orjuela Rojas, Ingrid Lizeth Lizarazo Rodríguez
BACKGROUND Historically, clinical researchers have underestimated the prevalence and importance of musical obsessions, which are defined as intrusive, repetitive, persistent sounds or tunes, not controlled by the will, that cause clinically significant anxiety and distress. Musical obsessions have also been described as the "stuck song syndrome" and their prevalence is not clearly established, because few cases have been reported. CASE REPORT This study reports a case of a 32-year-old female with a history of musical obsessions over the course of 12 years...
November 7, 2018: American Journal of Case Reports
Franchesca Arias, Alberto C Bursian, Joshua W Sappenfield, Catherine E Price
BACKGROUND Delirium is a well-established clinical phenomenon that remains largely underdiagnosed. In light of its association with diminished postoperative outcomes, recent efforts involve implementing preventive strategies and fostering early detection. This report highlights how multidisciplinary interventions can inform risk for delirium and the challenges that accompany identifying at-risk patients. CASE REPORT A 75-year-old male with a history of postoperative cognitive complications including delirium and mild cognitive impairment...
November 6, 2018: American Journal of Case Reports
Tsuyoshi Ito, Satoshi Koyama, Shotaro Iwamoto, Masahiro Hirayama, Eiichi Azuma
BACKGROUND Acquired platythorax, or flattening of the chest with a reduction in the anteroposterior (AP) diameter, is very rare and the prognosis depends on the degree of the deformity, respiratory function, and on any underlying disease. Drug-induced pulmonary fibrosis is associated with pulmonary hypoplasia. A case of acquired platythorax is presented in a young man previously treated with cyclophosphamide in childhood. CASE REPORT A 20-year-old man began to experience cough, chest pain, and mild exertional dyspnea...
November 5, 2018: American Journal of Case Reports
Kristopher S Pfirman, Corey A White, Abiy Kelil, Hemant C Modi
BACKGROUND Brugada syndrome is a cardiac disorder associated with sudden death due to sodium channelopathy, most commonly the SCN5a mutation. There are 3 different patterns of electrocardiogram (ECG) changes characterized as type I, II, and III. ECG patterns consist of variations of incomplete RBBB and ST elevation in anterior precordial leads only. Treatment, if warranted, consists of implantable cardioverter-defibrillator. CASE REPORT A 63-year-old male presented with abdominal pain for 4 days that was persistent, and after further imaging, he was found to have hepatic metastases from a stage IV small cell carcinoma of the lung...
November 3, 2018: American Journal of Case Reports
Abdulelah Nuqali, Qaiser Shafiq, Mubbasher M Syed, Mujeeb Sheikh
BACKGROUND Non-atherosclerotic causes of ST-segment elevation myocardial infarction (STEMI) are uncommon, and there are few case reports of acute myocardial infarction secondary to coronary artery embolism. CASE REPORT A 66-year-old man presented with shortness of breath and leg swelling. Diagnoses of congestive heart failure and atrial fibrillation were made. He was electrically cardioverted to normal sinus rhythm. Coronary angiogram was performed to rule out ischemic etiology of new-onset systolic heart failure, and anticoagulation therapy was interrupted for cardiac catheterization...
November 2, 2018: American Journal of Case Reports
Fuminari Takahashi, Shinichiro Hiraiwa, Genki Takahashi, Yusuke Kondo, Gen Tasaki, Tomoko Sugiyama, Takuma Tajiri, Fumio Sakamaki
BACKGROUND Pulmonary thromboembolism (PTE) sometimes leads to a shock state and sudden death due to acute massive pulmonary arterial thrombosis. The origins of pulmonary arterial thrombi are varied, but most arise from deep vein thrombosis. We herein presented a very rare cause of PTE due to paradoxical embolism caused by arteriovenous fistula from common iliac artery to common iliac vein. CASE REPORT A 74-year-old man was admitted because of increasing dyspnea on exertion. The diagnosis of idiopathic pulmonary fibrosis was made and corticosteroid therapy was started...
November 1, 2018: American Journal of Case Reports
Sunhae Song, Kyeongbong Lee, Sunhye Jung, Suho Park, Hyunrae Cho, Gyuchang Lee
BACKGROUND The aim of the present study was to investigate the effect of horizontal whole-body vibration (WBV) training on trunk and lower-extremity muscle tone and activation, balance, and gait in a child with spastic diplegia cerebral palsy. CASE REPORT A 10-year-old male with spastic diplegia cerebral palsy received horizontal WBV training followed by conventional physiotherapy (50 min per day, 12 days per month), but only conventional physiotherapy during followup. Muscle tone was assessed using the Modified Ashworth Scale (MAS) and muscle activation with surface electromyography...
October 31, 2018: American Journal of Case Reports
Muhammad Shabbir Rawala, S Tahira Shah Naqvi, Muhammad Yasir Khan, Amr El Toukhy
BACKGROUND Thrombotic thrombocytopenic purpura is mostly characterized by symptoms and signs of hemolytic anemia, thrombocytopenia, renal impairment, fever and neurologic dysfunction. It is not always necessary to have all 5 characteristic symptoms, and presentations can vary. It can be congenital or acquired by any etiology that causes deficiency or dysfunction of ADAMST13 enzyme. CASE REPORT We present a case of a 71-year-old man who presented to our hospital initially with abdominal pain. He was diagnosed with pancreatitis, and conservative management was started with pain control and hydration...
October 30, 2018: American Journal of Case Reports
Uzung Yoon, Madeel Abdullah, Elia Elia, Jay Herman
BACKGROUND Acute hypotensive transfusion reaction (AHTR) is characterized by the abrupt onset of hypotension immediately after the start of transfusion and usually resolves when transfusion ceases. Recent studies have shown an association with pre-operative treatment with an angiotensin-converting enzyme (ACE) inhibitor. This report presents two cases of AHTR in non-related patients and describes the diagnosis and management. CASE REPORT A 68-year-old woman underwent lumbar fusion surgery due to spinal stenosis and an 86-year-old man underwent a pancreaticoduodenectomy (Whipple's procedure)...
October 29, 2018: American Journal of Case Reports
Amanda Steele, Joe Jabbour, Paul D Fischer, John G O'Neill
BACKGROUND Pneumomediastinum is an uncommon clinical condition that usually occurs spontaneously, or is caused by blunt thoracic or abdominal trauma. This report is of a rare case of pneumomediastinum caused by blunt neck trauma in an adult and describes the clinical and radiological features and the principles of clinical management. CASE REPORT A 23-year-old man presented with increased neck swelling, dysphonia and pain on swallowing (odynophagia) after blunt neck trauma during a rugby game. Chest X-ray and computed tomography (CT) showed features that were consistent with pneumomediastinum, including extensive subcutaneous emphysema...
October 27, 2018: American Journal of Case Reports
Yoo Jin Lee, Sihyung Park, Yang Wook Kim, Kang Min Park, Il Hwan Kim, Jin Han Park, Byeong Ju Lee, Bong Soo Park
BACKGROUND Rhabdomyolysis is a syndrome characterized by muscle necrosis and secretion of intracellular muscle components into the blood circulation. Acute compartment syndrome is a potential complication of severe rhabdomyolysis. CASE REPORT We report 3 cases of compartment syndrome-related peripheral neuropathy in alcoholic individuals with rhabdomyolysis. All patients were confirmed to have peripheral neuropathy by electrophysiologic studies. CONCLUSIONS Patients with underlying metabolic abnormalities, such as those related to long-term alcoholism, should be aware that rhabdomyolysis is likely to cause neurological abnormalities...
October 26, 2018: American Journal of Case Reports
Ivan Cherrez-Ojeda, Miguel Felix, Emanuel Vanegas, Valeria L Mata
BACKGROUND Many conditions and triggers have been identified and associated with spontaneous pneumomediastinum (SPM), including asthma, strenuous exercise, chronic obstructive pulmonary disease, diabetic ketoacidosis, inhalational drugs, and other activities associated with the Valsalva maneuver. Among rare findings reported in patients with SPM is tracheal diverticulum. We present a case of SPM that on further evaluation was noted to have a tracheal diverticulum, together with a possible diagnosis of asthma...
October 25, 2018: American Journal of Case Reports
Erik A Holzwanger, Zainab Alam, Emily Hsu, Andrew Hsu, Mark Mangano, Deirdre L Kathman
BACKGROUND Granulocytic sarcoma, or 'chloroma,' due to extramedullary acute myeloid leukemia (AML) or due to acute myelomonocytic leukemia (AML M5), is rare and is associated with a poor prognosis. This report is of a case of granulocytic sarcoma of the gallbladder and describes the approach to diagnosis and treatment. CASE REPORT A 74-year-old Hispanic woman from Ecuador presented to the emergency department with a five-day history of fever, jaundice, and right upper quadrant abdominal pain. The right upper quadrant ultrasound showed a thickened gallbladder wall with cholelithiasis, a positive sonographic Murphy sign, and marked dilatation of the common bile duct, which was up to 17 mm in diameter...
October 24, 2018: American Journal of Case Reports
Muhammad Shabbir Rawala, Varun Badami, Syed Bilal Rizvi, Aravinda Nanjundappa
BACKGROUND Hemetemesis is rarely caused by an aorta-esophageal fistula with thoracic aorta aneurysm in patients. This uncommon etiology, AEF/TAA, can potentially rupture and cause death if left untreated. Thoracic endovascular aorta repair places a stent-graft to seal the aneurysm and cover the fistulous track. Open surgical repair is associated with high risk of morbidity and mortality; therefore, TEVAR is a much safer alternative to it. However, recurrent or persistent infection remains a major concern with TEVAR for AEF...
October 23, 2018: American Journal of Case Reports
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