Journal of medical cases最新文献_第9页

Catastrophic Antiphospholipid Syndrome in a Lupus Patient With Severe Recurrent Life-Threatening Clinical Manifestations. 一名红斑狼疮患者出现严重的抗磷脂综合征，并反复出现危及生命的临床表现。

Journal of medical cases Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.14740/jmc4255

Abdulrahman Ali M Khormi, Maged Ba Gunaid, Mohammed Fayyad, Mostafa Mohrag, Ali Abdullah AlAseeri

引用次数: 0

Navigating a Complex Case of Hypoplastic Right Lung With Bronchiectasis: A Ten-Year Journey. 探索右肺发育不良伴支气管扩张的复杂病例：十年历程。

Journal of medical cases Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.14740/jmc4283

Muhammad Umer Riaz Gondal, Grant Gillespie, Fawwad Ansari, Swarup Sharma Rijal, Zainab Kiyani, Ayushi Lalwani, Toqeer Khan, Syed Ayan Zulfiqar Bokhari, Ayushma Acharya, Ryan Zimmerman

{"title":"Navigating a Complex Case of Hypoplastic Right Lung With Bronchiectasis: A Ten-Year Journey.","authors":"Muhammad Umer Riaz Gondal, Grant Gillespie, Fawwad Ansari, Swarup Sharma Rijal, Zainab Kiyani, Ayushi Lalwani, Toqeer Khan, Syed Ayan Zulfiqar Bokhari, Ayushma Acharya, Ryan Zimmerman","doi":"10.14740/jmc4283","DOIUrl":"10.14740/jmc4283","url":null,"abstract":"Unilateral pulmonary hypoplasia (UPH) is a rare congenital disorder that presents rarely in adulthood. Most patients succumb to complications at a young age, and those who survive are rare and susceptible to frequent lifelong pulmonary infections. It has a high infant mortality rate. We present the case of a 66-year-old male with rheumatoid arthritis and severe persistent asthma who first presented to our emergency department in 2013 with worsening shortness of breath. Chest imaging with a computed tomography (CT) scan revealed right hemithorax volume loss with hypoplasia, honeycomb lung formation, and right mediastinal shift. He was treated with prednisone, inhalers, and antibiotics for asthmatic bronchitis. He continued to suffer frequent hospital admissions (56 to our hospital alone) over the next decade for pneumonia and asthma exacerbations. The hypoplastic right lung was deemed to be contributing to recurrent infections/inflammation, and he is currently being re-evaluated for a right pneumonectomy, as surgical resection is an option for localized bronchiectasis associated with recurrent respiratory infections.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 10","pages":"257-260"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335959","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}

引用次数: 0

Role of Continuous Drainage of Tense Ascites in Peritoneal Dialysis: Mehandru/Masud Technique. 腹膜透析中持续引流张力性腹水的作用：Mehandru/Masud 技术。

Journal of medical cases Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.14740/jmc4056

Sushil K Mehandru, Supreet Kaur, Avais Masud, Kyrillos Rezkalla, Qalb Khan, Prit Paul Singh, Eric Constanzo, Walid Abboud, Tushar Vachharajani, Arif Asif

{"title":"Role of Continuous Drainage of Tense Ascites in Peritoneal Dialysis: Mehandru/Masud Technique.","authors":"Sushil K Mehandru, Supreet Kaur, Avais Masud, Kyrillos Rezkalla, Qalb Khan, Prit Paul Singh, Eric Constanzo, Walid Abboud, Tushar Vachharajani, Arif Asif","doi":"10.14740/jmc4056","DOIUrl":"10.14740/jmc4056","url":null,"abstract":"Insertion of a peritoneal dialysis (PD) catheter in end-stage renal disease (ESRD) patients with cirrhosis and tense ascites remains a challenge for nephrologists. Ascitic fluid leak at the surgical site, a common postoperative occurrence, leads to the disqualification of many patients who could be otherwise great candidates for PD. The ascitic fluid leak has been described to occur during or immediately after surgery even after the entire volume of ascitic fluid has been drained. In this study, we report a case study of three patients with ESRD, liver cirrhosis, and tense ascites on hemodialysis. The patients required super large volume paracentesis (SLVP), draining 9,000 - 15,000 cc of ascitic fluid twice weekly in an interventional radiology setup. Besides ascitic fluid drainage, the patients needed in-center hemodialysis (ICHD) 3 days a week, leading to their engagement in procedures 5 days a week. In addition, intradialytic symptomatic hypotension, hypoalbuminemia, and other adverse effects of hemodialysis lead to their poor lifestyle. To improve their lifestyle, all patients desired to switch to PD from ICHD. Upon the PD catheter insertion and drainage of the entire ascitic fluid, leaks developed at the insertion site within a few hours. To overcome these leaks, PD catheters of all three patients were attached via a transfer set to a bag for continuous drainage of ascitic fluid for about 2 weeks. No leak or complication was noted, leading to complete healing of insertion site. We recommend, for the patients with tense ascites requiring SLVP, approximately 2 weeks of healing period continuously be performed till initiation of PD training,.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 10","pages":"287-296"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335961","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}

引用次数: 0

Combination Therapy With Asciminib and Ponatinib as a Bridge to Brexucabtagene Autoleucel and Maintenance in a Patient With Relapsed Refractory Philadelphia Positive B-Cell Acute Lymphoblastic Leukemia. 将阿西米尼和泊纳替尼联合疗法作为一名复发难治性费城阳性B细胞急性淋巴细胞白血病患者通往布雷克巴肽自体白血病和维持治疗的桥梁

Journal of medical cases Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.14740/jmc4287

Alina Amin Muhammad, Erum Mir Ghazi, Amir Ali, Eric Tam, Karrune Woan, Preet Chaudhary, George Yaghmour, Abdullah Ladha

{"title":"Combination Therapy With Asciminib and Ponatinib as a Bridge to Brexucabtagene Autoleucel and Maintenance in a Patient With Relapsed Refractory Philadelphia Positive B-Cell Acute Lymphoblastic Leukemia.","authors":"Alina Amin Muhammad, Erum Mir Ghazi, Amir Ali, Eric Tam, Karrune Woan, Preet Chaudhary, George Yaghmour, Abdullah Ladha","doi":"10.14740/jmc4287","DOIUrl":"10.14740/jmc4287","url":null,"abstract":"Tyrosine kinase inhibitors (TKIs) have changed the prognosis of Philadelphia-positive B-cell acute lymphoblastic leukemia (ALL); however, relapsed and refractory disease after multiple TKIs continues to be a clinical challenge. Brexucabtagene autoleucel (brexu-cel) is a novel FDA-approved therapy for relapsed and refractory ALL. Given the lengthy manufacturing time, bridging therapy is commonly employed prior to brexu-cel. Here we describe a case of a 75-year-old Hispanic male patient with relapsed/refractory Philadelphia-positive B-cell ALL with extramedullary disease involving abdominal lymph nodes and skin. He was initially treated with chemotherapy in combination with imatinib, and later received dasatinib and subsequently blinatumomab and nilotinib. As the patient progressed, he received ponatinib with low-dose salvage chemotherapy and did not show kinase domain mutation. In a final effort, a novel combination of ponatinib with asciminib was used as a bridge therapy before brexu-cel and later as maintenance therapy after brexu-cel. This novel combination was able to control disease prior to brexu-cel for 2 months and maintained remission for at least 10 months. This report shows that the novel combination of ponatinib and asciminib is tolerable and effective as a bridge and maintenance therapy after brexu-cel.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 10","pages":"261-266"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335956","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}

引用次数: 0

Double Segmental Femoral Fracture: A Rare Injury Following High-Energy Trauma. 双节段股骨骨折：高能量创伤后的罕见损伤

Journal of medical cases Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.14740/jmc4298

Athanasios Galanis, Michail Vavourakis, Spyridon Karampitianis, Panagiotis Karampinas, Evangelos Sakellariou, Georgios Tsalimas, Iordanis Varsamos, Angelos Kaspiris, Elias Vasiliadis

{"title":"Double Segmental Femoral Fracture: A Rare Injury Following High-Energy Trauma.","authors":"Athanasios Galanis, Michail Vavourakis, Spyridon Karampitianis, Panagiotis Karampinas, Evangelos Sakellariou, Georgios Tsalimas, Iordanis Varsamos, Angelos Kaspiris, Elias Vasiliadis","doi":"10.14740/jmc4298","DOIUrl":"10.14740/jmc4298","url":null,"abstract":"Femoral fractures are indubitably common injuries that can occur either from high-energy trauma in young patients or due to fragility in the geriatric population. Femoral fractures affecting two or more regions of the femur are exceedingly infrequent injuries, ordinarily caused by high-energy trauma and are considered segmental femoral fractures. We present a rare case of a 33-year-old male patient presented to our Emergency Department with multiple femoral fractures at the subtrochanteric, diaphyseal and supracondylar femoral regions, a condition regarded as double segmental femoral fracture. After assiduous consideration of treatment options, intramedullary nailing was employed for osteosynthesis. Fracture reduction was laborious, as an entirely separated femoral fragment was present between the fracture lines. The reaming process required paramount attentiveness as the middle femoral fragment was prone to rotational displacement by the reamer. Finally, the intramedullary nail was successfully placed, and the patient was discharged without complications after 11 days of hospitalization. Currently, the patient is capable of full weight-bearing without crutches. This paper underlines the challenges that double-segmental femoral fractures' treatment can bring on to the orthopedic surgeon.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 10","pages":"297-303"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335957","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}

引用次数: 0

Graves' Disease Associated With Pulmonary Hypertension and Cardiac Arrest. 与肺动脉高压和心脏骤停有关的巴塞杜氏病

Journal of medical cases Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.14740/jmc4289

Archana Rajagopal Nair, Mitra Asadi, Sheikh Arshad, Suresh P Jain, Aditya Mangla, Zoran Lasic

引用次数: 0

Orogastric Tube Fracture and Ingestion in a Patient With Hyperacute Delirium: A Unique and Potentially Catastrophic Complication. 超急性谵妄患者逆胃管断裂和吞咽：一种独特的潜在灾难性并发症。

Journal of medical cases Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.14740/jmc4295

Lefika Bathobakae, Shaimaa Elshaarawy, Rammy Bashir, Phenyo Phuu, Gabriel Melki, Bassam Hajjar

引用次数: 0

Hemophagocytic Lymphohistiocytosis Secondary to Acute Human Immunodeficiency Virus and COVID-19. 嗜血细胞淋巴组织细胞增多症继发于急性人类免疫缺陷病毒和 COVID-19。

Journal of medical cases Pub Date : 2024-09-01 Epub Date: 2024-08-10 DOI: 10.14740/jmc4226

Selia Chowdhury, Harshavardhan Sanekommu, Paula Gonzalez, Evgeniya Angelova, Swapnil Patel

{"title":"Hemophagocytic Lymphohistiocytosis Secondary to Acute Human Immunodeficiency Virus and COVID-19.","authors":"Selia Chowdhury, Harshavardhan Sanekommu, Paula Gonzalez, Evgeniya Angelova, Swapnil Patel","doi":"10.14740/jmc4226","DOIUrl":"https://doi.org/10.14740/jmc4226","url":null,"abstract":"Hemophagocytic lymphohistiocytosis (HLH), characterized by acute and progressive hyperinflammation, is a rare syndrome documented in a limited number of coronavirus disease 2019 (COVID-19) and human immunodeficiency virus (HIV) cases. While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can provoke extensive immune activation and systemic inflammation, individuals with HIV, susceptible to immune dysregulation, are at heightened risk of severe complications from SARS-CoV-2. We report a case of a 24-year-old male with no significant medical history presenting with fever, weight loss, respiratory symptoms, and acute renal failure. Initial diagnosis revealed HIV with a CD4 count < 20 and concurrent COVID-19 infection leading to development of HLH. Despite aggressive management including antiretroviral therapy (ART), dexamethasone and supportive care, the patient deteriorated rapidly, leading to multiorgan failure. Coinfection with HIV and SARS-CoV-2 presents unique challenges, especially when complicated by secondary conditions such as HLH, which remains a diagnostic and therapeutic dilemma. Prompt recognition and aggressive management are crucial, necessitating a high index of suspicion and comprehensive evaluation including bone marrow biopsy to improve diagnostic accuracy and guide therapeutic interventions in such complex scenarios.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 9","pages":"222-226"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116824","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}

引用次数: 0

Unexpected Rasburicase-Induced Hemolysis in a Patient With Normal Glucose-6-Phosphate Dehydrogenase Activity. 一名葡萄糖-6-磷酸脱氢酶活性正常的患者意外发生拉斯布酶诱导的溶血。

Journal of medical cases Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.14740/jmc4277

Saba Musleh Ud Din, Khine Shan, Tauseef Ur Rehman, Stanislav Ivanov, Fernando M Vargas-Madueno

{"title":"Unexpected Rasburicase-Induced Hemolysis in a Patient With Normal Glucose-6-Phosphate Dehydrogenase Activity.","authors":"Saba Musleh Ud Din, Khine Shan, Tauseef Ur Rehman, Stanislav Ivanov, Fernando M Vargas-Madueno","doi":"10.14740/jmc4277","DOIUrl":"https://doi.org/10.14740/jmc4277","url":null,"abstract":"Tumor lysis syndrome (TLS) presents significant challenges in oncology, primarily due to metabolic complications such as hyperuricemia, which can lead to acute kidney injury. Rasburicase, a recombinant urate oxidase, is frequently employed to manage hyperuricemia in TLS patients. However, its use is an absolute contraindication in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency due to the risk of hemolysis. In this case, the patient developed hemolytic anemia post-rasburicase administration even though she had normal G6PD activity, which was confirmed on two separate occasions, including during an acute episode and 3 months later. This case is unique as it documents hemolytic anemia induced by rasburicase in a patient without G6PD deficiency, challenging current understandings of the drug's safety profile. It suggests the need for caution and thorough screening before rasburicase use, even in patients considered low risk for G6PD deficiency. The report highlights the importance of close monitoring for adverse effects and the potential for alternative mechanisms of rasburicase-induced hemolysis.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 9","pages":"231-236"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116827","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}

引用次数: 0

Intraoperative Takotsubo Syndrome. 术中 Takotsubo 综合征。

Journal of medical cases Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.14740/jmc4293

Gentian Huti, Filadelfo Coniglione, Alert Drishti, Mustafa Bajraktari, Alert Xhaja, Asead Abdyli, Krenar Lilaj, Diamant Lulaj, Rudin Domi

{"title":"Intraoperative Takotsubo Syndrome.","authors":"Gentian Huti, Filadelfo Coniglione, Alert Drishti, Mustafa Bajraktari, Alert Xhaja, Asead Abdyli, Krenar Lilaj, Diamant Lulaj, Rudin Domi","doi":"10.14740/jmc4293","DOIUrl":"https://doi.org/10.14740/jmc4293","url":null,"abstract":"Takotsubo cardiomyopathy is a rare condition that presents a diagnostic challenge due to its close resemblance to acute myocardial ischemia and other cardiac disorders. The excessive production of catecholamines triggers abnormal and severe changes in the myocardium, typically resulting in significant dyskinesia of the left ventricle's apex, reduced ejection fraction, hypotension, and pulmonary edema. Recent reports suggest that potential risk factors may include postmenopausal syndrome and intense, unexpected stress, whether related to life events or medical conditions. Complications such as heart failure, thrombosis, and severe arrhythmias are infrequent and more likely to occur in patients with pre-existing cardiac conditions. We present the case of a 22-year-old woman who developed intraoperative Takotsubo cardiomyopathy during a transsphenoidal resection of a prolactin-secreting pituitary tumor under general anesthesia. Perioperative combination of cabergoline and oxymetazoline induced intraoperative hypertension, pulmonary edema, and Takotsubo stress cardiomyopathy. To our knowledge, this is the first reported case in the literature of intraoperative Takotsubo cardiomyopathy, potentially linked to the specific combination of intraoperative cabergoline and oxymetazoline.","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"15 9","pages":"242-249"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116825","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}

引用次数: 0