Journal of Community Hospital Internal Medicine Perspectives最新文献

Duodenal Perforation From Dislodged Prophylactic Pancreatic Stent Following ERCP for Hilar Cholangiocarcinoma: A Rare Adverse Event. 肝门胆管癌ERCP术后预防性胰腺支架移位致十二指肠穿孔：罕见的不良事件。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1610

Mina Alkomos, Jolie Ibrahim, Karan Desai, Beshoy E Elkomos, Walid Baddoura, Youssef Botros

{"title":"Duodenal Perforation From Dislodged Prophylactic Pancreatic Stent Following ERCP for Hilar Cholangiocarcinoma: A Rare Adverse Event.","authors":"Mina Alkomos, Jolie Ibrahim, Karan Desai, Beshoy E Elkomos, Walid Baddoura, Youssef Botros","doi":"10.55729/2000-9666.1610","DOIUrl":"10.55729/2000-9666.1610","url":null,"abstract":"We report a rare complication of prophylactic pancreatic duct stenting during ERCP for suspected hilar cholangiocarcinoma. A 47-year-old woman presented with two weeks of painless jaundice, total bilirubin 18 mg/dL, and cholestatic enzymes. Imaging revealed intrahepatic biliary dilation without CBD dilation. ERCP with cholangioscopy identified a right hepatic duct stricture; biopsies were obtained. A 10 mm × 4 cm covered metal stent was placed in the CBD, a 7 Fr × 12 cm plastic stent in the right hepatic duct, and a 4 Fr × 5 cm pancreatic stent was prophylactically inserted after inadvertent duct cannulation. Two days later, she developed acute abdominal pain. CT revealed stent migration with duodenal perforation. Repeat ERCP removed the dislodged stent, closed the defect endoscopically, and replaced the metal biliary stent with plastic. Biopsies confirmed perihilar cholangiocarcinoma. This case emphasizes that although prophylactic stenting reduces the risk of post-ERCP pancreatitis, migration and perforation can occur, underscoring the importance of vigilance and early recognition of post-procedural complications.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 4","pages":"147-150"},"PeriodicalIF":0.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872904","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

Left-ventricular Non-compaction Cardiomyopathy Presenting With Atrial Flutter With Rapid Ventricular Response. 左心室非压实性心肌病表现为心房扑动伴心室快速反应。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1611

Sahil Ghay, Baneet Kaur, Juan A Talavera, Koushik Sanku, Viky S Loescher, Julien A Exposito

引用次数: 0

Steroid-responsive Encephalopathy Associated with Autoimmune Thyroiditis: A Case Fulfilling Definite Graus Criteria. 类固醇反应性脑病与自身免疫性甲状腺炎：一例满足明确的格劳斯标准。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1618

Stephanie Ammari, Nawras Ibrahim, Sravani Karuchola, Samir Ouais

{"title":"Steroid-responsive Encephalopathy Associated with Autoimmune Thyroiditis: A Case Fulfilling Definite Graus Criteria.","authors":"Stephanie Ammari, Nawras Ibrahim, Sravani Karuchola, Samir Ouais","doi":"10.55729/2000-9666.1618","DOIUrl":"10.55729/2000-9666.1618","url":null,"abstract":"Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also known as Hashimoto encephalopathy, is a rare immune-mediated neurological syndrome with an incidence of 2.1 per 100,000 and a 4:1 female predominance. Neurological manifestations are independent of thyroid status, occurring in 30-40% of euthyroid patients, and include cognitive impairment, confusion, seizures, and psychiatric symptoms. Diagnosis is challenging in the elderly, where symptoms overlap with dementia or delirium, with only 51 reported cases in patients aged ≥65 years. We describe a 70-year-old woman with autoimmune hypothyroidism and levothyroxine nonadherence who presented with progressive weakness, melena, dyspnea, and altered mental status complicated by obstructive uropathy, gastrointestinal bleeding, hypocalcemia, and severe hypothyroidism. Despite normalization of metabolic parameters and thyroid function, profound encephalopathy with fluctuating alertness, psychomotor slowing, memory impairment, psychosis, and a seizure-like episode persisted. Workup revealed elevated anti-thyroid antibodies, positive ANA, inflammatory CSF, diffuse EEG slowing, and low-titer GAD65 antibodies. High-dose prednisone led to dramatic improvement within 48 h, fulfilling adapted Graus criteria for definite SREAT. This case distinguishes SREAT from myxedema coma by the temporal dissociation between thyroid normalization and steroid response, emphasizes avoiding overinterpretation of low-titer GAD65 antibodies, and highlights CSF findings as supportive evidence. Early recognition is crucial in elderly patients with refractory encephalopathy and autoimmune thyroiditis.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 4","pages":"115-119"},"PeriodicalIF":0.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793781","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

Rare Presentation of Sequential Mucosa-Associated Lymphoid Tissue Lymphoma, Follicular Lymphoma, and Chronic Lymphocytic Leukemia: A Case-Based Review. 顺序性粘膜相关淋巴组织淋巴瘤、滤泡性淋巴瘤和慢性淋巴细胞白血病的罕见表现：一项基于病例的回顾。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1621

Khushi J Desai, Ansy H Patel, Patrick T O'Dowd, Joseph A Tworek, Preeti G Misra, Li Ding

{"title":"Rare Presentation of Sequential Mucosa-Associated Lymphoid Tissue Lymphoma, Follicular Lymphoma, and Chronic Lymphocytic Leukemia: A Case-Based Review.","authors":"Khushi J Desai, Ansy H Patel, Patrick T O'Dowd, Joseph A Tworek, Preeti G Misra, Li Ding","doi":"10.55729/2000-9666.1621","DOIUrl":"10.55729/2000-9666.1621","url":null,"abstract":"Introduction: Occurrence of 2 (or more) Hodgkin's and non-Hodgkin's lymphoma concordantly or sequentially in a single patient is very rare.Case: An 88-year-old Italian male with a history of mucosa-associated lymphoid tissue (MALT) lymphoma in remission and indolent follicular lymphoma under surveillance, presented with acute autoimmune hemolytic anemia (AIHA). While initially speculated to be secondary to follicular lymphoma relapse, stable mesenteric lymphadenopathy compared to prior CT abdomen/pelvis and smudge cells on peripheral smear prompted further evaluation. Peripheral blood flow cytometry indicated a mature B-cell neoplasm, which was confirmed to be chronic lymphocytic leukemia (CLL) with a bone marrow biopsy. Minimal improvement was observed with high-dose steroids, IV immunoglobulin, and rituximab therapy, ultimately leading to hospice care.Discussion: A population-based cancer registry study calculated the prevalence of sequential or composite lymphomas to be only 0.44%. Their occurrence can be explained by the common precursor cells hypothesis, chronic antigenic stimulation, and microenvironmental dependence. Possibly shared fundamental genetic alterations and acquired distinct secondary events lead to divergent clonal evolution. Limited data are available on the incidence of sequential lymphomas, and our case emphasizes the need for large, multicentric studies to stratify their risk factors, clinical implications, and suspicion index.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 4","pages":"159-167"},"PeriodicalIF":0.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793797","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

A Tight Squeeze - Cardiac Tamponade in a Scleroderma Patient. 硬皮病患者的紧挤压-心脏填塞。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1608

Ifrah Nadeem, Charles E Geringer

引用次数: 0

A Case of Nivolumab-Induced Bullous Pemphigoid-Successfully Treated with Rituximab. 利妥昔单抗成功治疗尼伏单抗致大疱性类天疱疮1例。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1613

Rawa Amin, Neel Ranpura, Haris Hatic

引用次数: 0

Rectal Dieulafoy Lesion with Severe Hematochezia in a Warfarin-Treated Patient. 1例使用华法林治疗的患者伴严重便血的直肠尿潴留病变。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1625

Carlos Elizondo Alatorre, Maria G Rubianes Guerrero, Julio C Valencia Manrique, Jennifer Harley

引用次数: 0

Progressive facial Swelling and Airway Symptoms Revealing a Deep Neck Abscess With Atypical Microbiology. 进行性面部肿胀和气道症状显示有非典型微生物的深颈部脓肿。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1616

Drew K Knight, Sulaiman Hakam, Arash Bakian, Ilya Fonarov

引用次数: 0

Adult-onset IgA Vasculitis Initially Attributed to a Cutaneous Drug Reaction and Diverticulitis. 成人发病IgA血管炎最初归因于皮肤药物反应和憩室炎。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1626

Leila C Tou, Catherine Grace P Hobayan, Shane Devine, Sarah Koraym

引用次数: 0

A Case of N-Methyl-D-Aspartate (NMDA) Autoimmune Encephalitis in a 34-Year-Old Man Thought to Have Schizophrenia. 34岁男性n -甲基- d -天冬氨酸（NMDA）自身免疫性脑炎1例被认为患有精神分裂症。

IF 0.6

Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.55729/2000-9666.1630

Riyad Amin, Michael Wilson, Morgan Koontz, Khawaja Omar

{"title":"A Case of N-Methyl-D-Aspartate (NMDA) Autoimmune Encephalitis in a 34-Year-Old Man Thought to Have Schizophrenia.","authors":"Riyad Amin, Michael Wilson, Morgan Koontz, Khawaja Omar","doi":"10.55729/2000-9666.1630","DOIUrl":"10.55729/2000-9666.1630","url":null,"abstract":"Background: N-methyl-d-aspartate (NMDA) autoantibody encephalitis is a rare autoimmune condition affecting approximately 1.5 per million people per year [1]. It predominantly occurs in young women and is often associated with tumors, particularly teratomas [3]. The diagnosis is aided by testing cerebrospinal fluid (CSF) or serum for NMDA receptor antibodies along with careful evaluation of symptoms. Misdiagnosis is common, as its symptoms can mimic other more prevalent conditions, such as upper respiratory illnesses or psychiatric disorders like acute psychosis or schizophrenia.Case report: We present the case of a 34-year-old man who was initially incarcerated and subsequently developed decreased communication and mild agitation over several days, leading to his transfer to a psychiatric institute with a presumed diagnosis of schizophrenia. As his encephalopathy worsened over weeks, he exhibited catatonic symptoms and was referred to our facility for further evaluation after an unrevealing workup, including an initial lumbar puncture.Upon re-evaluation, a lumbar puncture was repeated with an autoimmune panel, returning positive for anti-NMDA antibodies, confirming the diagnosis. The patient was initially treated with steroids and plasma exchange, resulting in minimal improvement. He later received intravenous immunoglobulin (IVIG) and concomitant rituximab, leading to some functional improvement to a non-verbal but alert state.Conclusion: This case highlights the importance of considering rare autoimmune encephalitis' in patients presenting with worsening encephalopathy in the setting of a new psychiatric diagnosis, despite its rare nature.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"16 4","pages":"94-99"},"PeriodicalIF":0.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793717","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