International Medical Case Reports Journal最新文献

{"title":"\"SGLT2 Inhibitor-Associated Diabetic Ketoacidosis in a Pediatric Patient: An Off- Label Use Case Report\".","authors":"Bashair Fahad Aldossari, Sheikhah Aldossari","doi":"10.2147/IMCRJ.S537615","DOIUrl":"10.2147/IMCRJ.S537615","url":null,"abstract":"<p><p>A 7-year-old boy presented with new-onset type one diabetes mellitus (T1DM) and moderate diabetic ketoacidosis (DKA). The patient presented with polyuria, polydipsia, and weight loss along with reduced activity and excessive sleepiness. Initial blood tests revealed elevated blood glucose levels, high anion-gap metabolic acidosis, and ketonuria. The patient was treated with fluid resuscitation, insulin infusion, and electrolyte replacement, which resolved within three days. During medication reconciliation, the patient was administered empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, by a family member without medical supervision. This case highlights the challenges in managing pediatric diabetes, potential risks of unauthorized medication use, and need for comprehensive family education in diabetes care. This also raises questions regarding the safety and benefits of SGLT2 inhibitors in children under 10 years of age with type 1 diabetes mellitus, an area that requires further research.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"977-983"},"PeriodicalIF":0.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816582","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-Immune Hydrops Fetalis in a Pregnant Woman with Chronic Alcohol Use: A Case Report.","authors":"Aisyah Shofiatun Nisa, Hadi Susiarno, Gatot Nyarumenteng Adipurnawan Winarno, Putri Nadhira Adinda Adriansyah","doi":"10.2147/IMCRJ.S529728","DOIUrl":"10.2147/IMCRJ.S529728","url":null,"abstract":"<p><strong>Introduction: </strong>Hydrops fetalis is a condition characterized by excessive fluid accumulation within the fetal extravascular compartments and body cavities. It is classified into two categories: immune hydrops fetalis (IHF) and non-immune hydrops fetalis (NIHF). The primary cause of NIHF is fetal cardiovascular abnormalities, often stemming from congenital heart disease. One of the significant contributors to congenital heart defects is prenatal alcohol exposure (PAE).</p><p><strong>Case illustration: </strong>A woman in her early 30s presented to the emergency department with the chief complaint of not feeling fetal movements for one day prior to admission. This was her fourth pregnancy, with no history of miscarriage or abortion. The patient reported a history of regular smoking (two packs per day) and frequent alcohol consumption. Her vital signs were unremarkable upon admission. The baby was delivered weighing 1755 grams and measuring 44 cm, with grade 2 maceration and no signs of life. Physical findings, including fluid accumulation in the chest and body, led to a pediatric diagnosis of hydrops fetalis.</p><p><strong>Conclusion: </strong>The risk factor for hydrops fetalis in this case is likely associated with prenatal alcohol exposure, which may have disrupted fetal teratogenesis. Comprehensive prenatal examinations are essential for monitoring fetal health, identifying complications and congenital abnormalities, and assessing risk factors.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"969-975"},"PeriodicalIF":0.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816584","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":"Bilateral Streak Ovaries in a Patient with Isochromosome Xq: A Case Report of a Turner Syndrome Variant.","authors":"Amadea Ivana Hartanto, Ruswana Anwar, Mirza Ismail, Erick Caesarrani Asmara, Putri Nadhira Adinda Adriansyah","doi":"10.2147/IMCRJ.S529460","DOIUrl":"10.2147/IMCRJ.S529460","url":null,"abstract":"<p><strong>Introduction: </strong>Turner syndrome (TS) is a chromosomal disorder characterized by complete or partial loss of one X chromosome. One structural variant, isochromosome Xq [46,X,i(Xq)], results in duplication of the long arm and loss of the short arm of the X chromosome (Xp), which contains genes essential for normal ovarian development and function. This chromosomal imbalance leads to accelerated germ cell apoptosis and subsequent ovarian dysfunction. In this case, a 33-year-old woman with chronic anovulation and uterine hypoplasia was diagnosed with 46,X,i(Xq) karyotype without evidence of mosaicism.</p><p><strong>Case illustration: </strong>A 33-year-old woman with a history of irregular menstruation since adolescence was referred for evaluation of uterine hypoplasia and chronic anovulation. Clinical findings included short stature, but no webbed neck or congenital heart defects, making this an atypical presentation of Turner syndrome. Transvaginal ultrasound revealed a small uterus and bilateral streak ovaries. Hormonal evaluation showed elevated FSH levels consistent with hypergonadotropic hypogonadism. Diagnostic laparoscopy confirmed bilateral streak ovaries with normal appearing uterus and fallopian tubes. Chromosomal analysis using G-banding revealed a 46,X,i(Xq) karyotype, indicating an isochromosome Xq abnormality, a recognized variant of Turner syndrome. This genetic alteration explains her ovarian dysfunction and infertility, highlighting the importance of chromosomal evaluation in cases of primary ovarian insufficiency.</p><p><strong>Conclusion: </strong>This case highlights a structurally abnormal but nonmosaic 46,X,i(Xq) karyotype variant of Turner syndrome presenting primarily with ovarian insufficiency. Despite the absence of classic phenotypic features such as webbed neck or congenital heart defects, a high index of suspicion led to the correct diagnosis. This case underscores the need to consider Turner syndrome variants in women with unexplained ovarian insufficiency, even in the absence of overt clinical stigmata, to guide appropriate genetic counseling and fertility planning.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"953-961"},"PeriodicalIF":0.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816583","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":"Splenectomy for Primary Sjögren's Syndrome Associated with Massive Splenomegaly: Two Case Reports.","authors":"Fang Gui, Li-Xuan Zhou, Xue-Mei Liu, Yong-Long He, Qi-Bin Yang","doi":"10.2147/IMCRJ.S539313","DOIUrl":"10.2147/IMCRJ.S539313","url":null,"abstract":"<p><strong>Background: </strong>Primary Sjögren's syndrome (pSS) is an autoimmune disease characterized by exocrine glands involving mainly the lacrimal and salivary glands. Splenomegaly from pSS is a rare clinical feature unless the pSS is complicated by lymphoma. Splenectomy could exclude malignant lymphoma, reduce the risk of spontaneous spleen rupture and remove hypersplenism to improve pancytopenia.</p><p><strong>Case presentation: </strong>We reported the case of a 49-year-old female patient who was diagnosed with pSS according to dry mouth, dry eyes, splenomegaly, multiple positive autoantibodies, positive Schirmer's test and biopsy of labial gland with decreased number of acini and focal lymphocytic infiltration. Due to hematological involvement and liver dysfunction repeatedly, the pSS patient was admitted to the hospital and treated with glucocorticoids, immunosuppressants and hepatoprotective drugs. However, the pancytopenia failed to improve. Considering pancytopenia of the pSS patient caused by massive splenomegaly, splenectomy was recommended to the patient. The hematological involvement was significantly improved after splenectomy. Besides, another 46-year-old woman with a similar clinical manifestation was diagnosed with pSS complicated by massive splenomegaly, however, the patient refused to undergo the splenectomy.</p><p><strong>Conclusion: </strong>Splenectomy may be an effective treatment of pSS complicated by massive splenomegaly resulting in hematological involvement.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"963-968"},"PeriodicalIF":0.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816585","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":"Phenotypic Manifestations in Two Cases of Osmotic Demyelination Syndrome.","authors":"Noon Elimam, Eman Elimam, Victoria Krylova, Oleg Lobanov, Larysa Panteleienko","doi":"10.2147/IMCRJ.S532153","DOIUrl":"10.2147/IMCRJ.S532153","url":null,"abstract":"<p><p>Osmotic demyelination syndrome (ODS) is an emergency acute neurological condition that usually occurs secondary to rapid correction of chronic hyponatremia (low concentration of sodium in the blood). We present two cases: one with typical ODS following rapid sodium correction, showing classic MRI findings in the pons and basal ganglia; and another with atypical ODS presenting with cranial nerve palsy and ataxia, despite normal sodium levels, and diffuse hyperintensities in the pons and medulla on MRI. These cases emphasize the clinical and radiological variability of ODS, highlighting the importance of careful monitoring and gradual correction of electrolytes, particularly sodium, in high-risk patients.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"949-952"},"PeriodicalIF":0.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775358","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":"From Eruptive Xanthoma to Acute Pancreatitis: Clinical Warning and Implications of Rapid Disease Progression.","authors":"Yanling Zhu, Xin He, Ya Lan, Yongqiong Deng","doi":"10.2147/IMCRJ.S531146","DOIUrl":"10.2147/IMCRJ.S531146","url":null,"abstract":"<p><p>Xanthoma is a common cutaneous manifestation typically associated with abnormal lipid metabolism, particularly hyperlipidemia. Both hyperlipidemia and hyperglycemia are significant components of metabolic syndrome and can elevate the risk of pancreatitis. Acute pancreatitis is a serious inflammatory disease that can be life-threatening and may be triggered by various factors, including hyperlipidemia. In conclusion, there appears to be a potential link between xanthoma, hyperlipidemia, and acute pancreatitis, which seem to be distinct diseases. By analyzing the diagnostic and treatment processes for this patient, we found that early identification and intervention in xanthoma patients are crucial. This approach not only aids in controlling the progression of xanthoma but also helps prevent a range of serious complications associated with hyperlipidemia, such as acute pancreatitis. Ultimately, this reduces the impact of the disease on health and enhances the quality of life and survival rates for patients.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"943-947"},"PeriodicalIF":0.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775357","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":"Fetal Bradycardia in Last Trimester Imposed as Fetal Distress: Case Report.","authors":"Aisyah Shofiatun Nisa, Luthfi Rahman, Johanna Sharon Carolina, Adhi Pribadi, Alce Everdien, Ruswana Anwar","doi":"10.2147/IMCRJ.S514045","DOIUrl":"10.2147/IMCRJ.S514045","url":null,"abstract":"<p><strong>Objective: </strong>Atrioventricular block (AVB) is one of the most common causes of fetal bradyarrhythmia. This case highlights a misdiagnosis of fetal bradyarrhythmia as fetal distress and underscores the importance of accurately distinguishing fetal bradycardia from fetal distress through precise prenatal evaluation.</p><p><strong>Case report: </strong>A 33-year-old pregnant woman was referred to a tertiary care center after an initial diagnosis of suspected fetal distress at a local hospital. Due to limited resources and qualified clinicians to perform accurate diagnosis, further evaluation at the primary facility was not possible. Upon arrival at the tertiary center, one week later, fetal echocardiography was performed. The fetal heart rate was found to be persistently low at 60-70 beats per minute. Fetal echocardiography confirmed the presence of congenital heart disease along with a diagnosis of fetal bradyarrhythmia, most likely due to atrioventricular block.</p><p><strong>Conclusion: </strong>Fetal bradycardia may indicate the presence of congenital heart disease or conduction abnormalities such as AV block. Accurate diagnosis using fetal echocardiography is essential to distinguish true bradyarrhythmia from non-specific signs of fetal distress and guide appropriate management.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"925-930"},"PeriodicalIF":0.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12311231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759996","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":"Giant Infarcted Lactating Adenoma Mimicking Inflammatory Breast Carcinoma: A First Case Report from Somalia.","authors":"Ismail Mohamud Abdullahi, Ismail Gedi Ibrahim","doi":"10.2147/IMCRJ.S528825","DOIUrl":"10.2147/IMCRJ.S528825","url":null,"abstract":"<p><p>A lactating adenoma is a rare and benign breast tumor that usually occurs during pregnancy or lactation period for women. These adenomas are typically small, <3 centimeters, well circumscribed, mobile, and lobulated masses, and are most commonly witnessed in primiparous women (those having their first child) between the ages of 20 and 40 years during the third trimester of their pregnancies due to hormonal changes. In this case report, we describe an unusual variant of lactating adenoma that is characterized by the ischemic infarction of breast tissue and its giant dimensions, surpassing 16 centimeters. The case in question had poorly defined margins in addition to chronic mastitis, which can make differentiating from standard lactating adenoma presentations quite difficult clinically. Infarction associated with chronic mastitis serves to complicate the distinction, and tends to mimic inflammatory breast carcinoma. This case report emphasizes how these rare and unusual presentations of lactating adenomas can mimic a highly aggressive malignancy, leading to diagnostic confusion and potentially unnecessary interventions. Inflammatory breast carcinoma is a rapidly progressive malignancy requiring aggressive oncological management, unlike infarcted lactating adenomas, which are benign and can be effectively treated with surgical excision alone. This case adds an important dimension to the medical literature, particularly given its context of occurrence in Somalia, where resources and access to advanced diagnostic tools are limited. By detailing this unique instance, the study not only contributes to the understanding of breast pathology but also emphasizes the necessity for keen clinical acumen in achieving appropriate therapeutic interventions in diverse health-care settings.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"931-936"},"PeriodicalIF":0.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753313","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":"Combined Superior Mesenteric Artery Syndrome and Nutcracker Syndrome in a Young Male Patient Presenting as Atypical Vomiting and Rapid Weight Loss: A Case Report.","authors":"Mohamed Osman Dahir Alasow, Abdinasir Mohamed Elmi, Abdirahman Mahmud Haji, Shuayb Moallim Ali Jama, Hanan Hassan Hirei, Ahmed Adam Osman","doi":"10.2147/IMCRJ.S519808","DOIUrl":"10.2147/IMCRJ.S519808","url":null,"abstract":"<p><p>Superior mesenteric artery (SMA) syndrome, also known as Wilkie syndrome, is an uncommon condition marked by the compression of the third segment of the duodenum between the SMA and the aorta, often occurring after rapid weight loss, particularly in young, slim individuals. Symptoms consist of epigastric pain, bloating, and vomiting. Nutcracker syndrome (NCS) is characterized by the compression of the left renal vein (LRV) between the superior mesenteric artery and the aorta. This condition results in venous varices and elevated pressure within the LRV, which may manifest as hematuria, proteinuria, pelvic congestion, and flank pain. Although each of these syndromes is infrequent, their simultaneous incidence is remarkably occasional. This case report examines a young male patient diagnosed with both SMA syndrome and NCS, emphasizing the importance of considering these conditions in the differential diagnosis of abdominal and renal symptoms.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"937-942"},"PeriodicalIF":0.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742122","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":"Identifying the Multifactorial Triggers of Monthly Recurrent HSV-1 Reactivation: A Case Report.","authors":"Ulfa Fetriani, Nanan Nur'aeny","doi":"10.2147/IMCRJ.S536607","DOIUrl":"10.2147/IMCRJ.S536607","url":null,"abstract":"<p><strong>Background: </strong>Herpes simplex virus 1 (HSV-1) causes recurrent oral lesions with reactivation triggered by factors such as stress, hormones, and nutrition. Immune suppression caused by these factors plays an important role in HSV-1 reactivation and requires comprehensive management.</p><p><strong>Purpose: </strong>This case report aims to analyze the relationship between triggering factors and recurrent HSV-1 infection and to achieve therapy to prevent recurrence.</p><p><strong>Case presentation: </strong>A 39-year-old woman came with recurrent ulcers every month during her menstrual cycle. The results of the anamnesis showed other factors such as malnutrition and stress. Clinical examination showed ulcers on the lips, labial mucosa, and gingiva. A hemogram (complete blood count) examination revealed normal results, IgG anti-HSV-1 with reactive results, and IgM anti-HSV-1 non-reactive. The diagnosis was Herpes Labialis and Recurrent Intraoral Herpes (RIH).</p><p><strong>Case management: </strong>Pharmacological therapy was acyclovir cream, chlorine dioxide mouthwash, acyclovir tablets, and vitamins. Non-pharmacological therapy includes improving oral hygiene, stress management (evaluation using the Depression Anxiety Stress Scale-21/DASS-21), and improving nutrition. By the third visit, ulcers on the labial mucosa and lip commissures showed improvement, however, a new ulcer developed on the lower labial mucosa. The use of oral acyclovir tablets, hyaluronic acid gel, and stress management monitored using DASS-21 resulted in complete ulcer healing by the fifth visit.</p><p><strong>Conclusion: </strong>The multifactorial triggers for recurrent HSV-1 infection in this case are stress, hormonal, and nutritional. Pharmacological therapy in the form of acyclovir and chlorhexidine requires comprehensive management that combines antiviral therapy, stress management, and lifestyle changes by improving nutrition to overcome recurrent HSV-1 infections in the future.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"915-923"},"PeriodicalIF":0.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742123","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}