International Medical Case Reports Journal最新文献

{"title":"Complete Atrioventricular Block Due to Severe Hyperkalemia in a Hemodialysis Patient: Successful Management with Temporary Transvenous Pacing.","authors":"Ahmed Elmi Abdi, Can Baba Arın, Ishak Ahmed Abdi, Said Abdirahman Ahmed, Osman Farah Dahir, Ahmed Shafici Aden, Mohamed Omar Hassan","doi":"10.2147/IMCRJ.S596948","DOIUrl":"https://doi.org/10.2147/IMCRJ.S596948","url":null,"abstract":"<p><p>Severe hyperkalemia is a potentially fatal electrolyte disturbance that can produce a broad spectrum of cardiac conduction abnormalities. Although electrocardiographic changes classically follow a predictable progression, advanced atrioventricular block is an uncommon and often overlooked manifestation. We report the case of a 70-year-old woman with end-stage renal disease on maintenance hemodialysis who presented with altered mental status, profound bradycardia, and hypotension. Initial electrocardiography demonstrated complete atrioventricular block with a ventricular escape rhythm of 15-20 beats per minute. Laboratory evaluation confirmed severe hyperkalemia with a serum potassium level of 8.5 mmol/L. Despite prompt initiation of standard medical therapy, including intravenous calcium gluconate, insulin with glucose, and nebulized salbutamol, the patient remained hemodynamically unstable with no improvement in heart rate. Emergency temporary transvenous pacing was therefore performed, resulting in immediate hemodynamic stabilization. Definitive treatment with urgent hemodialysis led to normalization of serum potassium levels and complete recovery of normal sinus rhythm within 24 hours, allowing safe removal of the temporary pacemaker. This case highlights a rare and life-threatening presentation of hyperkalemia-induced complete atrioventricular block and underscores the limitations of medical therapy alone in advanced conduction disturbances. Early recognition and timely implementation of temporary transvenous pacing can be life-saving in hemodynamically unstable patients while definitive correction of hyperkalemia is achieved.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"596948"},"PeriodicalIF":0.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837821","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":"Non-Wound Tetanus Mimicking Botulism in a Low-Resource Setting: Early Recognition and Successful Intensive Care Management.","authors":"Abdullahi Hassan Elmi, Ahmed Omar Abdi","doi":"10.2147/IMCRJ.S606704","DOIUrl":"https://doi.org/10.2147/IMCRJ.S606704","url":null,"abstract":"<p><strong>Introduction: </strong>Tetanus is a vaccine-preventable, toxin-mediated neurologic emergency caused by <i>Clostridium tetani</i>. Although classically associated with contaminated wounds, the portal of entry may be trivial or unrecognized, resulting in so-called non-wound presentations that can delay diagnosis. Early tetanus may also mimic other toxin-mediated syndromes, including botulism, particularly when cranial or bulbar symptoms predominate.</p><p><strong>Case presentation: </strong>A 41-year-old man in Somalia presented with rapidly progressive trismus, neck stiffness, dysarthria, perioral paresthesia, and marked masseter rigidity over 12 hours. He had no limb weakness or focal neurologic deficits, and brain MRI and CT angiography were unremarkable. Initial history raised concern for botulism because of recent laser eye surgery and ingestion of home-canned vegetables. Repeated history-taking later revealed extensive post-flood debris cleanup with possible unnoticed hand punctures. His most recent documented tetanus vaccination was in 2020, but prior immunization history was incomplete. He received tetanus toxoid, intramuscular human tetanus immunoglobulin, intravenous metronidazole, and ICU observation. He improved within 24 hours and recovered fully by 48 hours.</p><p><strong>Conclusion: </strong>This case illustrates that tetanus can present without an identifiable wound and may closely mimic botulism when bulbar symptoms and misleading exposure histories are present. In patients with acute trismus and painful rigidity, tetanus should remain a leading consideration despite normal neuroimaging and absent wounds. Early empiric antitoxin, antibiotics, vaccination, and close monitoring can be decisive, and repeated environmental exposure history, especially after flooding or debris handling, may reveal the missing diagnostic link. Importantly, tetanus occurred despite a recent documented vaccination, highlighting uncertainty about protection when prior immunization history is incomplete.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"606704"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837774","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 Report: Liver Metastasis from Ductal Carcinoma In Situ of the Breast.","authors":"Weiya Zhuang, Daozhe Lin, Chengliang Chen","doi":"10.2147/IMCRJ.S593264","DOIUrl":"https://doi.org/10.2147/IMCRJ.S593264","url":null,"abstract":"<p><strong>Purpose: </strong>This article reports a rare case of liver metastasis in a patient with breast ductal carcinoma in situ (DCIS) after surgery, aiming to emphasize the rarity and potential metastatic risk of DCIS, especially liver metastasis, and provide reference for clinical diagnosis and treatment.</p><p><strong>Patients and methods: </strong>The clinical data of a 35-year-old female patient with liver metastasis from DCIS admitted to our hospital were collected, and the latest literature and clinical guidelines were systematically reviewed.</p><p><strong>Results: </strong>The patient was diagnosed with high-grade, HER2-positive, large-volume (5.0 cm × 3.5 cm) DCIS (TisN0M0) in September 2021. Liver metastasis was confirmed 5 months after surgery. After 10 cycles of TCbHP regimen (docetaxel + carboplatin + trastuzumab + pertuzumab), liver metastases achieved complete remission. Subsequent maintenance therapy with HP combined with capecitabine maintained stable disease without recurrence.</p><p><strong>Conclusion: </strong>Distant metastasis of DCIS is extremely rare but can occur in high-risk populations. High-grade, large tumor size (>3 cm), HER2 positivity, and high Ki-67 are independent high-risk factors with moderate-to-high evidence levels. Early identification of high-risk DCIS and active anti-HER2 targeted combination therapy can significantly improve the prognosis of metastatic patients.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"593264"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837807","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":"Isolated Tubal Torsion in the Absence of Ovarian Pathology: A Case Report and Literature Review.","authors":"Everett Lwamulungi, Prisca Ibe, Dickson Ndukwe Otaka","doi":"10.2147/IMCRJ.S575102","DOIUrl":"https://doi.org/10.2147/IMCRJ.S575102","url":null,"abstract":"<p><strong>Background: </strong>Isolated fallopian tube torsion (IFTT) is an uncommon but important cause of acute lower abdominal pain, particularly in premenarchal girls. Its nonspecific clinical presentation and inconclusive imaging findings often lead to delayed or incorrect diagnosis.</p><p><strong>Case presentation: </strong>We report the case of a 13-year-old premenarchal girl who presented with right iliac fossa pain and was initially found to have a para-ovarian mass on ultrasonography. Her symptoms temporarily subsided with conservative management; however, she re-presented with worsening pain. Diagnostic laparoscopy revealed torsion of the right fallopian tube associated with a hemorrhagic para-tubal cyst. A right salpingectomy was performed due to irreversible ischemic changes of the tube.</p><p><strong>Conclusion: </strong>This case highlights the challenges of diagnosing IFTT in young females. It aims to increase awareness among clinicians as early surgical intervention can preserve tubal function and prevent complications.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"575102"},"PeriodicalIF":0.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837748","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":"Management and Outcomes of an Open Distal Femur Fracture in an HIV-Positive Patient: A Case Report From Madina Hospital, Somalia.","authors":"Bashir Dahir Ahmed, Mohamed Hassan Mohamud, Omar Sidow Zubair, Mohamed Abdi Warsame, Tigad Abdisad Ali","doi":"10.2147/IMCRJ.S599622","DOIUrl":"https://doi.org/10.2147/IMCRJ.S599622","url":null,"abstract":"<p><strong>Background: </strong>HIV infection has historically been associated with impaired fracture healing due to immune dysregulation, altered inflammatory responses, and reduced bone mineral density. However, emerging evidence suggests that patients with well-controlled HIV receiving antiretroviral therapy (ART) may achieve surgical outcomes comparable to HIV-negative individuals, even following complex orthopedic trauma. This case report aims to describe the management and outcome of an open distal femur fracture in an HIV-positive patient in a resource-limited setting.</p><p><strong>Case presentation: </strong>We report the case of a 25-year-old male with previously undiagnosed HIV infection who sustained an open, displaced distal femur fracture secondary to a gunshot injury. HIV infection was confirmed using a WHO-recommended sequential rapid testing algorithm. The patient demonstrated moderate immune competence (CD4 count: 400 cells/mm³). Initial management included prompt surgical debridement, copious irrigation, intravenous antibiotics, and temporary immobilization. Definitive internal fixation using a distal femoral locking plate was performed ten days later, alongside initiation of ART (tenofovir, lamivudine, and dolutegravir). Postoperative recovery was uncomplicated. Radiographic follow-up at one and eight months demonstrated complete fracture union and stable fixation without evidence of infection or implant failure.</p><p><strong>Conclusion: </strong>This case supports growing evidence that HIV infection, when appropriately diagnosed and managed, should not be considered a contraindication to internal fixation of open femoral fractures. Timely surgical intervention, adherence to open fracture management principles, and early initiation of ART can result in favorable outcomes, even in resource-limited settings.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"599622"},"PeriodicalIF":0.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837793","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":"Genetic Features and Clinical Heterogeneity of Leber Hereditary Optic Neuropathy in Adolescent and Adult Patients: A Case Series on Arab Patients.","authors":"Esraa Basalem, Nooran Badeeb","doi":"10.2147/IMCRJ.S571657","DOIUrl":"https://doi.org/10.2147/IMCRJ.S571657","url":null,"abstract":"<p><p>Leber hereditary optic neuropathy (LHON) is a rare disorder characterized by painless progressive visual loss. LHON is caused by maternally inherited mitochondrial DNA (mtDNA) point mutations, impairing the electron transport chain and oxidative phosphorylation. Environmental and nuclear factors may further influence disease manifestation. This case series describes the clinical characteristics, mutation profiles, and visual outcomes in patients from Saudi Arabia and Yemen, regions where reported data remain scarce. Patients were diagnosed with LHON based on characteristic clinical features confirmed through genetic testing. The series highlights both adolescent-and adult-disease onset, with most patients carrying the m.11778G>A mutation, consistent with global prevalence patterns. Distinct modifiable risk factors were identified in several cases. Treatment with Idebenone (two out of two patients) was associated with visual improvement and favorable outcomes, while patients treated with coenzyme Q10 reported subjective visual improvement that was not detected through visual assessments. These findings contribute to the limited data on LHON in the Arabian Peninsula underscoring the importance of early genetic testing and treatment initiation. However, the small sample size, non-uniform participant visit schedules, and variable follow-up period limit the generalizability of the findings. Increased regional awareness and reporting, as well as mitigating financial obstacles, are essential to improve diagnostic timing and optimize outcomes in this rare but impactful disorder.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"571657"},"PeriodicalIF":0.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837756","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":"Rare Postoperative Pelvic Lymphocyst Infection by <i>Streptococcus mitis/oralis</i>: A Case Study.","authors":"Xiaoyu Cheng, Anping Guo, Fengmei Wang","doi":"10.2147/IMCRJ.S584541","DOIUrl":"https://doi.org/10.2147/IMCRJ.S584541","url":null,"abstract":"<p><p>Lymphatic cyst with infection is caused by interruption of lymphatic vessels during para-aortic lymphnode dissection in patients with gynecological malignancies. It is generally considered that the infection is caused by bacteria invading through the lower limb and perineal wound, but the pathogenic factors of most lymphatic cysts are not clear. Our literature search revealed no previously reported cases similar to ours, in which a lymphatic cyst infection resulted from a co-infection with <i>Streptococcus mitis/oralis</i> (<i>S. mitis/oralis</i>) and <i>Klebsiella pneumoniae</i> (<i>K. pneumoniae</i>). A woman of 61 years of age, was diagnosed in endometrial cancer, carcinosarcoma FIGO grade 3, stage IIIC of the FIGO system. During the third postoperative pelvic replacement and drainage procedure, the patient developed a fever with a peak temperature of 39.2°C on the second day after the removal of the drainage tube. Empiric broad-spectrum antibiotics were started upon hospital readmission, but the patient showed poor response to therapy, with persistent and recurrent lower abdominal tenderness, raising concern for ongoing intra-abdominal or pelvic infection. As a result, it is important to identify pathogenic bacteria associated with lymphatic cyst infections and determine antimicrobial regimens. We further investigated the pathogenicity and antibiotic resistance of <i>S. mitis/oralis</i>, formulated an appropriate anti-infective treatment strategies. Consequently, the patient recovered and was discharged.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"584541"},"PeriodicalIF":0.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837751","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":"Electrochemotherapy Treatment for Squamous Cell Carcinoma of the Lip: A Case Report.","authors":"Gianluca Nicolai, Francesco Campanella, Sergio Alexandre Gehrke, Antonio Scarano","doi":"10.2147/IMCRJ.S578531","DOIUrl":"https://doi.org/10.2147/IMCRJ.S578531","url":null,"abstract":"<p><strong>Background: </strong>Squamous cell carcinoma is a malignant tumor that affects the skin and mucous membranes. It may present as painless superficial lesions, or as rapidly growing, exophytic masses, sometimes ulcerated, which can invade and damage surrounding tissues. It is the second most common malignant neoplasm of the skin, characterized by high clinical variability, which makes early diagnosis and timely treatment essential to improve prognosis. The aim of this case report is to evaluate the clinical efficacy, tolerability, and durability of response of electrochemotherapy in the treatment of cutaneous squamous cell carcinoma of the lip in patient with compromised general health.</p><p><strong>Case presentation: </strong>We report the case of a 79-year-old male with multiple comorbidities, including chronic kidney disease, diabetes, and ischemic heart disease, who presented with a rapidly growing lesion on the lower lip. The surgical approach would entail a functional deficit of the lips and an aesthetic impairment. Due to the patient's systemic condition, a more conservative treatment was chosen, namely treating the neoplasm with electrochemotherapy.</p><p><strong>Results: </strong>The treatment led to controlled necrosis of the lesion and complete healing by secondary intention within three months. The patient experienced no functional impairment or recurrence during a four-year follow-up.</p><p><strong>Conclusion: </strong>This case highlights the potential of electrochemotherapy as a safe and effective alternative for managing lip squamous cell carcinoma, particularly in patients who are not candidates for surgery or radiotherapy. The favorable clinical and aesthetic outcomes support its consideration in selected cases.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"578531"},"PeriodicalIF":0.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837804","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":"Silent Intruders: Air in the Cavernous Sinus and Neck Spaces-A Case Report.","authors":"Muhammad Faisal Wadiwala, Anwar Ibrahim Joudeh, Sheik Akbar Hussain","doi":"10.2147/IMCRJ.S589643","DOIUrl":"https://doi.org/10.2147/IMCRJ.S589643","url":null,"abstract":"<p><strong>Introduction: </strong>Air in the cavernous sinus is rare and often linked to severe conditions like trauma, septic thrombosis, or gas-forming infections. However, advances in imaging and awareness of iatrogenic causes suggest it may also result from transient, self-limiting venous air embolism, especially after routine procedures like peripheral intravenous canulation.</p><p><strong>Case presentation: </strong>A middle-aged diabetic male presented to the emergency department with dizziness and persistent nausea for two days. There was no history foe headache, fever or blurring of vision. On examination, he was severely dehydrated with reduced skin turgor and resting tachycardia. The patient was treated with intravenous hydration with improvement in his symptoms. Laboratory investigations showed only mild hyperglycemia with high lactic acid. Initial non-contrasted computed tomography (CT) of the head revealed air within the cavernous sinus and neck spaces. Four hours later, a repeated contrast-enhanced CT of the head and neck showed complete spontaneous resolution of the cavernous gas bubbles. Recent peripheral intravenous canulation was the likely cause of transient venous air embolism in this case.</p><p><strong>Conclusion: </strong>This case underscores the importance of differentiating benign, iatrogenic causes of pneumatosis from life-threatening conditions to prevent unnecessary interventions. Clinicians should consider recent intravenous canulation as a potential benign cause in clinically stable and asymptomatic patients, while systematically excluding other serious pathologies.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"589643"},"PeriodicalIF":0.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815300","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":"POEMS Syndrome with Peripheral Neuropathy as the First Presentation: A Case Report.","authors":"Yujie Di, Chongmei Liu","doi":"10.2147/IMCRJ.S594691","DOIUrl":"https://doi.org/10.2147/IMCRJ.S594691","url":null,"abstract":"<p><strong>Introduction: </strong>POEMS syndrome is a rare multisystem plasma cell disorder, often misdiagnosed when peripheral neuropathy is the initial manifestation. This report illustrates the effectiveness of autologous hematopoietic stem cell transplantation (ASCT) combined with lenalidomide that reversed neurological deficits, supported by objective electrophysiological evidence rarely documented.</p><p><strong>Case presentation: </strong>A 54-year-old Chinese woman presents with progressive bilateral lower extremity weakness, numbness, and edema. Initially misdiagnosed as suspected spinal metastases, POEMS syndrome was later confirmed by elevated serum IgG-λ M protein (2.57 g/L) and VEGF (556.74 pg/mL). Treatment follows a three-phase regimen: induction with lenalidomide (25 mg/day, days 1-21) plus dexamethasone (20 mg/day pulsed); ASCT with cyclophosphamide mobilization, melphalan conditioning (300 mg), and CD34⁺ cell infusion (5.18×10⁶/kg); and maintenance with lenalidomide consolidation (25 mg/day, days 1-14 monthly).</p><p><strong>Results: </strong>Significant symptom resolution occurred post-treatment. Serum M-protein and VEGF normalized. Complete remission (CR) was sustained over 24 months. Repeat electromyography demonstrated sensory nerve amplitude increased 2-4 fold (eg, left sural nerve: 2.2 → 9.0 μV) and motor conduction velocity improved >50% in lower limbs (eg, left tibial nerve: 15.8 → 36.7 m/s).</p><p><strong>Conclusion: </strong>This case demonstrates that ASCT-lenalidomide combination achieves dual neurological and hematological remission in POEMS syndrome. Early VEGF testing and multidisciplinary collaboration are critical to prevent diagnostic delays. Quantitative EMG improvement provides objective evidence for treatment efficacy assessment.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"594691"},"PeriodicalIF":0.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815293","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}