Clinical Case Reports最新文献

{"title":"Adrenal Crisis Induced by Viral Myocarditis Unveils Sheehan Syndrome at 16 Years Postpartum: A Case Report","authors":"Shivali Rao,&nbsp;Aakash Mishra,&nbsp;Pasang Sherpa,&nbsp;Keepa Manandhar,&nbsp;Lokesh Acharya,&nbsp;Isha Upadhyaya,&nbsp;Anwesha Pandey,&nbsp;Sujana Kc","doi":"10.1002/ccr3.71059","DOIUrl":"10.1002/ccr3.71059","url":null,"abstract":"<p>Sheehan's syndrome (SS) is a rare complication of postpartum hemorrhage. Here, we present a case of a 37-year-old female with Sheehan's syndrome who remained undiagnosed for 16 years and ultimately presented with an adrenal crisis that was precipitated by viral myocarditis. Clinicians should consider SS in patients with postpartum hemorrhage, regardless of the delivery setting, to prevent complications arising from delayed diagnosis, particularly in developing countries with limited access to obstetric care.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205957","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":"Cold Agglutinin Syndrome as the Initial Presentation of Acute Myeloid Leukemia: A Case Report","authors":"Mohsen Vakili Sadeghi,&nbsp;Zeinab Vosough,&nbsp;Davoud Jahansouz","doi":"10.1002/ccr3.71061","DOIUrl":"10.1002/ccr3.71061","url":null,"abstract":"<p>Cold agglutinin-mediated autoimmune hemolytic anemia, when secondary to viral and bacterial infections or, rarely, malignancy, is called cold agglutinin syndrome. This is the first case in which acute myeloid leukemia (AML) was the underlying cause of this syndrome. Here, we present a 64-year-old man with weight loss, jaundice, anemia, and a recent episode of red urine. The blood drawn from the patient clotted swiftly, and then the cold agglutinin test became positive. Bone marrow specimen microscopy revealed monocytic AML. Standard treatment resulted in clinical improvement, although he later faced progression to hyperleukocytosis and liver failure, which led to his death. This case emphasizes the necessity of maintaining a level of suspicion for underlying hematologic malignancies in individuals with secondary cold agglutinin-mediated hemolytic anemia. This is the first documented case of cold agglutinin syndrome related to AML, contributing to the growing knowledge of the connection between autoimmune hemolytic anemia and hematologic cancers.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205982","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":"Resection of Bilateral Endometriosis of the Uterosacral Ligaments Resolves Voiding Dysfunction: A Case Report","authors":"Viktória Szántó,&nbsp;Balázs Kenyeres,&nbsp;Miklós Koppán","doi":"10.1002/ccr3.70929","DOIUrl":"https://doi.org/10.1002/ccr3.70929","url":null,"abstract":"<p>Patients with deep endometriosis of the posterior pelvic compartment might present various lower urinary tract symptoms, including urinary retention, without any prior pelvic surgery in their medical history. These symptoms, including urinary retention, pollakiuria or urge incontinence, urinary urgency, and decreased bladder sensitivity, imply an infiltration of the pelvic autonomic nerves by endometriosis lesions, in combination with inflammatory phenomena. Although there are numerous publications dealing with de novo urinary dysfunction after endometriosis surgery, significantly less scientific information is available on the effect of endometriosis surgery specifically tailored to improve preoperative voiding dysfunction in endometriosis. Therefore, in this case report, we analyze the effect of laparoscopic endometriosis surgery in a 28-year-old nulliparous woman with serious preoperative urinary retention mandating clean intermittent self-catheterization three to four times daily. Patient history revealed neither prior pelvic nor abdominal operation, nor any neurological or other known disease. Uroflowmetry demonstrated significant voiding dysfunction. Filling cystometry showed signs of reduced bladder sensation (normal desire to void at 400 mL) along with preserved bladder compliance. During the pressure-flow study, the patient was unable to initiate micturition, although abdominal straining and detrusor contraction were registered. The cause of voiding dysfunction was deemed to be pelvic floor dysfunction (dysfunctional voiding) rather than detrusor underactivity. Alpha blocker, muscle relaxant therapy, and pelvic floor relaxation training were introduced, achieving poor short-term response. Transvaginal ultrasound examination showed hypoechogenic alterations on both uterosacral ligaments in the vicinity of their cervical attachment sites. These areas appeared to be painful while scanning with the probe. MRI examination confirmed the previous finding of transvaginal ultrasound with regard to bilateral alteration of the uterosacral ligaments characteristic of endometriosis. During laparoscopy, we confirmed the presence of endometriotic lesions of both uterosacral ligaments that were completely removed. The patient showed significantly improved emptying function following surgery. Uroflowmetry also demonstrated improved voiding parameters. We conclude that laparoscopic removal of endometriotic lesions of the uterosacral ligaments can significantly improve bladder function in patients suffering from preoperative voiding dysfunction.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70929","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224349","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":"Kartagener's Syndrome With Complications: Diagnostic Challenges in a Resource-Limited Setting","authors":"Nahid Afsar,&nbsp;A. K. M. Zahin,&nbsp;Md. Habib-E-Rasul,&nbsp;Md. Alfanuzzaman,&nbsp;A. M. Wadud Al Hasan","doi":"10.1002/ccr3.71064","DOIUrl":"10.1002/ccr3.71064","url":null,"abstract":"<p>Kartagener's Syndrome (KS) is a rare genetic disorder characterized by bronchiectasis, chronic sinusitis, and situs inversus. This case report presents a 14-year-old girl from rural Bangladesh diagnosed with KS, who exhibited progressive respiratory distress, recurrent sinus infections, and primary amenorrhea. Diagnostic imaging revealed dextrocardia, bronchiectasis, and pulmonary hypertension. The patient was managed with oxygen therapy, chest physiotherapy, antibiotics, bronchodilators, diuretics, and hormonal support. This case highlights the challenges of diagnosing KS in low-resource settings and emphasizes the importance of early diagnosis and multidisciplinary care to prevent disease progression and improve patient outcomes.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205994","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":"Unexpected Coronary Sinus Embolization of a Leadless Pacemaker due to Initial Device Failure: A Case Report","authors":"Yutaro Oshima,&nbsp;Tsuyoshi Nozue,&nbsp;Masahiro Katamine,&nbsp;Taku Iwaki","doi":"10.1002/ccr3.70984","DOIUrl":"https://doi.org/10.1002/ccr3.70984","url":null,"abstract":"<p>Leadless pacemakers reduce complications compared to transvenous systems, but device dislodgement and embolization can occur. We report an 81-year-old man with atrial fibrillation and bradycardia who underwent Micra implantation. Because of inner shaft damage and insufficient tine fixation, the device embolized into the coronary sinus. It was successfully retrieved using a double-snare technique, and a new device was implanted. This case highlights the importance of meticulous deployment technique and thorough intraprocedural assessment of device attachment, as well as troubleshooting strategies for unexpected embolization.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.70984","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224155","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":"Case of Severe Hiccups Causing SIADH, Treated With Lorazepam","authors":"Lisa Matlen","doi":"10.1002/ccr3.71048","DOIUrl":"10.1002/ccr3.71048","url":null,"abstract":"<p>This is a presentation of severe hiccups which led to the syndrome of inappropriate antidiuretic hormone (SIADH). The patient presented after 3 days of severe hiccups associated with vomiting and oral intake intolerance. SIADH was diagnosed by hyponatremia (initial 128 millimoles/liter (mmol/L), nadir 119 mmol/L; normal range 136–146 mmol/L) and urine studies; this was initially attributed to sertraline, but a 48-h medication hold did not improve sodium and caused withdrawal. An upper gastrointestinal (GI) study demonstrated mesenteroaxial gastric malrotation with hiatal hernia; these were non-operative. Hyponatremia was corrected with 3% sodium, fluid restriction, and urea; hiccups continued despite sodium correction to 138 mmol/L. Various treatments of hiccups including chlorpromazine, gabapentin, baclofen, metoclopramide, and antacids were trialed, but ultimately hiccups persisted for 11 days. Hiccups ceased following IV lorazepam administration, and sodium normalized thereafter. The patient was eventually able to discontinue all hyponatremia interventions post-discharge with continued normal sodium (138–142 mmol/L) upon 2 months of follow-up, and hiccups have remained in remission. Although other case reports have described hyponatremia causing hiccups whereby correcting the hyponatremia treated the hiccups, this is the first case demonstrating the reverse causal relationship. The anatomic findings of unusual GI anatomy (mesenteroaxial gastric malrotation with hiatal hernia) were assessed to be potential contributing factors to the refractory hiccups. The case also highlights the need to avoid anchoring to other common causes of SIADH, and supports a trial of lorazepam in refractory, severe hiccups.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205985","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":"Two Cases of Heterozygous Familial Hypercholesterolemia in Children Effectively Managed With Pitavastatin and Ezetimibe Combination Therapy","authors":"Katsufumi Nishioka,&nbsp;Sonoko Kondo,&nbsp;Kanako Irie,&nbsp;Takeo Kondo,&nbsp;Takashi Iwase,&nbsp;Ryosuke Tani,&nbsp;Tomoko Inoue,&nbsp;Keiji Matsunaga,&nbsp;Tetsuo Minamino,&nbsp;Takashi Kusaka","doi":"10.1002/ccr3.71018","DOIUrl":"10.1002/ccr3.71018","url":null,"abstract":"<p>Heterozygous familial hypercholesterolemia (HeFH) strongly predisposes individuals to atherosclerosis, including coronary artery disease, leading to death from cardiovascular diseases in &gt; 60% of untreated cases. Appropriate intervention from childhood is necessary. In Japan, only pitavastatin is approved for pediatric FH. A poor response to statins makes treatment challenging; optimal intervention may require combination therapy.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205658","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":"Gallbladder Cancer Concomitant With Para-Aortic Paraganglioma: A Case Report","authors":"Hisashi Murakami,&nbsp;Satoshi Okubo,&nbsp;Yutaro Naka,&nbsp;Noritaka Kudo,&nbsp;Yutaka Takazawa,&nbsp;Masahiro Kobayashi,&nbsp;Masaru Matsumura,&nbsp;Junichi Shindoh,&nbsp;Masaji Hashimoto","doi":"10.1002/ccr3.71066","DOIUrl":"10.1002/ccr3.71066","url":null,"abstract":"<p>Gallbladder cancer often presents a poor prognosis and can cause skip metastasis to the para-aortic lymph nodes. Accurate diagnosis is essential for appropriate treatment. We present the case of an 86-year-old male patient with gallbladder cancer initially suspected to have para-aortic lymph node metastasis. Intraoperative pathology of a para-aortic mass revealed that it was a paraganglioma (PGL); both tumors were successfully resected. The patient was discharged on the ninth postoperative day without complications and remained recurrence-free for 18 months. The final diagnosis was gallbladder adenocarcinoma (pT1a(M)pN0pM0, pStage I) and para-aortic PGL. Differentiating para-aortic masses in gallbladder cancer is crucial. Preoperative evaluations, including positron emission tomography-computed tomography and endoscopic ultrasound-fine needle biopsy, can enhance diagnostic accuracy. This case underscores the importance of considering PGL as a differential diagnosis of a para-aortic mass and the value of intraoperative pathology in guiding appropriate surgical interventions.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205932","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":"Spontaneous Pneumomediastinum in a Patient With Severe COVID-19 Pneumonia: A Case Report","authors":"Merga Daba Mulisa,&nbsp;Abel Tenaw Tasamma,&nbsp;Sebhatleab Teju Mulate,&nbsp;Eskedar Ferdu Azerefegne","doi":"10.1002/ccr3.71042","DOIUrl":"10.1002/ccr3.71042","url":null,"abstract":"<p>Pneumomediastinum is a rare complication of Coronavirus disease 2019 (COVID-19). It can occur spontaneously or as a complication of mechanical ventilation. Patients typically present with chest pain or shortness of breath. There are only a few case reports of pneumomediastinum complicating a course of COVID-19 pneumonia. Here, we present a case of a 35-year-old male patient who presented with shortness of breath for 3 days. Subsequent evaluation using polymerase chain reaction (PCR) and a chest computed tomography (CT) scan revealed severe COVID-19 pneumonia complicated by pneumomediastinum. He was managed conservatively for pneumomediastinum and was discharged with improvement.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205992","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":"Orthograde Endodontic Retreatment Following Apicoectomy and Resorption of Extruded MTA—A Case Report With 8-Year Follow-Up","authors":"Sumaya O. Basudan,&nbsp;Bashayer H. Baras","doi":"10.1002/ccr3.71024","DOIUrl":"10.1002/ccr3.71024","url":null,"abstract":"<p>Orthograde retreatment following unsuccessful apicoectomy is a valid treatment option instead of surgical retreatment. This case report details the successful orthograde retreatment of a 34-year-old female patient with persistent symptoms following prior apicoectomy without retrofilling materials and conventional root canal treatment. The mandibular left premolars (#44 and #45) had incomplete apical resections and lacked retrofilling materials, and a nonsurgical approach was chosen due to compromised periodontal conditions. Mineral Trioxide Aggregate (MTA) plugs were placed orthogradely, with unintentional extrusion into the periapical tissues. Despite this, an 8-year follow-up revealed complete resolution of periapical radiolucencies, re-establishment of the lamina dura, and resorption of the extruded MTA. This case highlights the efficacy of orthograde retreatment with MTA plugs in achieving periapical healing, even after failed apicoectomy. Moreover, MTA extrusion may heal satisfactorily without compromising the outcome. Relevant literature is also discussed.</p>","PeriodicalId":10327,"journal":{"name":"Clinical Case Reports","volume":"13 10","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205938","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}