European journal of case reports in internal medicine最新文献

{"title":"Successful Bevacizumab Therapy in a 25-Year-Old Patient with Recurrent Respiratory Papillomatosis.","authors":"Gita Dambrova, Zaiga Kravale, Dace Žentiņa, Andra Krūmiņa","doi":"10.12890/2024_004840","DOIUrl":"10.12890/2024_004840","url":null,"abstract":"<p><strong>Background: </strong>Recurrent respiratory papillomatosis (RRP) is a chronic condition caused primarily by human papilloma virus (HPV) types 6 and 11, leading to recurrent growths in the respiratory tract. These types of papilloma can cause significant morbidity due to airway obstruction, often requiring frequent surgical interventions. Traditional treatments, including surgical removal and adjunctive therapies like antivirals and immune modulators, often fail to prevent recurrence, impacting the patient's quality of life.</p><p><strong>Case description: </strong>This report presents a 25-year-old female with a long-standing history of RRP, diagnosed at age 2. Despite numerous interventions, including CO₂ laser ablations, interferon therapy, HPV vaccination, and a laryngotomy with tracheal reconstruction, the patient continued to experience severe airway obstruction requiring frequent surgeries. In 2023, intravenous therapy with bevacizumab, vascular endothelial growth factor inhibitor was introduced, leading to a significant reduction in the frequency of surgical interventions from 8 to 4 per year. This reduction improved the patient's respiratory function and quality of life, highlighting bevacizumab's therapeutic potential.</p><p><strong>Conclusion: </strong>The case underscores the debilitating nature of RRP and the challenges of its management. Bevacizumab, by targeting vascular endothelial growth factor (VEGF), has shown promise in reducing papilloma growth and the need for frequent surgeries. This case supports the inclusion of bevacizumab as an adjunctive therapy in RRP treatment, warranting further research to confirm its long-term efficacy and safety.</p><p><strong>Learning points: </strong>Recurrent respiratory papillomatosis is a rare and complex disease that severely impacts patients' quality of life.This case report demonstrates that bevacizumab can significantly reduce surgical interventions in recurrent respiratory papillomatosis (RRP), offering a promising treatment that improves management of this chronic condition.Bevacizumab, already used in treating various diseases by targeting VEGF, shows promise in managing RRP as well, highlighting its potential across multiple conditions and expanding its therapeutic versatility.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380360","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":"Revealing the Unanticipated: An Uncommon Case of Colorectal Adenocarcinoma Transitioning to Choriocarcinoma - A Case Report and Literature Review.","authors":"Hector Garcia Pleitez, Sakditad Saowapa, Diego Olavarria-Bernal, Michel Juarez, Chanakarn Kanitthamniyom, Udit Verma","doi":"10.12890/2024_004838","DOIUrl":"10.12890/2024_004838","url":null,"abstract":"<p><p>Choriocarcinomas are uncommon tumors, with non-gestational types occurring in both males and females. Primary choriocarcinoma of the colon is extremely rare. It presents significant diagnostic and therapeutic challenges due to its aggressive nature and poor prognosis, with no cure available, and a mean survival of 8 months. This case report describes a 48-year-old woman who presented with abdominal pain and an ovarian mass, initially suspected to be ovarian cancer. Further workup showed a primary tumor in the colon, with extension to the ovary and liver metastasis. The pathology findings confirmed the presence of colorectal adenocarcinoma with choriocarcinomatous differentiation, as indicated by immunohistochemistry. The patient initially responded to the cisplatin/etoposide regimen; however, she relapsed shortly after. The patient received additional treatments with pembrolizumab, paclitaxel, and olaparib, which resulted in partial remission. Despite challenges during treatment, such as suspected uveitis related to immune-checkpoint inhibitors and potential interference of antibodies with beta-human chorionic gonadotropin (β-hCG) testing, the patient maintained a good performance status for over 1.5 years after being diagnosed. The case emphasizes the difficulties in treating choriocarcinomas, primarily because of their aggressiveness and the absence of standardized therapy. Our goal with this case is to draw multidisciplinary attention to this rare condition. Further studies are necessary to comprehend its clinical characteristics, prognosis factors, molecular markers, and treatment approaches. Such studies may be crucial in establishing targeted and personalized therapy.</p><p><strong>Learning points: </strong>Primary choriocarcinoma of the colon is rare and often misdiagnosed due to its atypical presentation, complicating timely and accurate diagnosis.The aggressive nature of this tumor and lack of standardized therapy necessitates a multidisciplinary approach and personalized treatment plans, especially following relapse.Molecular profiling guided the use of immunotherapy, which showed potential but also presented challenges, highlighting the need for further research in treating this rare malignancy.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380357","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":"Pheochromocytoma and Thyroid Storm Presenting as ST-Elevation Myocardial Infarction in a Patient with Non-Obstructive Coronary Arteries.","authors":"Mustafa Shehzad, Dawood Shehzad, Muhammad Ahmad, Humna Younis, Abdul Wassey, Rida Fatima","doi":"10.12890/2024_04825","DOIUrl":"10.12890/2024_04825","url":null,"abstract":"<p><strong>Introduction: </strong>Pheochromocytomas can present as a diagnostic challenge, given their diverse clinical manifestations. Though classically taught as presenting with headaches, palpitations and paroxysmal hypertension, only 1 in 4 present with such a triad. Catecholamines affect the myocardium in various ways, ranging from beta-adrenergic receptor-mediated myofibril dysfunction to direct myocardial injury by catecholamine oxidation products.</p><p><strong>Case description: </strong>We report the case of a 41-year-old female with no significant past medical history, who presented with acute coronary syndrome. She was found to have myocardial infarction with non-obstructive coronary arteries (MINOCA), and her clinical course was complicated by erratic blood pressure management. Laboratory findings and imaging findings confirmed the diagnosis of pheochromocytoma. Post-cardiac catheterisation, she developed a thyroid storm and fatal cardiac arrest.</p><p><strong>Conclusions: </strong>The combination of hyperthyroidism with pheochromocytoma is rare but often fatal; iodinated angiography contrast likely precipitated her thyroid storm. This case underscores the importance of considering pheochromocytoma early in patients with MINOCA, particularly in those with erratic blood pressure. Pheochromocytomas have been reported to be associated with MINOCA in rare cases and have significant mortality. Current guidelines do not include pheochromocytoma as a possible differential diagnosis; recognition and early diagnosis are crucial for improved outcomes.</p><p><strong>Learning points: </strong>Pheochromocytoma and thyroid disease should be added as recommended differential diagnoses in patients with myocardial infarction with non-obstructive coronary artery disease (MINOCA) despite current guidelines not including them in the routine work-up.For patients with erratic blood pressure and MINOCA, the possibility of a pheochromocytoma should be considered early, as a prompt diagnosis can result in favourable outcomes.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380352","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":"Starvation Ketoacidosis on the Acute Medical Take: An Easily Missed Complication of the Keto Diet.","authors":"Ayesha Shaikh, David M Williams, Jeffrey W Stephens, Rhodri Edwards","doi":"10.12890/2024_004830","DOIUrl":"10.12890/2024_004830","url":null,"abstract":"<p><p>Starvation ketoacidosis represents one of the three forms of metabolic acidosis caused by the accumulation of ketone bodies within the blood stream. It can be easily missed in patients who present acutely and are found to have an unexplained or profound metabolic acidosis. Here, we present a life-threatening case of severe ketoacidosis in a breast-feeding mother without diabetes who was on a strict ketogenic diet. Although a ketogenic diet has been previously considered to be safe in non-pregnant individuals, its safety in breast-feeding mothers in the post-partum period is less known and may be associated with greater harm. Health professionals and mothers should be aware of the potential risks associated with a strict ketogenic diet when combined with breast-feeding, especially in the earlier stages of the post-partum period. Prompt investigation, diagnosis and immediate management is vital to avoid life-threatening complications. We report a case admitted on the acute medical take with starvation ketoacidosis associated with ketogenic diet and adequate calorie consumption who was breast-feeding at the time of admission.</p><p><strong>Learning points: </strong>Always check ketones in patients with an unexplained metabolic acidosis; there can be overlap between starvation, alcohol-related and lactic acidosis.Management of starvation ketoacidosis is often empirical, involving close monitoring of fluid status and electrolytes.Clinicians should discuss the risk of ketoacidosis associated with the ketogenic diet in women who plan to breast-feed and lose weight following pregnancy.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153464","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":"Calcified Maxillary Fibroma in a Patient on Hemodialysis for Seven Years.","authors":"Wachid Putranto, Yeremia Suryo Pratama, Krisandryka Krisandryka, Eko Adi Pangarso, Meira Dewi Kusuma Astuti, Nurhasan Agung Prabowo","doi":"10.12890/2024_004850","DOIUrl":"10.12890/2024_004850","url":null,"abstract":"<p><strong>Background: </strong>The presentation of mineral bone disorder (MBD) in individuals with chronic kidney disease (CKD) may vary. Consequently, physicians should be capable of recognising this condition when there is a suspicion of its existence. This case report will describe a calcified maxilla tumour as a manifestation of CKD-MBD.</p><p><strong>Case description: </strong>Initially asymptomatic, a 32-year-old female presented with progressive swelling of the upper left jaw. She had a history of routine haemodialysis. Further laboratory, radiological, and histopathological workup revealed the mass was indeed calcified maxillary fibroma arising from the manifestation of CKD-MBD.</p><p><strong>Conclusion: </strong>This study underscores the significance of clinical comprehension of the broad-spectrum manifestations of CKD-MBD, including an initially asymptomatic mass. In addition, the screening of the patient's biochemical was required to determine the necessity of early intervention and improve the patient's outcome.</p><p><strong>Learning points: </strong>The case emphasises the importance of recognising atypical presentations of chronic kidney disease-mineral bone disorder (CKD-MBD), such as a calcified mass, which are rarely reported but critical for timely intervention.This report underscores the necessity for routine screening for secondary hyperparathyroidism in CKD patients, as early detection can significantly impact patient outcomes.Surgical management of the overlying mass and underlying parathyroid gland hyperplasia should always be considered in the management of the symptomatic CKD-MBD patient.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380329","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":"Effective Extracorporeal Treatment of Metformin-Associated Lactic Acidosis using Continuous Venovenous Hemodiafiltration.","authors":"Mèdea Brouwer, Mandy Offermans, Lisanne van Nuil, Astrid Poukens, Brigit van Oijen, Tom Dormans","doi":"10.12890/2024_004784","DOIUrl":"10.12890/2024_004784","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of type 2 diabetes mellitus has surged globally. Metformin is recommended as the first-line oral treatment. However, metformin-associated lactic acidosis (MALA) is recognized as a rare but potentially dangerous complication. The pathogenesis of MALA is multifactorial, primarily resulting from the interference of metformin with mitochondrial function and hepatic gluconeogenesis, leading to lactate accumulation. Risk of MALA escalates with impaired kidney function, poorly controlled diabetes, fasting, and liver dysfunction.</p><p><strong>Case description: </strong>A 57-year-old woman with diabetes and hypertension presented with prolonged gastrointestinal symptoms. During this episode she continued using metformin. She had severe metabolic acidosis and acute kidney injury. Continuous venovenous hemodiafiltration was initiated, resulting in significant clinical improvement and normalized arterial blood gas parameters within 16 hours.</p><p><strong>Discussion: </strong>The pharmacokinetic properties of metformin facilitate efficient elimination via hemodialysis and/or hemofiltration. Continuous venovenous hemodiafiltration emerges as effective for MALA treatment. In the case described the calculated metformin clearance during continuous venovenous hemodiafiltration was notably higher than reported values, possibly due to residual renal clearance. Clinical improvement occurred despite elevated metformin levels, suggesting a lack of correlation between metformin levels and patient outcomes. Comorbidities rather than metformin levels guide treatment decisions in MALA.</p><p><strong>Conclusion: </strong>This case underscores the efficacy of continuous venovenous hemodiafiltration in the treatment of MALA, suggesting its potential as a standard therapeutic approach. However, further research is needed to elucidate the complex interplay between metformin levels, clinical presentation, (extracorporeal) treatment modalities and outcome in MALA.</p><p><strong>Learning points: </strong>Continuous venovenous hemodiafiltration seems to be an efficient and effective treatment to eliminate metformin in patients with metformin-associated lactic acidosis.The metformin level does not seem to correlate with the clinical condition of the patient.For a comparison between the effectiveness of different renal replacement therapies in metformin-associated lactic acidosis, more research is needed.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153422","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":"Severe Coagulopathy and Intra-Alveolar Haemorrhage Due to Fat Malabsorption in Celiac Disease.","authors":"Ori Lencovsky, Daphna Katz-Talmor, Benjamin Aronoff","doi":"10.12890/2024_004763","DOIUrl":"10.12890/2024_004763","url":null,"abstract":"<p><p>Celiac disease, a prevalent autoimmune disorder, can present atypically with fat malabsorption and coagulopathy due to vitamin K malabsorption. A 64-year-old male presented with haemoptysis and severe anaemia (Hb 6 g/dl). Despite normal previous coagulation tests, admission laboratory tests revealed an international normalised ratio (INR) of 7.0 and iron deficiency anaemia. Initial blood products and vitamin K treatment corrected the INR temporarily, but the patient's haemoptysis returned, and his INR values continued to rise. Further investigation revealed celiac disease with fat malabsorption, leading to vitamin K malabsorption and along with a previously prescribed antiplatelet aggregation therapy, this led to diffuse alveolar haemorrhage. A gluten-free diet and vitamin supplementation normalised the patient's INR and stopped the bleeding. This case highlights the importance of considering celiac disease in unexplained coagulopathies and the effectiveness of dietary management.</p><p><strong>Learning points: </strong>Celiac disease can cause severe coagulopathy due to fat malabsorption and vitamin K deficiency.High suspicion is required for atypical presentations of celiac disease.A gluten-free diet is essential for managing celiac disease and normalising coagulation profiles.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153462","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":"Tirzepatide-Related Acute Liver Injury.","authors":"Irrum Abdullah, Husam El-Ghousain, Meshaan Alenezi","doi":"10.12890/2024_004813","DOIUrl":"10.12890/2024_004813","url":null,"abstract":"<p><p>Tirzepatide, a modified protein containing 39 amino acids, acts as a dual agonist at the gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, showing great promise in weight-loss treatment. While rare, there have been reports of hepatotoxicity associated with tirzepatide use, and the exact mechanism of liver injury remains unclear. This case report highlights the experience of a 24-year-old female schoolteacher who started her weight-loss journey with tirzepatide. Despite its potential, she developed an idiosyncratic drug-related liver injury after escalating doses of tirzepatide prescribed by a private doctor. Her symptoms of recurrent vomiting, nausea and abdominal pain, initially indicative of hypoglycaemia and mild metabolic disturbances, ultimately revealed acute hepatitis and impaired coagulopathy. This case underscores the need for further research and frequent following of liver enzymes when using tirzepatide for weight loss.</p><p><strong>Learning points: </strong>Tirzepatide should be used cautiously, with regular monitoring of liver function tests.If patients develop severe gastrointestinal symptoms or worsening abdominal pain, immediate hospital admission is necessary for further work-up, including a CT abdomen.Daily liver function tests, renal function tests and international normalised ratio (INR) tests should be conducted to identify and manage potential complications.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153466","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":"Legionella Pneumophila Presenting as a Rare Cause of Acute Thrombocytopenia: A Case Report and Review of Literature.","authors":"Ryan Berenji, Sarah Faisal, Syed Ather Hussain, Asma Faisal, Hafsa Faisal","doi":"10.12890/2024_004817","DOIUrl":"10.12890/2024_004817","url":null,"abstract":"<p><strong>Introduction: </strong><i>Legionella pneumophila</i> can cause a wide spectrum of clinical manifestations, ranging from a mild flu-like illness to fulminant multi-organ involvement, characterised by severe pneumonia, diarrhoea, encephalopathy, shock, hepatic dysfunction and renal failure. Very rarely, it can be associated with haematologic conditions such as thrombotic thrombocytopenic purpura (TTP), haemolytic uraemic syndrome (HUS) and immune thrombocytopenic purpura (ITP). We report a rare case of <i>L. pneumophila</i> causing ITP and review previously published cases of thrombocytopenia associated with Legionellosis in the literature.</p><p><strong>Case description: </strong>A 53-year-old male presented with fevers, chills, a productive cough and severe haemoptysis. Blood work was remarkable for leukocytosis, severe thrombocytopenia and hyponatraemia. Computed tomography (CT) imaging showed left lower lobe lung consolidation, and a peripheral blood smear showed giant platelets consistent with ITP. Legionella urine antigen testing returned positive. He was treated with intravenous immunoglobin, steroid taper and a ten-day course of azithromycin, which led to normalisation of his platelet count and resolution of the pneumonia.</p><p><strong>Discussion: </strong><i>L. pneumophila</i> can lead to complement-mediated destruction of platelets resulting in ITP. Antibodies against <i>L. pneumophila</i> can also cross-react with the enzyme ADAMTS13, inhibiting its function and resulting in TTP and HUS. Additionally, <i>L. pneumophila</i> can infect vascular endothelial cells causing their death and stimulating release of von Willebrand factor (vWF) multimers into the bloodstream, promoting thrombosis and platelet consumption.</p><p><strong>Conclusion: </strong>It is important for internists to consider <i>L. pneumophila</i> in the differential for any patient presenting with pneumonia and severe thrombocytopenia. Earlier detection and intervention can lead to prevention of critical bleeding and better outcomes.</p><p><strong>Learning points: </strong><i>Legionella pneumophila</i> is rarely associated with different haematologic disorders resulting in severe bleeding diathesis as well as thrombosis.It is important for internists to consider <i>Legionella pneumophila</i> in the differential diagnosis for any patient presenting with pneumonia and severe thrombocytopenia.Earlier detection and intervention can lead to prevention of critical bleeding and better outcomes.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153425","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":"Ischaemic Strokes Caused by Spontaneous Cerebral Air Embolism, A Rare Complication of Interstitial Lung Disease.","authors":"Serena Yi Ling Tan, Jian Ping Jen, Kayvan Khadjooi","doi":"10.12890/2024_004356","DOIUrl":"10.12890/2024_004356","url":null,"abstract":"<p><p>Air embolism is a rare cause of ischaemic stroke. It is known that air can enter the cerebral arterial circulation from pulmonary venous circulation through a bronchovenous fistula, or in cases of pulmonary barotrauma in deep-sea diving. We describe a case of spontaneous cerebral air embolism against a background of advanced interstitial lung disease (ILD). To our knowledge, this case demonstrates a mechanism of stroke in ILD patients that has not been previously described.</p><p><strong>Learning points: </strong>This case demonstrates a mechanism of stroke in patients with severe interstitial lung disease (ILD) that has not been previously described, and we suggest that in cases of advanced ILD, clinicians should consider this as a possible mechanism of stroke. The management of these patients should include transferring them to hyperbaric facilities to prevent further air emboli.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153424","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}