Medical Reports最新文献

{"title":"Primary pulmonary choriocarcinoma: A case report","authors":"Anirudh Singh,&nbsp;Anuja Kapoor,&nbsp;Muthu Manikandan,&nbsp;Jaspreet Kaur","doi":"10.1016/j.hmedic.2025.100201","DOIUrl":"10.1016/j.hmedic.2025.100201","url":null,"abstract":"<div><div>Primary Pulmonary Choriocarcinoma (PPC) is an extremely rare and aggressive malignancy originating in the lung parenchyma. This case report describes a 38-year-old female who presented with sudden-onset, progressive chest pain and breathing difficulty. Initial evaluation revealed a lung mass, elevated lactate dehydrogenase, and markedly elevated beta-human chorionic gonadotropin (βhCG). PET-CT imaging showed a large hypermetabolic mass in the right upper lobe with mediastinal extension and lymph node involvement. Biopsy confirmed choriocarcinoma, with immunohistochemistry positive for CK7 and βhCG. The patient received four cycles of cisplatin and etoposide chemotherapy, resulting in partial response with a decrease in tumor size, βhCG and resolution of mediastinal lymphadenopathy. This case highlights the diagnostic challenges and management approach for PPC, emphasizing the importance of considering this rare entity in patients presenting with lung masses and elevated βhCG. The partial response to chemotherapy underscores the potential efficacy of this treatment modality in PPC management.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lipomatous intussusception in a 52-year-old man: A case report","authors":"Sarah Saleh ,&nbsp;Houssein Chebbo ,&nbsp;Amer yazbak ,&nbsp;Karam Karam ,&nbsp;Sarah Jalloul ,&nbsp;Lamia Azizi ,&nbsp;Pierre Hani","doi":"10.1016/j.hmedic.2025.100200","DOIUrl":"10.1016/j.hmedic.2025.100200","url":null,"abstract":"<div><div>Intussusception is a rare cause of abdominal pain in adults accounting to only 5 % of all intussusception cases. Most cases of adult intussusception are linked to an underlying lead point including neoplasm, polyps, Meckel’s diverticulum, strictures, and benign neoplasms. Colonic lipomas (CL) are a type of benign tumor of the colon composed of adipose tissue encapsulated by a fibrous layer that may result in intussusception, most commonly in the ascending colon. We herein present a case of a 52-year-old male patient presenting with diffuse abdominal pain, where further investigations revealed the diagnosis of colonic intussusception secondary to a 5 cm colon lipoma. Of note, the patient underwent colonoscopy a year ago and was normal. Subsequently, the patient underwent surgical removal of the lipoma through an ileo-cecal resection technique.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious colitis exacerbation following a single dose of Kayexalate","authors":"Philippe Attieh ,&nbsp;Karim Zodeh ,&nbsp;Antonio Al Hazzouri ,&nbsp;Sandra Rizk ,&nbsp;Karam Karam ,&nbsp;Mirna Fares ,&nbsp;Elias Fiani","doi":"10.1016/j.hmedic.2025.100199","DOIUrl":"10.1016/j.hmedic.2025.100199","url":null,"abstract":"<div><div>Kayexalate, an important treatment for hyperkalemia, especially in chronic renal failure, can be administered orally or as an enema. Potential side effects include constipation, vomiting, diarrhea, and nausea, with the most significant being colitis due to ulceration and wall perforation. This effect is most commonly observed in patients with chronic kidney disease. We report a case of a 76-year-old man known to have heart failure, hemiplegia and no history of chronic renal failure (CRF) who presented with septic shock and fever. A CT scan and colonoscopy revealed infectious colitis. He was admitted to the intensive care unit for monitoring and further management. One day later, laboratory results showed hyperkalemia that was likely due to acute renal failure (ARF) secondary to septic shock, and a single dose of 30 g of Kayexalate was administered to prevent life-threatening arrhythmias. However, two days later, the patient experienced worsening abdominal pain. A follow-up colonoscopy revealed worsening colitis, indicating an exacerbation of his condition due to Kayexalate. Medical management with antibiotics and adequate hydration was continued, leading to an improvement in his abdominal pain, then the patient was discharged. This case report highlights a rare occurrence of Kayexalate-worsening colitis after just a single dose in a patient with no history of kidney disease. It aims to raise awareness about avoiding even one dose of Kayexalate in patients with pre-existing colitis.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment resistant hyperammonemia in beta ketothiolase deficiency in an infant: A case report","authors":"Ifra Ahmed ,&nbsp;Jameela Anwar ,&nbsp;Munazza Iqbal ,&nbsp;Rana Uzair Ahmad ,&nbsp;Fatima Aslam","doi":"10.1016/j.hmedic.2025.100195","DOIUrl":"10.1016/j.hmedic.2025.100195","url":null,"abstract":"<div><h3>Background</h3><div>Beta-keto thiolase deficiency, also known as Alpha-methyl acetoacetic aciduria, T2 deficiency, 2-methyl acetoacetyl-CoA thiolase (MAT) deficiency, is a rare genetic organic aciduria caused by mitochondrial enzyme acetoacetyl-CoA thiolase (T2) deficiency that affects both ketone body metabolism and the catabolism of isoleucine, both of which are crucial for energy production.</div></div><div><h3>Case presentation</h3><div>A 12-month-old baby girl, meeting typical developmental milestones, presented with a wide range of symptoms, including altered sensorium, fever, rapid breathing, lethargy, and irritability over three days. History revealed consanguineous marriage between her parents and the death of an undiagnosed sibling. Physical examination showed a lethargic, pale, and dehydrated child with tachypnea and characteristic acidotic breath. Laboratory tests revealed anemia, severe metabolic acidosis with a high anion gap, hyperkalemia, and high serum ammonia. Urine organic acids analysis showed elevated levels of 2-methyl-3-hydroxybutyric acid and 3-hydroxybutyric acid, which confirmed the diagnosis of beta-keto thiolase deficiency.Genetic testing further supported this diagnosis by identifying an ANTXR2 gene mutation.</div></div><div><h3>Discussion</h3><div>A supportive treatment plan included adequate fluid to correct dehydration, bicarbonate to correct metabolic acidosis, and sodium benzoate to reduce ammonia levels. The patient was also advised to follow a protein-restricted diet and take biotin and sodium bicarbonate in the long run to manage the condition. With treatment, the patient's condition improved, and she began to achieve developmental milestones. However, the crisis affected her speech, and speech therapy was recommended.</div></div><div><h3>Conclusion</h3><div>This case report highlights the importance of early neonatal screening in Pakistan, particularly in light of the increasing rate of consanguineous marriages and the rising incidence of organic acidemias, which can lead to early diagnosis and prompt management.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical stress cardiomyopathy associated with intraoperative catecholamine administration: A case report","authors":"Syed H. Ali ,&nbsp;Huynh Pham ,&nbsp;Jamon Patterson ,&nbsp;Shangir Siddique ,&nbsp;Steven A. Alexander","doi":"10.1016/j.hmedic.2025.100197","DOIUrl":"10.1016/j.hmedic.2025.100197","url":null,"abstract":"<div><h3>Background</h3><div>Takotsubo syndrome (TTS), also known as stress cardiomyopathy, typically presents as apical ballooning in response to physical or emotional stress. However, atypical forms of stress cardiomyopathy can occur, such as mid-ventricular akinesis with apical sparing. Excessive catecholamine administration, particularly in a perioperative setting, is a known precipitant of this rare condition.</div></div><div><h3>Case presentation</h3><div>We present a case of a 48-year-old Caucasian woman who developed atypical stress cardiomyopathy following the administration of high-dose catecholamines to treat intraoperative hypotension during an elective esophageal myotomy. The patient received multiple intravenous vasopressors, including epinephrine, norepinephrine, phenylephrine, and vasopressin, resulting in severe myocardial stress. Postoperatively, the patient experienced hemodynamic instability with ECG changes and troponin elevation suggestive of non-ST elevation myocardial infarction (NSTEMI). However, coronary angiography revealed no obstructive coronary artery disease, and transthoracic echocardiogram (TTE) demonstrated mid-ventricular akinesis with preserved apical function, consistent with atypical TTS. The patient was managed conservatively with beta-blockers and ACE inhibitors, leading to recovery of left ventricular function on repeat imaging.</div></div><div><h3>Conclusion</h3><div>This case underscores the potential for high-dose catecholamines to induce atypical stress cardiomyopathy in the perioperative setting. Given the lack of obstructive coronary artery disease, the myocardial dysfunction was likely caused by catecholamine-induced myocardial stunning and excessive adrenergic stimulation. Recognition of this phenomenon is crucial for managing perioperative hypotension without exacerbating myocardial injury. Careful selection and titration of vasopressors may prevent the development of iatrogenic TTS in high-risk patients.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The “breathless heart” of a 38-year-old healthcare worker: A case report","authors":"Emmanouil Mantzouranis ,&nbsp;Panayotis K. Vlachakis ,&nbsp;Theofani Rimpa ,&nbsp;Ioannis Leontsinis ,&nbsp;Eleftheria Kakargia ,&nbsp;Stamatis Katsenos ,&nbsp;Ioannis Mamarelis ,&nbsp;Kyriakos Dimitriadis ,&nbsp;Konstantinos Tsioufis","doi":"10.1016/j.hmedic.2025.100188","DOIUrl":"10.1016/j.hmedic.2025.100188","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 has been associated with a wide spectrum of cardiovascular conditions. On the other hand, patients hospitalized with severe acute respiratory distress syndrome (ARDS) may often require long-term intubation. Laryngotracheal stenosis (LTS) is a well described complication of the latter, potentially leading to acute airway obstruction.</div></div><div><h3>Case summary</h3><div>We present the case of a 38-year-old healthcare worker with acute respiratory failure due to LTS as a complication of prior intubation for COVID-19. Emergent therapeutic bronchoscopy successfully treated airway obstruction. ECG alterations, accompanied by elevated troponin and wall motion abnormalities raised the suspicion for acute coronary syndrome, without signs of active infection. Coronary computed tomography angiography led to the diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA). Cardiac magnetic resonance (CMR) revealed patchy non-ischemic lesions. 3-month ECG and echocardiogram were normal suggesting Takotsubo syndrome (TTS) the most likely diagnosis. Patient was finally treated by implantation of an endotracheal silicone hourglass stent.</div></div><div><h3>Discussion</h3><div>Our case highlights the importance of multidisciplinary medical management. A definite diagnosis of TTS requires the performance of a CMR and the reversal of systolic dysfunction. LTS is a well described complication of long-term intubation and a high index of suspicion is warranted. Treatment is individualized including interventional treatments and surgical techniques.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech arrest as sole presenting symptom of midline seizures – A case report","authors":"Michael Fana,&nbsp;Ahmad Yusuf-Solaiman,&nbsp;Ahmad Riad Ramadan","doi":"10.1016/j.hmedic.2025.100190","DOIUrl":"10.1016/j.hmedic.2025.100190","url":null,"abstract":"<div><div>Speech arrest without impaired awareness poses diagnostic challenges with a broad differential. We describe the case of a 63-year-old male with chronic alcohol use, HIV, and diabetes who presented with speech arrest episodes with midline seizures identified on the electroencephalogram despite normal imaging. The patient’s condition was successfully managed with anti-epileptic medications. This case highlights the diagnostic complexity of midline seizures, particularly in patients with ambiguous clinical presentations.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-HMGCR myopathy secondary to statins diagnosed in the emergency department","authors":"Claire M. Halberg ,&nbsp;Matthew P. Lazio","doi":"10.1016/j.hmedic.2025.100194","DOIUrl":"10.1016/j.hmedic.2025.100194","url":null,"abstract":"<div><div>Statins (hydroxymethylglutaryl‐coenzyme A (HMG-CoA) reductase inhibitors) are a class of medication often used to control cholesterol levels. Anti-3-hydroxymethylglutaryl-coenzyme A reductase (anti-HMGCR) myopathy is a rare form of autoimmune myositis which presents as a result of statin therapy. In this report, we present the case of a 63-year-old male presenting to the emergency department (ED) with inability to ambulate, proximal muscle weakness, elevated creatine kinase (CK) and prior quadriceps muscle biopsy demonstrating highly active and chronic necrotizing myopathy. A presumptive diagnosis of anti-HMGCR myopathy was made in the ED, HMGCR antibody IgG was ordered, and was markedly elevated when it resulted a few days later. He was hospitalized and started on systemic corticosteroids and intravenous immunoglobulin (IVIG). He was ultimately discharged with home health, physical therapy, monthly IVIG infusions, prednisone taper starting at 80 mg daily, biweekly creatinine kinase measurements, and rheumatology and neurology follow-up. These measures successfully reduced his symptoms, and his mobility had increased at the time of follow-up to the point that he could again ambulate. Anti-HMGCR myopathy should remain on the emergency physician’s differential for a patient currently on or previously exposed to statins presenting with proximal muscle weakness.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rash that unraveled: A case report of DRESS syndrome in a 45-year-old woman","authors":"Aqsa Saleem ,&nbsp;Haris Waheed ,&nbsp;Sampana Fatima","doi":"10.1016/j.hmedic.2025.100192","DOIUrl":"10.1016/j.hmedic.2025.100192","url":null,"abstract":"<div><div>Drug rash with eosinophilia and systemic symptoms, which is a severe form of hypersensitivity drug reaction caused by drugs, is very difficult to recognize due to its insidious onset and non-specific symptoms. Such is the case with a 45-year-old female who presented to the emergency department with a fever reaching 38 °C, vomiting, diarrhea, and an erythematous maculopapular itchy rash on the trunk and extremities. The patient had a history of HTN, asthma, and chronic renal failure. Based on clinical evaluation and laboratory findings, DRESS syndrome was diagnosed and managed with hydrocortisone and glycerin, emphasizing the need for comprehensive clinical evaluation in every patient.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mad honey intoxication: A case report from eastern Nepal","authors":"Akash Roy ,&nbsp;Sumit Kumar Singh ,&nbsp;Suman Rijal ,&nbsp;Abinash Kumar Sah ,&nbsp;Anjan Nepali","doi":"10.1016/j.hmedic.2025.100189","DOIUrl":"10.1016/j.hmedic.2025.100189","url":null,"abstract":"<div><div>Mad honey poisoning, caused by ingestion of honey contaminated with grayanotoxins from specific rhododendron species, poses health risks in regions like Nepal, Turkey, Canada, and Japan. Grayanotoxins bind to sodium channels, leading to prolonged depolarisation and causing bradycardia and hypotension. Historically used in traditional medicine, mad honey’s recent recreational consumption has increased, leading to cases of intoxication from excessive use. We report a case of mad honey poisoning in a 53-year-old woman who consumed approximately 30 mL of honey bought from eastern Nepal, presenting with drowsiness, bradycardia, and hypotension. Despite initial stabilization with atropine, hydrocortisone, and fluid resuscitation, her condition required prolonged monitoring for 72 h. This case highlights the need to consider mad honey poisoning in patients presenting with altered sensorium or unexplained hypotension, even outside endemic regions. Efforts to raise public awareness, regulate honey sales, and improve diagnostic capabilities are essential to prevent and manage future cases. Further studies on toxin variability and rhododendron species in Nepal are also needed.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"11 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}