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Clinical Case Reports

Mari Miyawaki, Seitaro Oda, Kenichiro Hirata, Hideaki Yuki, Daisuke Utsunomiya, Hidetaka Hayashi, Yasumiko Sakamoto, Shinichiro Okamoto, Kazuhiko Fujii, Yasuyuki Yamashita
Granulomatosis with polyangiitis (GPA) is characterized by necrotizing granulomatous inflammation usually involving the upper and lower respiratory tracts and necrotizing vasculitis predominantly affecting small-sized vessels. Although categorized as a small vessel vasculitis, GPA can cause periaortitis and pericarditis. Physicians should recognize all categories of vasculitis can affect any size arteries.
October 2017: Clinical Case Reports
Shireesh Saurabh
Biliopancreatic limb obstruction after laparoscopic Roux-en-Y gastric bypass is a challenging diagnosis as the symptoms are very nonspecific. CT scan is the optimal study for evaluation. Early diagnosis and treatment is essential in reducing the morbidity and mortality associated with this condition.
October 2017: Clinical Case Reports
Sanjay Dwarakanath, Monica Cheriyan, Annette Rebel
The presence of Internal Jugular Valves can pose a diagnostic and procedural challenge during ultrasound-guided cannulation. After ruling out dissection, thrombus, or ultrasound artifacts, it can still be accessed and successfully cannulated with appropriate precautions including use of Live ultrasound, positioning, use of soft-tipped catheters, and minimizing duration of catheter placement.
October 2017: Clinical Case Reports
Konstantinos C Fragkos
Sézary syndrome is an extremely rare form of cutaneous T-cell lymphoma. It presents suddenly and is associated with a poor prognosis. Clinical recognition is crucial for the diagnostic process and initiation of appropriate treatment. Plantar keratoderma is usually pathognomonic for Sézary syndrome and clinicians should be alerted to its presence.
October 2017: Clinical Case Reports
Naoki Kadota, Tsutomu Shinohara, Keishi Naruse, Nobuo Hatakeyama
A clinical diagnosis of metastatic bone tumors is usually based on radiological findings without bone biopsy. Plasmacytoma can present as a single osteolytic lesion as described in this case. Early bone biopsy should be considered in unusual clinical settings for a differential diagnosis of primary bone tumors.
October 2017: Clinical Case Reports
Mohammed Osman, Ahmed Abdalla, Mohammed Al-Qasmi, Ghassan Bachuwa
Bilateral thalamic infarction (BTI) can present as sleep-like coma without focal neurological signs which can lead to delay in the diagnosis. Due to the diagnostic challenge, treatment is often delayed. The early use of DWI-MRI in suspected cases can help in the early diagnosis and treatment.
October 2017: Clinical Case Reports
Abhilash Koratala, Deepti Bhattacharya
Extrarenal pelvis is an anatomical variant that appears as a large hypoechoic mass just outside the renal sinus and can be confused with hydronephrosis, especially on a point-of-care renal ultrasound. Unlike hydronephrosis, it is not associated with dilated calyces, parenchymal thinning, hydroureter, or enlarged kidney per se.
October 2017: Clinical Case Reports
Stylianos Kapetanakis, Grigorios Gkasdaris, Evangelos Nastoulis, Vladimir Stavrev
A 15-year-old female patient presented with neck pain accompanied by cervical scoliosis, on the existence of torticollis. Although rare, hemivertebra of the cervical spine is a congenital deformation associated with these three clinical features.
October 2017: Clinical Case Reports
Yuta Seko, Kenichi Sasaki, Takao Kato, Moriaki Inoko
The decreased 123I-BMIPP uptake, while having normal perfusion, in the correspondent coronary artery territory is caused by a delayed metabolic recovery after the recovery of perfusion. This phenomenon termed ischemic memory can clearly differentiate vasospastic angina from other chest pain syndromes.
October 2017: Clinical Case Reports
Abhilash Koratala, Indirakshi Jamalpur, Harikrishna Reddy Mogili
The three most common classes of medications implicated in drug-induced gum enlargement are anticonvulsives, calcineurin inhibitors, and calcium channel blockers. Treatment primarily consists of withdrawing the offending agent whenever possible, in addition to maintaining good oral hygiene. Gingivectomy or flap surgery may be needed in resistant cases.
October 2017: Clinical Case Reports
Masaki Tago, Yoshimasa Oda, Naoko E Furukawa, Shu-Ichi Yamashita
Spontaneous dissection without an aneurysm limited to left gastric artery is fairly rare. Physicians should be alert to the possibility of this condition in patients with sudden-onset abdominal pain.
October 2017: Clinical Case Reports
Suranut Charoensri, Chutintorn Sriphrapradang, Hataikarn Nimitphong
High-dose intravenous thyroxine (T4) is the preferable treatment for myxedema coma. We describe the clinical course of a 69-year-old man who presented with myxedema coma and received oral levothyroxine (LT4) therapy (1 mg) in a split dose. This suggests split high-dose oral LT4 as a therapeutic option in myxedema coma.
October 2017: Clinical Case Reports
Asha Birmingham, Carissa Mancuso, Craig Williams
A comparison of this case to previously published reports suggests that granulocyte colony-stimulating factor may be associated with improved prognosis in severe antithyroid drug-induced neutropenia, and that weight-based doses could be an appropriate strategy.
October 2017: Clinical Case Reports
Lonneke C Gerbrands, Eric G Haarman, Margot A Hankel, Martijn J J Finken
If an infant with cystic fibrosis exhibits failure to thrive, despite adequate disease management, Silver-Russell syndrome should be considered, given the locations of these conditions in the genome. However, an earlier clue to the diagnosis is small-for-gestational-age birth.
October 2017: Clinical Case Reports
Chaitanya Kumar, Sakshi Kohli, Srikanth Chiliveru, Minish Jain, Bandana Sharan
APCEDEN (®) is an autologous monocyte-derived dendritic cell-based immunotherapy. A 58-year-old man with adenocarcinoma of oropharynx shows complete remission after receiving APCEDEN (®) in conjunction with Geftinib validated by reduction in size, whereas Gefitinib alone lead to disease progression.
October 2017: Clinical Case Reports
Abdul-Monem Badran, Anatoli Fotiadou, Simon Kayemba Kay's
Pancreatic polycystosis is one of rare causes of recurrent abdominal pain of pancreatic origin in children frequently associated with other organ's cysts which are to be searched. Association with pineal cyst is exceptional, and link between the two locations is to be elucidated. MRI is highly valuable to characterize cysts.
October 2017: Clinical Case Reports
Courtney Pollard, Shane M Mesko, Lawrence E Ginsberg, Merrill S Kies, Shaan M Raza, Shirley Y Su, Sam Tung, Jack Phan
Detection of nodal metastasis in the neck or adjacent structures is common in nasopharyngeal carcinoma (NPC) when there is frank primary disease. Intracranial extension without obvious nasopharyngeal disease is not common. Here, we discuss a patient with NPC that presented with extensive intracranial disease with subtle findings in the nasopharynx.
October 2017: Clinical Case Reports
Enrico E DiVito, Khang T Le
A major cause for endodontic failure is the inability to treat all anatomy. Studies report endodontic retreatments contain 42% missed canals. This case illustrates dentin preservation of a molar with an uninstrumented mesiobuccal-3 canal revealed post-GentleWave Procedure. Efficient cleaning and disinfection with maintained healing to 18 months is demonstrated.
October 2017: Clinical Case Reports
Patrick Zuercher, Daniel Gerber, Nadia Schai, Matthias Nebiker, Stefan König, Joerg C Schefold
Acute life-threatening intoxications with insecticides are rare. We report a case of accidental near-fatal thiacloprid intoxication with mass spectrometry-based analytical confirmation. The initial clinical presentation resembled imminent brain death and/or severe postanoxic encephalopathy. Prolonged supportive treatment resulted in full recovery underlining intoxication as an important differential diagnosis in unclear coma.
October 2017: Clinical Case Reports
Takeshi Umazume, Satoshi Hayasaka, Fumi Kato, Satoshi Ishikawa, Mamoru Morikawa, Hisanori Minakami
There have been no reports regarding imaging-documented bronchospasm in patients with amniotic fluid embolism (AFE). In a woman with scheduled cesarean section for placenta previa, transient bronchospasm and pulmonary hypertension were documented explaining a sudden drop in SpO2. Mild AFE was the most likely diagnosis in this patient.
October 2017: Clinical Case Reports
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