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Journal of Investigative Medicine High Impact Case Reports

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https://www.readbyqxmd.com/read/29761112/takotsubo-cardiomyopathy-mimicking-stent-thrombosis-after-percutaneous-coronary-intervention
#1
Furqan Khattak, Muhammad Khalid, Ghulam Murtaza, Timir K Paul
Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a transient left ventricular dysfunction associated with stress (usually emotional) induced myocardial injury and stunning. It often presents as myocardial infarction on surface electrocardiogram (EKG). Diagnosis is made by coronary angiography, which rules out coronary artery disease and shows pathognomonic apical ballooning. In this article, we present a case of a 72-year-old woman who initially presented with an ST segment elevation myocardial infarction on EKG...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29761111/myocardial-infarction-as-an-early-presentation-in-thrombotic-thrombocytopenic-purpura-a-rare-case-series
#2
Sumit Dahal, Dipesh K C Ghimire, Saroj Sapkota, Suyash Dahal, Paritosh Kafle, Manjul Bhandari
Renal and neurological involvements are frequently seen in thrombotic thrombocytopenic purpura (TTP). Cardiac involvement, however, has been rarely reported. In this article, we present 2 cases of myocardial infarction in patients with TTP. In the first case, a young man presented with non-ST-segment elevation myocardial infarction that resolved promptly with plasmapheresis. The second patient developed ST-segment elevation myocardial infarction early in the course of the disease and died before plasmapheresis could be initiated...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29761110/granulomatous-invasive-aspergillus-flavus-infection-involving-the-nasal-sinuses-and-brain
#3
Roopam Jariwal, Arash Heidari, Ahana Sandhu, Janushe Patel, Kamelia Shoaepour, Piruthiviraj Natarajan, Everardo Cobos
Invasive fungal infections are commonly associated with some form of immunosuppression. On the nasal epithelial surface, Aspergillus flavus , under favorable conditions, can aggressively breach multiple cell lines invading the local tissues. We present the case of a 35-year-old woman with granulomatous invasive Aspergillus flavus infection involving the nasal sinuses and the brain. Antifungal agents administered in the previous episodes contained the infection; however, the infected site evolved over time surrounded with calcified tissues in the left maxillary sinus...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29707593/spontaneous-coronary-artery-dissection-a-case-series-of-9-patients-with-literature-review
#4
Ali Raza Ghani, Faisal Inayat, Nouman Safdar Ali, Reema Anjum, Michael Viray, Arsalan Talib Hashmi, Iqra Riaz, Bruce D Klugherz, Hafeez Ul Hassan Virk
Spontaneous coronary artery dissection is an increasingly recognized nonatherosclerotic cause of acute coronary syndrome. Reports regarding the prognosis and natural history of this disease are limited. In addition to the diagnostic difficulty, this condition poses a significant therapeutic challenge due to the lack of specific management guidelines. We present here a case series of 9 patients with spontaneous coronary artery dissection. Additionally, this article reviews the incidence, clinical characteristics, risk factors, diagnostic modalities, therapeutic approaches, and patterns of recurrence in patients with spontaneous coronary artery dissection...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29707592/varicella-pneumonia-case-report-and-review-of-a-potentially-lethal-complication-of-a-common-disease
#5
John T Denny, Zoe M Rocke, Valerie A McRae, Julia E Denny, Christine Hunter Fratzola, Sajjad Ibrar, Joyce Bonitz, James T Tse, Shaul Cohen, Scott J Mellender, Geza K Kiss
Varicella zoster virus causes varicella (chickenpox). It can be reactivated endogenously many years later to cause herpes zoster (shingles). Although varicella is usually a benign disease in healthy children, it resulted in over 11 000 hospitalizations and over 100 deaths every year, in all ages, in the United States. Morbidity was considerably worse in older teenagers and adults. Between 5% and 15% of cases of adult chickenpox will produce some form of pulmonary illness. Progression to pneumonia risk factors include pregnancy, age, smoking, chronic obstructive pulmonary disease, and immunosuppression...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29707591/miliary-tuberculosis-presenting-with-meningitis-in-a-patient-treated-with-mycophenolate-for-lupus-nephritis-challenges-in-diagnosis-and-review-of-the-literature
#6
Precious Macauley, Mark Rapp, Sarah Park, Olaoluwatomi Lamikanra, Pratibha Sharma, Michael Marcelin, Kavita Sharma
Tuberculosis is one of the top 10 causes of death worldwide according to the World Health Organization. Central nervous system involvement is usually the least common presentation of tuberculosis occurring in about 1% of all cases but yet can have very devastating outcomes. Lupus nephritis is one of the most common complications of systemic lupus erythematosus with up to two thirds of patients presenting with some degree of renal dysfunction. The mainstay of treatment is glucocorticoids; however, to sustain remission, steroid sparing agents such as cyclophosphamide, azathioprine and mycophenolate mofetil are used...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29707590/reverse-takotsubo-cardiomyopathy-following-exploratory-laparotomy
#7
Tamer Akel, Emad Barsoum, Jad Mroue, Nikhil Nalluri, Frank Tamburino, Marc Bogin
Reverse takotsubo cardiomyopathy is an uncommon cardiomyopathy characterized by reversible regional wall motion abnormalities in the basilar segment of the left ventricle. This happens in the absence of any coronary artery pathology. Although it shares some pathogenic mechanisms with its more common variant, takotsubo cardiomyopathy, differences exist in terms of echocardiographic features, demographics, clinical manifestations, laboratory features, and prognosis. Cases of postoperative reverse takotsubo cardiomyopathy are less described in the literature...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29623280/neo-left-main-channel-creation-using-double-stenting-alongside-a-sapien-3-aortic-valve-bioprosthesis-for-left-main-coronary-obstruction-following-valve-in-valve-transcatheter-aortic-valve-replacement-a-case-report-with-review-of-literature
#8
Apurva D Patel, Thomas Haldis, Kais Al Balbissi, Timir Paul
Transcatheter aortic valve replacement in the setting of failed surgical bioprosthesis (valve-in-valve) is a valuable option for patients with bioprosthetic aortic stenosis or regurgitation who are deemed high risk for repeat open heart surgery. Although the procedure is successful with proper preprocedural assessment, instances of left main (LM) coronary artery ostium obstruction have been documented. We present a case of LM coronary obstruction in the immediate postoperative period following implantation of a 20-mm Edwards Sapien 3 valve inside the degenerated 21-mm Mitroflow bioprosthesis stenosis, which was treated with double stenting alongside the Edwards Sapien 3 valve creating a channel ("neo left main") that extended from mid-LM to the upper margin of the Edwards Sapien 3 valve...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29623279/-clostridium-difficile-colitis-leading-to-reactive-arthritis-a-rare-complication-associated-with-a-common-disease
#9
Asghar Marwat, Hassan Mehmood, Ali Hussain, Muzammil Khan, Asad Ullah, Medha Joshi
The relationship between reactive arthritis and enteric infections caused by Yersinia enterocolitica, Campylobacter jejuni , and Salmonella typhimurium is well documented. Clostridium difficile colitis is a less recognized cause of reactive arthritis. We present a case of a 58-year-old woman with Clostridium difficile colitis complicated by reactive arthritis. A 58-year-old woman with no significant past medical history presented to our hospital with complaints of nonbloody watery diarrhea, abdominal pain for the past 1 week, and right knee pain starting 1 day prior...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29623278/an-innocent-esophageal-mucosal-bridge-case-report-and-literature-review
#10
Tagore Sunkara, Eric Omar Then, Krishna Sowjanya Yarlagadda, Manan Jhaveri, Vinaya Gaduputi
An esophageal mucosal bridge is a rare finding that is seldom encountered on upper endoscopy. They most commonly present secondary to an underlying inflammatory disorder and cause chest pain and dysphagia, among other symptoms. More rarely, they present asymptomatically with no identifiable inflammatory conditions. Our case consists of a 31-year-old woman who presented with an asymptomatic, noninflammatory mucosal bridge of the esophagus. To our knowledge, this makes the third such case. The rarity of this condition coupled with the lack of epidemiologic data available make this case worthy for literature review...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29619395/sirolimus-in-refractory-cronkhite-canada-syndrome-and-focus-on-standard-treatment
#11
Catherine Langevin, Hugo Chapdelaine, Jean-Maxime Picard, Pierre Poitras, Raymond Leduc
Cronkhite-Canada syndrome is a rare syndrome consisting of extensive gastrointestinal polyposis and ectodermal changes including cutaneous hyperpigmentation, alopecia, and onychodystrophy. We report the case of a 45-year-old Caucasian male patient who failed multiple treatments over 2 years including steroids, azathioprine, adalimumab, and cyclosporine. He had recurrent and prolonged hospitalizations because of diarrhea, abdominal pain, weight loss, and malnutrition. Sirolimus was initiated with a significant clinical and endoscopic benefit apparent within, respectively, 2 and 8 weeks...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29581993/hypereosinophilic-syndrome-complicated-by-eosinophilic-myocarditis-with-dramatic-response-to-steroid
#12
Mazin Khalid, Vijay Gayam, Sumit Dahal, Ebad Ur Rahman, Kamal Fadllala, Jaspreet Kaler, Mowyad Khalid, Alix Dufresne
Introduction. Eosinophilic myocarditis is an infiltrative disease that affects the myocardium leading to various presentations. It can be precipitated by medications, helminthiasis, or hypereosinophilic syndrome. Case. We present the case of a young, male patient who presented with palpitations and dyspnea and was found to have heart failure with reduced ejection fracture of 12%. His past medical history was significant for recent lung problem treated with steroids. Based on his history and laboratory findings, he was started on intravenous steroids for treatment of eosinophilic myocarditis...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29568783/kratom-an-emerging-drug-of-abuse-raises-prolactin-and-causes-secondary-hypogonadism-case-report
#13
Lauren LaBryer, Rohan Sharma, Kaustubh Suresh Chaudhari, Mitali Talsania, Robert Hal Scofield
Background. Kratom is a drug derived from the leaves of the tree Mitragyna speciose , which is native to southern Thailand. The route of administration is oral. Kratom has become increasingly available in the United States. The active ingredients in the drug bind the opioid mu-receptor; therefore, kratom has similar physiological effects as mu-opioids. Elevated prolactin is a common medical condition frequently caused by a variety drugs, including opioids. Case Report. A 42-year-old man presented with poor energy and low libido...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29568782/proteinuria-hypoalbuminemia-and-chronic-lymphocytic-leukemia-an-unusual-trio
#14
William Wung, Shubha Ananthakrishnan, Brian A Jonas
Chronic lymphocytic leukemia (CLL) is a chronic, progressive lymphoproliferative disorder characterized by a monoclonal population of functionally incompetent lymphocytes. Renal involvement is rare and poorly described. A 57-year-old male with no prior medical history was diagnosed with CLL and followed with a watch and wait approach. He was referred to our institution several months later due to concern for Richter's transformation to diffuse large B-cell lymphoma. A positron emission tomography/computed tomography scan showed no evidence of diffuse large B-cell lymphoma; however, the patient was noted to have hypoalbuminemia, nephrotic range proteinuria, an acute left renal vein thrombus, and a right pulmonary embolus...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29568781/renal-artery-rupture-in-association-with-fibromuscular-dysplasia
#15
Tamer Akel, Suzanne Elsayegh
Fibromuscular dysplasia is a noninflammatory arteriopathy of unknown etiology that affects medium-sized arteries. Although patients affected with it are often asymptomatic, some might have recurrent catastrophic events that depend mainly on the arterial bed involved. The most worrisome vascular complications of the disease are aneurysmal rupture and arterial dissection. Herein, we report a case of a 49-year-old woman who presented with sudden-onset abdominal pain without any inciting factors. She was found to have active blood extravasation from a capsular branch of the renal artery that happened spontaneously...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29568780/drug-induced-liver-injury-an-institutional-case-series-and-review-of-literature
#16
Vijay Gayam, Mazin Khalid, Binav Shrestha, Muhammad Rajib Hossain, Sumit Dahal, Pavani Garlapati, Arshpal Gill, Amrendra Kumar Mandal, Ruby Sangha
Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the USA. DILI can be broadly classified as Intrinsic and Idiosyncratic. Identifying predictors and at-risk patients are challenging but can have a substantial clinical implication. This case report series demonstrates the importance of valproic acid, fluconazole, and amiodarone as potential hepatoxic agents of drug-induced liver injury leading to acute hepatic failure. The causality in all cases was established by Roussel Uclaf Causality Assessment Method/Council for International Organizations of Medical Sciences score and Naranjo Algorithm...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29552570/myocardial-infarction-presenting-as-ear-fullness-and-pain
#17
Israel Ugalde, Ibrar Anjum, Saberio Lo Presti, Alfonso Tolentino
Acute coronary syndrome usually presents with retrosternal chest pain, nausea, vomiting, sweating, and jaw and arm pain. Some patients only present with neck, epigastric, or ear discomfort. A 47-year-old male with a history of hypertension and coronary artery disease presented to the emergency department complaining of bilateral otalgia. He never felt chest pain, jaw pain, nausea, diaphoresis, or shortness of breath. He had a history of 2 acute coronary events and had a stress test 2 months prior to admission, which was unremarkable...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29552569/a-recurrent-platinum-refractory-ovarian-cancer-patient-with-a-partial-response-after-rrx-001-resensitization-to-platinum-doublet
#18
Hope Cottrill, Stephanie Cason, Scott Caroen, Bryan Oronsky, Elvis Donaldson
This case report describes the clinical course of a heavily pretreated patient enrolled on the Phase II QUADRUPLE THREAT clinical trial (NCT02489903) with recurrent metastatic epithelial ovarian cancer that was previously treated with a platinum doublet and that benefited from another reintroduction of a platinum doublet after a brief priming period with RRx-001. Platinum-taxane combination is the initial treatment of choice in ovarian cancer and the "go-to regimen" for patients with recurrent, platinum-sensitive disease...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29552568/response-of-bortezomib-chemotherapy-in-hepatic-amyloidosis
#19
Syed M Hasan, Nida N Ahmed, Zunirah Ahmed, Allan Seibert
Amyloidosis is a rare disorder with a wide spectrum of presentations and anomalies. It is subdivided into 2 broad categories based on protein deposition; primary and secondary amyloidosis. It can present as a single-organ involvement or as a diffuse infiltrative multi-organ process. Isolated hepatic amyloidosis presentation is a rare phenomenon that develops due to insoluble amyloid deposition in liver. Its clinical presentation is usually vague and ranges from mild hepatomegaly with elevated liver enzymes to acute liver failure and hepatic rupture...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29536021/small-cell-carcinoma-of-prostate-a-case-report-of-a-patient-with-concomitant-transitional-cell-cancer-of-the-bladder
#20
Waiel Abusnina, Eric Yiman Auyoung, Mohammed Megri, Toni Pacioles
Small cell carcinomas (SCCs) are aggressive neoplasms commonly associated with a pulmonary origin. However, albeit rare, extrapulmonary SCC can occur in a variety of sites with an incidence in North America approximated to be 0.1% to 0.4%. Among these sites, approximately 10% of extrapulmonary SCC cases occur in the prostate and are associated with a poor mortality with a median survival of 10 months. Because of the rarity of the prostatic SCC, there is no formal treatment protocol. In this case report, we present a patient who was diagnosed with SCC in the prostate as primary origin...
January 2018: Journal of Investigative Medicine High Impact Case Reports
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