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Recurrent ischemic strokes in a patient with ITP: A case report ITP患者复发性缺血性卒中1例报告

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-08-16 DOI: 10.1016/j.hmedic.2025.100343

Ahmad S. Ali , Yaqian Xu , Walter Husar

{"title":"Recurrent ischemic strokes in a patient with ITP: A case report","authors":"Ahmad S. Ali , Yaqian Xu , Walter Husar","doi":"10.1016/j.hmedic.2025.100343","DOIUrl":"10.1016/j.hmedic.2025.100343","url":null,"abstract":"<div><h3>Background</h3><div>Primary Immune Thrombocytopenia (ITP) is typically associated with bleeding risks due to thrombocytopenia. However, paradoxical thrombotic events such as stroke may occur in rare cases, posing a clinical dilemma in management.</div></div><div><h3>Case presentation</h3><div>We present the case of a 65-year-old male with a history of ITP and recurrent venous thromboembolism who experienced multiple ischemic strokes despite therapeutic anticoagulation. The initial presentation revealed subacute bilateral frontal infarcts while on Rivaroxaban, with extensive workup suggesting a cryptogenic stroke etiology. The patient was subsequently switched to Warfarin and treated for ITP with steroids and Rituximab, resulting in improved platelet counts. Eight months later, he suffered a pontine infarct despite therapeutic INR. His anticoagulation goal was adjusted, and he remained stroke-free on close follow-up.</div></div><div><h3>Discussion:</h3><div>This case highlights the underrecognized thrombotic risk in ITP patients and the challenges in balancing anticoagulation with bleeding risk. Mechanisms may include increased platelet microparticles and immune-mediated endothelial injury. The individualized INR target and ITP treatment strategy led to improved clinical outcomes.</div></div><div><h3>Conclusion</h3><div>ITP can predispose patients to thrombotic complications such as stroke, even in the setting of thrombocytopenia. Personalized anticoagulation goals and multidisciplinary care are critical for optimal management. Further studies are needed to establish standardized treatment guidelines for this unique patient population.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100343"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157642","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}

引用次数: 0

A rare case of fibro-thecoma mimicking ovarian malignancy: Diagnostic challenges and surgical management 一例罕见的纤维瘤模拟卵巢恶性肿瘤：诊断挑战和手术处理

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-07-26 DOI: 10.1016/j.hmedic.2025.100327

Hafsa Taheri , Oussama lamzouri , Youssef Aloua , Hanane Saadi , Ahmed Mimouni

引用次数: 0

Homozygous DEAF1 mutation with developmental delay, microcephaly, and optic atrophy – A case report 纯合子DEAF1突变伴发育迟缓、小头畸形和视神经萎缩1例报告

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-08-28 DOI: 10.1016/j.hmedic.2025.100349

Aisha Shahid , Umer Shahid , Reet Ramani , Zubaid Moazzam Sheikh , Ubaid Shahid , Saba Safdar

{"title":"Homozygous DEAF1 mutation with developmental delay, microcephaly, and optic atrophy – A case report","authors":"Aisha Shahid , Umer Shahid , Reet Ramani , Zubaid Moazzam Sheikh , Ubaid Shahid , Saba Safdar","doi":"10.1016/j.hmedic.2025.100349","DOIUrl":"10.1016/j.hmedic.2025.100349","url":null,"abstract":"<div><h3>Background</h3><div>Significant developmental difficulties are frequently caused by neurodevelopmental diseases, which are frequently brought on by environmental causes and genetic mutations. The DEAF1 gene is associated with serious neurological disorders and is essential for brain development. The purpose of this study is to investigate the potential effects of a homozygous mutation in the DEAF1 gene on developmental delays, specifically in consanguineous families, using the example of a 1.5-year-old boy.</div></div><div><h3>Methods and results</h3><div>A harmful mutation in the DEAF1 gene (c.1051C>T p.(Arg351Ter)) was discovered by genetic research. The child had generalized epileptic activity, optic atrophy, microcephaly, and global developmental delay. There was no discernible developmental improvement even after getting antiepileptic medication, occupational therapy, and physical therapy. Similar developmental difficulties were also shown by a first cousin, suggesting a close genetic connection. Genetic testing and thorough neurological examinations were among the evaluations.</div></div><div><h3>Conclusions</h3><div>The difficulties in treating neurodevelopmental abnormalities linked to the DEAF1 gene are highlighted by this example. The particular mutation emphasizes how important it is for developmental outcomes. The results highlight the value of preventive testing and genetic counseling in consanguineous relationships. Because of the severity of the mutation, the prognosis is still unknown even after intensive multidisciplinary care. All things considered, this instance highlights the need for more research in this field and offers insightful information on how DEAF1 mutations affect neurodevelopmental diseases.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100349"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913139","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}

引用次数: 0

Angiosarcoma unveiled: A rare case of arteriovenous fistula post kidney transplantation 血管肉瘤揭幕：肾移植术后罕见的动静脉瘘病例

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-09-05 DOI: 10.1016/j.hmedic.2025.100365

Maher Salloum , Batoul Abbas , Michael Khoury , Zaki Samia , Mona Youssef , Karam Karam , Maroun Abou-Jawde

引用次数: 0

Acute hepatitis A and E virus dual infection in a beta thalassemia major child complicated with hypocalcemia and secondary hyperparathyroidism: A case report 急性甲型和戊型肝炎病毒双重感染合并低钙血症和继发性甲状旁腺功能亢进1例

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-07-30 DOI: 10.1016/j.hmedic.2025.100331

Ayesha Mukhtar Rathore, Junaid Saleem, Inzimam ul Haq

{"title":"Acute hepatitis A and E virus dual infection in a beta thalassemia major child complicated with hypocalcemia and secondary hyperparathyroidism: A case report","authors":"Ayesha Mukhtar Rathore, Junaid Saleem, Inzimam ul Haq","doi":"10.1016/j.hmedic.2025.100331","DOIUrl":"10.1016/j.hmedic.2025.100331","url":null,"abstract":"<div><div>Hepatitis A (HAV) and E (HEV) dual infection, though rare and self-limiting, can lead to acute liver failure, particularly in high-risk patients such as those with beta-thalassemia major. This case report presents a 16-year-old male with beta-thalassemia major and no prior liver disease who presented to the outpatient department with a week's history of low-grade fever, jaundice, and dyspnea. Upon thorough investigation, dual-infection with hepatitis A and hepatitis E virus was found complicated by hypocalcemia (Ca = 4 mg/dl) and secondary hyperparathyroidism (PTH = 80 pg/dl). The diagnosis was confirmed through serology and laboratory findings, including elevated liver enzymes, low serum calcium, and high parathyroid hormone levels. He received aggressive supportive management, including intravenous hydration, syrup Hepa Merz (L-Ornithine, L-Aspartate) twice daily for seven days, folic acid supplementation for beta thalassemia, paracetamol for symptom relief, and intravenous calcium twice infusion over the span of seven days, leading to full recovery and discharge on oral calcium supplements. This case highlights the potential severity of HAV/HEV dual infection in thalassemia patients, emphasizing the need for prompt diagnosis, electrolyte monitoring, and aggressive supportive care. Additionally, it underscores the importance of preventive strategies, including HAV vaccination, improved hygiene, safe water and food practices and awareness and education. The report contributes to the limited literature on metabolic complications (hypocalcemia, secondary hyperparathyroidism) in such dual infections and reinforces the necessity of early intervention in high-risk populations. It also highlights the necessity of more research on the complications of dual infection with HAV and HEV in a beta-thalassemia major patient.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100331"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757445","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}

引用次数: 0

The forgotten double J ureteral stent complicated with large urinary bladder calculus formation: A case report 遗忘双J输尿管支架合并大膀胱结石1例

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-09-03 DOI: 10.1016/j.hmedic.2025.100360

Naqiuddin Mohd Fazali , Zaitul Azra Mohd Nasir , Mohamed Ashraf Mohamed Daud , Wan Fatihah Wan Sohaimi , Nur Asma Sapiai

引用次数: 0

Hemophagocytic lymphohistiocytosis in association with acute respiratory distress syndrome in the setting of influenza B infection 嗜血淋巴组织细胞增多症与乙型流感感染的急性呼吸窘迫综合征有关

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-09-24 DOI: 10.1016/j.hmedic.2025.100379

Abdelkader Dib , Johny Salem , Mirna Fares

引用次数: 0

Melkersson–Rosenthal syndrome masquerading as mucocutaneous leishmaniasis in a high leishmaniasis-burden area: A case report 在利什曼病高负担地区伪装成皮肤粘膜利什曼病的梅尔克森-罗森塔尔综合征：一个病例报告

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-11-18 DOI: 10.1016/j.hmedic.2025.100389

Mikias Woldetensay Woldemeleak , Suleiman Ayalew Belay , Ermias Teklehaimanot Yefter , Zelallem Aniley Workneh

{"title":"Melkersson–Rosenthal syndrome masquerading as mucocutaneous leishmaniasis in a high leishmaniasis-burden area: A case report","authors":"Mikias Woldetensay Woldemeleak , Suleiman Ayalew Belay , Ermias Teklehaimanot Yefter , Zelallem Aniley Workneh","doi":"10.1016/j.hmedic.2025.100389","DOIUrl":"10.1016/j.hmedic.2025.100389","url":null,"abstract":"<div><div>Melkersson–Rosenthal syndrome (MRS) is a rare neuro-mucocutaneous disorder characterized by the classical triad of recurrent orofacial swelling, peripheral facial palsy, and fissured tongue, although the complete presentation is uncommon. In regions where infectious diseases with overlapping manifestations are endemic, such as mucocutaneous leishmaniasis (MCL), MRS may be easily misdiagnosed. We present the case of a 30-year-old Ethiopian man with a 16-year history of recurrent, painless lip swelling initially treated as MCL without clinical improvement. Examination revealed firm swelling of the upper and right lower lips, a geographic tongue, and right-sided peripheral facial palsy. A prior lip biopsy had been interpreted as pemphigus vulgaris, further contributing to diagnostic delay. The presence of the complete clinical triad ultimately led to a diagnosis of MRS. The patient was managed with systemic corticosteroids, doxycycline, and intralesional triamcinolone acetonide, achieving significant improvement after three months and sustained response at six months. This case underscores the diagnostic challenges of MRS in leishmaniasis-endemic regions and highlights the importance of recognizing the classical triad to avoid misdiagnosis and facilitate timely, effective treatment.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100389"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578919","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}

引用次数: 0

Persistent crisis of fetal alcohol spectrum disorder in South Africa: Time for decisive action 南非胎儿酒精谱系障碍的持续危机：采取果断行动的时候了

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-08-26 DOI: 10.1016/j.hmedic.2025.100352

Babatope O. Adebiyi , Ferdinand C. Mukumbang

{"title":"Persistent crisis of fetal alcohol spectrum disorder in South Africa: Time for decisive action","authors":"Babatope O. Adebiyi , Ferdinand C. Mukumbang","doi":"10.1016/j.hmedic.2025.100352","DOIUrl":"10.1016/j.hmedic.2025.100352","url":null,"abstract":"<div><div>Fetal Alcohol Spectrum Disorder (FASD) represents a critical public health challenge in South Africa (SA), where the prevalence is among the highest worldwide. This commentary highlights the urgent need for coordinated, multifaceted approaches to address FASD, with prevalence rates as high as 310 per 1000 individuals, particularly in rural communities. Factors contributing to this high prevalence include historical practices like the \"dop system,\" pervasive poverty, limited healthcare access, and social norms around alcohol use. The consequences of FASD are profound, leading to lifelong impairments and significant economic impacts. Alcohol-related harms cost SA around 65–104 billion Rand annually. Despite the magnitude of the issue, SA lacks a comprehensive national strategy, resulting in fragmented services and care gaps. To mitigate this crisis, a combination of prevention, early diagnosis, and community-based interventions is essential. Suggested strategies include public awareness campaigns, integration of FASD prevention into primary healthcare, enhanced diagnostic services, and community empowerment initiatives. A national response involving government agencies, healthcare providers, educational institutions, community organizations, and private sector stakeholders is imperative. With sustained commitment, South Africa can substantially reduce the burden of FASD, ensuring a healthier future for its communities.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100352"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916311","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}

引用次数: 0

Triple attack: Cytomegalovirus, mycobacterium avium complex and aspergillus co-infection presenting as a cavitary pulmonary lesion in a patient with human immunodeficiency virus 三重攻击：巨细胞病毒、鸟分枝杆菌复合体和曲霉菌共同感染，在人类免疫缺陷病毒患者中表现为肺空洞性病变

Medical Reports Pub Date : 2025-12-01 Epub Date: 2025-08-24 DOI: 10.1016/j.hmedic.2025.100350

Ryan Njeim , Michel Al-Achkar , Wei Xue , Allison Glaser

{"title":"Triple attack: Cytomegalovirus, mycobacterium avium complex and aspergillus co-infection presenting as a cavitary pulmonary lesion in a patient with human immunodeficiency virus","authors":"Ryan Njeim , Michel Al-Achkar , Wei Xue , Allison Glaser","doi":"10.1016/j.hmedic.2025.100350","DOIUrl":"10.1016/j.hmedic.2025.100350","url":null,"abstract":"<div><h3>Background</h3><div>Opportunistic infections are a significant concern in immunocompromised patients, particularly those with human immunodeficiency virus (HIV). The diagnosis of these infections can be challenging due to overlapping clinical and radiological findings.</div></div><div><h3>Case description</h3><div>We report a rare case of triple co-infection by cytomegalovirus (CMV), Mycobacterium chimaera, and Aspergillus fumigatus causing pneumonia with a cavitary lesion in a 43-year-old HIV-infected female, non-adherent to antiretroviral therapy. Chest imaging revealed a left upper lobe cavitary lesion with ground-glass opacities. Serum CMV PCR was strongly positive. Bronchoscopic biopsy showed Aspergillus and focal CMV pneumonia, while post-discharge culture grew Aspergillus and Mycobacterium chimaera. The patient was treated with intravenous ganciclovir and voriconazole, then discharged on oral medications with plans for MAC treatment.</div></div><div><h3>Conclusion</h3><div>This case represents the first reported triple co-infection of its kind, particularly noteworthy given the patient's CD4 count above 50 cells/mm³ . It underscores the importance of comprehensive diagnostic workup and highlights the challenges in managing multiple opportunistic infections in severely immunocompromised individuals.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100350"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896264","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}

引用次数: 0