European journal of case reports in internal medicine最新文献_第9页

Infliximab in the Treatment of a Giant Coronary Aneurysm in Behçet's Disease. 英夫利西单抗治疗贝赫切特氏病巨大冠状动脉瘤。

European journal of case reports in internal medicine Pub Date : 2024-10-02 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004894

Salma Boustani, Abderrahmane Ibnyahia, Soukaina Wakrim, Wassila Bouissar

{"title":"Infliximab in the Treatment of a Giant Coronary Aneurysm in Behçet's Disease.","authors":"Salma Boustani, Abderrahmane Ibnyahia, Soukaina Wakrim, Wassila Bouissar","doi":"10.12890/2024_004894","DOIUrl":"https://doi.org/10.12890/2024_004894","url":null,"abstract":"Background: Behçet's disease (BD) is a rare, multisystemic inflammatory disorder with a diverse range of manifestations, primarily affecting the mucocutaneous and ocular systems. While vascular involvement is less frequent it can be severe, with coronary aneurysms being particularly rare.Case description: We report a 28-year-old male with BD who developed a giant anterior interventricular artery aneurysm. The patient, initially managed with azathioprine and colchicine, presented with acute chest pain and elevated cardiac markers. Imaging revealed a coronary aneurysm measuring 5.03 cm. Due to the inflammatory nature of the aneurysm surgical intervention was initially deferred, and the patient was treated with corticosteroids and cyclophosphamide. Despite these treatments, recurrent symptoms prompted the initiation of infliximab therapy. Administered at 5 mg/kg at weeks 0, 2 and 6, with subsequent doses every two months, infliximab led to a significant reduction in aneurysm size to 3.73 cm.Conclusion: This case highlights the effectiveness of infliximab in managing giant coronary aneurysms associated with BD, demonstrating its potential as a treatment option for severe vascular complications in BD. The substantial reduction in aneurysm size following infliximab therapy underscores the need for further investigation into its role in treating such rare but serious manifestations of BD.Learning points: A giant coronary aneurysm is a rare complication of Behçet's disease.Infliximab effectively reduced the aneurysm size.Imaging shows a substantial decrease in aneurysm size after infliximab treatment.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 11","pages":"004894"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617119","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

Nebivolol-Induced Hepatoxicity: A Case Report. 奈必洛尔诱发的肝中毒：病例报告

European journal of case reports in internal medicine Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004866

Lynn Srour, Majed Ali, Karam Karam, Elias Fiani

{"title":"Nebivolol-Induced Hepatoxicity: A Case Report.","authors":"Lynn Srour, Majed Ali, Karam Karam, Elias Fiani","doi":"10.12890/2024_004866","DOIUrl":"https://doi.org/10.12890/2024_004866","url":null,"abstract":"Nebivolol is a third-generation beta-blocker known for its high selectivity for beta-1 adrenergic receptors and its unique ability to induce vasodilation via nitric oxide (NO) release. Nebivolol, despite its favourable safety profile, can lead to significant liver injury. We describe the case of a 73-year-old hypertensive patient who developed significant liver enzyme elevations following the addition of nebivolol to her treatment regimen. Comprehensive workup ruled out other causes, leading to a diagnosis of drug-induced hepatotoxicity. Discontinuation of nebivolol resulted in normalization of liver enzymes. This case underscores the importance of monitoring liver function during beta-blocker therapy, particularly with nebivolol.Learning points: Nebivolol, despite its favourable safety profile, can lead to significant liver injury.Clinicians should remain vigilant and consider routine liver function monitoring in patients prescribed nebivolol, particularly if they present with nonspecific symptoms or abnormal liver enzyme tests.Early recognition and prompt discontinuation of the offending agent are crucial in preventing severe outcomes.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 11","pages":"004866"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617127","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

Imaging Insights Suggesting a Sinister Cause of a Breast Mass in Adolescents: A Case of Rhabdomyosarcoma in a Teenager. 影像学洞察力提示青少年乳房肿块的凶险原因：一例青少年横纹肌肉瘤病例

European journal of case reports in internal medicine Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004820

Mariam Malik, Rana Bilal Idrees, Maham Khalid, Ameena Munir, Saba Nawaz, Zainab Nawaz, Muhammad Hamid Chaudhary

{"title":"Imaging Insights Suggesting a Sinister Cause of a Breast Mass in Adolescents: A Case of Rhabdomyosarcoma in a Teenager.","authors":"Mariam Malik, Rana Bilal Idrees, Maham Khalid, Ameena Munir, Saba Nawaz, Zainab Nawaz, Muhammad Hamid Chaudhary","doi":"10.12890/2024_004820","DOIUrl":"10.12890/2024_004820","url":null,"abstract":"Background: Sarcomas of the breast are exceedingly rare, accounting for less than 1% of malignant breast tumors, with primary rhabdomyosarcomas being even rarer. Due to the scarcity of reported cases, the imaging characteristics of breast rhabdomyosarcoma are not well-defined, making diagnosis challenging, especially in adolescents.Case description: We present the case of a 17-year-old female diagnosed with embryonal rhabdomyosarcoma following a comprehensive workup for right breast masses. Initial imaging showed no distant metastasis, and the patient underwent a right mastectomy followed by adjuvant chemoradiotherapy. A few months post-treatment, she developed recurrent nodules in the chest wall. Further investigation confirmed the recurrence of embryonal rhabdomyosarcoma.Conclusions: This case underscores the importance of considering primary rhabdomyosarcoma as a differential diagnosis in adolescent breast lesions. Given its rare occurrence and potential imaging overlap with more common tumors like cystosarcoma phyllodes, awareness and careful evaluation are critical for accurate diagnosis and timely management.Learning points: Critical imaging insights: The report provides valuable imaging characteristics that can help differentiate rhabdomyosarcoma from more common breast tumors like fibroadenoma and cystosarcoma phyllodes, resulting in more accurate and timely diagnosis.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 10","pages":"004820"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380347","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

Life-Threatening Methaemoglobinaemia Secondary to Cetrimide. 继发于西曲嘧啶的危及生命的高铁血红蛋白血症。

European journal of case reports in internal medicine Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004837

Radwan Zeidan, Mohammed Abdallah, Nazem Matta, Patricia Nehme, Mirna Fares

{"title":"Life-Threatening Methaemoglobinaemia Secondary to Cetrimide.","authors":"Radwan Zeidan, Mohammed Abdallah, Nazem Matta, Patricia Nehme, Mirna Fares","doi":"10.12890/2024_004837","DOIUrl":"https://doi.org/10.12890/2024_004837","url":null,"abstract":"Methaemoglobinaemia is a rare but potentially life-threatening condition in which there is diminution of the oxygen-carrying capacity of the circulating haemoglobin. It can result from either congenital or acquired processes. Acquired methaemoglobinaemia is more prevalent than congenital methaemoglobinaemia, and notably it has a higher prevalence in infants and neonates than in adults; it results from exposure to oxidising agents. Methaemoglobin forms when haemoglobin is oxidised to contain iron in the ferric (Fe3+) state rather than the normal ferrous (Fe2+) state. Methaemoglobinaemia is a clinical diagnosis and is suspected in the presence of hypoxaemia refractory to supplemental oxygen and in the presence of chocolate-coloured blood. Symptoms are usually dependent on the methaemoglobin levels; at levels higher than 35%, systemic symptoms from tissue hypoxia may be fatal. We present a case of severe life-threatening methaemoglobinaemia following intra-abdominal use of cetrimide during hydatid cyst removal in a 60-year-old female.Learning points: Cetrimide can cause methaemoglobinaemia when used as a protoscolicidal agent during the surgical treatment of hydatid cysts.Severe methaemoglobinaemia has high mortality rate and is usually missed and not easily diagnosed.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 11","pages":"004837"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617123","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

Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction. 经皮内窥镜结肠造口术缓解恶性肠梗阻。

European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004872

Jerome Schwingel, Markus Casper, Manfred Lutz

{"title":"Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction.","authors":"Jerome Schwingel, Markus Casper, Manfred Lutz","doi":"10.12890/2024_004872","DOIUrl":"10.12890/2024_004872","url":null,"abstract":"Background: Malignant bowel obstruction due to peritoneal carcinomatosis is a common problem. When surgery is not feasible in the context of a high intraperitoneal tumour burden, other techniques are required.Case report: We report the case of a 67-year-old female with malignant obstruction of the ascending colon. Following an unsuccessful surgical attempt, decompression was successfully achieved via percutaneous endoscopic colostomy using a lumen-apposing metal stent. The patient was able to resume a full oral diet within 2 days. However, local inflammatory complications arose due to faecal contamination of the sutures. Once the sutures were removed, no further interventions were required.Conclusion: Percutaneous endoscopic colostomy is a safe and viable alternative for decompression in malignant bowel obstruction when surgery is not feasible. However, limitations include the risk of local infection due to sutures and its applicability only in cases with distal stenosis.Learning points: Malignant bowel obstruction is a frequent challenge in palliative care.Percutaneous colostomy with a lumen-apposing metal stent (LAMS) is a safe and effective option to relieve bowel obstruction.Percutaneous colostomy with a LAMS remains patent in the long term.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 10","pages":"004872"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380351","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

Sweet Syndrome Presenting with Features of Cellulitis Shortly after Femoral Angioplasty. 股骨血管成形术后不久出现蜂窝织炎特征的斯威特综合征

European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004670

Qi Wang, John Sinclair, Ayyappa Amaravadi, Onovughe Arioride

{"title":"Sweet Syndrome Presenting with Features of Cellulitis Shortly after Femoral Angioplasty.","authors":"Qi Wang, John Sinclair, Ayyappa Amaravadi, Onovughe Arioride","doi":"10.12890/2024_004670","DOIUrl":"10.12890/2024_004670","url":null,"abstract":"Neutrophilic dermatosis, or Sweet syndrome, is a cutaneous disorder caused by neutrophilic infiltration in the upper dermis. It has been associated with medications, infections and malignancies but to date it has not been associated with femoral arterial angioplasty or stenting. We present the case of a 75-year-old female who, after angioplasty and stent placement of the right superficial femoral artery, developed right heel pain with ulceration that did not respond to broad antibiotics. She underwent incision and drainage twice without improvement; both times produced negative cultures. She then underwent a punch biopsy by dermatology, which was consistent with acute spongiotic and other neutrophilic dermatoses. She was started on prednisone with immediate improvement of her symptoms. She was discharged to a rehabilitation centre with a prednisone taper and antibiotics. This report highlights the importance of maintaining Sweet syndrome on the differential for cellulitis as it is a rare mimicry of other infectious and non-infectious aetiologies, which are common in the perioperative space. Early treatment is crucial to improve symptoms, outcomes, healthcare cost and potentially the length of stay.Learning points: Sweet syndrome, a rare skin condition related to neutrophil infiltration, may be triggered by angioplasty.Sweet syndrome is easily misdiagnosed as infectious conditions such as cellulitis.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 10","pages":"004670"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380361","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

Pembrolizumab in Combination with Folfirinox for Treatment of Advanced Pancreatic Adenocarcinoma With MSI-H. Pembrolizumab 联合 Folfirinox 治疗 MSI-H 晚期胰腺腺癌。

European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004767

Ashmin Singh, Nairuti Sanghavi, Vandana Bandari, Iftekhar Khan, Abeer Alfaraj

引用次数: 0

Spontaneous Pneumomediastinum in a Patient with Marijuana Use. 一名吸食大麻患者的自发性气胸

European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004853

Nutthakorn Horugsa, Jiyeon Kim, Samuel Kim, Judy Lalmuanpuii

引用次数: 0

Appendiceal Bleeding, A Rare Yet Important Cause of Lower Gastrointestinal Bleed. 阑尾出血，下消化道出血的一个罕见但重要的原因。

European journal of case reports in internal medicine Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004683

Ayman Tabcheh, Johny Salem, Karim Zodeh, Ammar Ghazale

{"title":"Appendiceal Bleeding, A Rare Yet Important Cause of Lower Gastrointestinal Bleed.","authors":"Ayman Tabcheh, Johny Salem, Karim Zodeh, Ammar Ghazale","doi":"10.12890/2024_004683","DOIUrl":"10.12890/2024_004683","url":null,"abstract":"Background: Lower gastrointestinal bleeding accounts for 20 to 25% of all gastrointestinal bleedings. Appendiceal bleeding is a rare, yet important cause of lower gastrointestinal bleed; in many cases, it can be misdiagnosed as obscure gastrointestinal bleeding. Here, we present a case of appendiceal bleeding in an elderly female.Case description: A 79-year-old female presented with acute onset of gastrointestinal bleeding of same-day duration. Investigations showed that she had an appendiceal bleed originating from an ulcer secondary to a small appendicolith, which has passed through the appendiceal orifice, combined with her aspirin use. Within 12 hours, a laparoscopic appendectomy was performed. No evidence of malignancy or vascular malformation was detected, and the post-operative course was smooth, with resultant discharge at day 3 after her surgery.Discussion: For lower gastrointestinal bleeding, it is crucial for the endoscopist to reach the terminal ileum during the colonoscopy, and thoroughly inspect the orifice of the appendix to assess any source of bleed including but not limited to Dieulafoy's lesion, angiodysplasia or any vascular malformation. An effective treatment option for appendiceal bleeding is surgical management with appendectomy. Alternative approaches such as vessel embolization and endoscopic treatment have been reported to successfully control bleeding; nevertheless, the risk of acute appendicitis and recurrent bleeding following these procedures can be challenging to manage, potentially leading the patient to still need a surgical treatment with an appendectomy.Learning points: Appendiceal bleeding is a rare, yet important cause of lower gastrointestinal bleed; in many cases, it can be misdiagnosed as obscure gastrointestinal bleeding.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 10","pages":"004683"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380328","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

Coexistence of HHV-8-Associated Plasmacytic Multicentric Castleman Disease, Kaposi's Sarcoma, and Multiple Myeloma in a HIV-Negative Patient. 一名 HIV 阴性患者同时患有 HHV-8 相关浆液性多中心 Castleman 病、卡波西肉瘤和多发性骨髓瘤。

European journal of case reports in internal medicine Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI: 10.12890/2024_004876

Rashad Ismayilov, Olgu Erkin Cinar, Murat Ozdede, Ece Ozogul, Umit Yavuz Malkan, Aysegul Uner, Ibrahim Halil Gullu

{"title":"Coexistence of HHV-8-Associated Plasmacytic Multicentric Castleman Disease, Kaposi's Sarcoma, and Multiple Myeloma in a HIV-Negative Patient.","authors":"Rashad Ismayilov, Olgu Erkin Cinar, Murat Ozdede, Ece Ozogul, Umit Yavuz Malkan, Aysegul Uner, Ibrahim Halil Gullu","doi":"10.12890/2024_004876","DOIUrl":"10.12890/2024_004876","url":null,"abstract":"Background: Multicentric Castleman disease (MCD) is a rare, aggressive lymphoproliferative disorder. Human herpesvirus-8 (HHV-8) has an important role in the pathogenesis of the disease and its association with Kaposi's sarcoma has been reported, especially in people living with human immunodeficiency virus (HIV). In this report, we present the case of HHV-8 positive MCD accompanied by Kaposi's sarcoma and multiple myeloma in an HIV-negative patient.Case report: A 78-year-old man with Kaposi's sarcoma presented with B symptoms, pancytopenia, lymphadenopathy, and splenomegaly. The bone marrow biopsy demonstrated 70% lambda-restricted monotypic plasma cell infiltration consistent with plasma dyscrasia. Also, the patient was diagnosed with HHV-8 positive MCD as a result of inguinal lymph node excisional biopsy. Treatment was initiated including ganciclovir and methylprednisolone and followed by rituximab. The patient passed away at the 24th hour of rituximab infusion due to shock.Conclusions: MCD and associated malignancies are difficult to treat and have a poor prognosis. More studies and data are needed to manage these patients.Learning points: Multicentric Castleman disease (MCD), often linked with human herpesvirus-8 (HHV-8) and Kaposi's sarcoma, is rare and aggressive condition, particularly in human immunodeficiency virus (HIV)-positive patients.The coexistence of MCD, Kaposi's sarcoma, and multiple myeloma is exceptionally rare in HIV-negative, immunocompetent patient.This case highlights the challenges in diagnosing and managing complex presentations of MCD and related malignancies, with poor outcomes despite treatment.","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 10","pages":"004876"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380330","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