Journal of Medical Case Reports最新文献

{"title":"Sacral joint infection caused by Salmonella: a post-gastroenteritis complication-a case report.","authors":"Mario Cahueque, Enrique Azmitia, Ramirez Claudio","doi":"10.1186/s13256-025-05144-y","DOIUrl":"10.1186/s13256-025-05144-y","url":null,"abstract":"<p><strong>Background: </strong>Septic arthritis of the sacroiliac joint is an uncommon condition, accounting for only 1-2% of all septic arthritis cases. Its rarity, coupled with a nonspecific clinical presentation, often leads to diagnostic delays. While Staphylococcus aureus is the most common pathogen, Salmonella species are rare etiological agents, typically associated with specific risk factors. This case highlights the novelty of a Salmonella enteritidis-induced septic sacroiliitis in a previously healthy adolescent of Ladino ethnicity, emphasizing the importance of considering atypical pathogens.</p><p><strong>Case presentation: </strong>A 17-year-old Ladino male presented with severe lower back and buttock pain radiating to the left leg, 1 week after recovering from a gastrointestinal illness. Laboratory findings revealed elevated inflammatory markers, and imaging showed significant inflammation of the left sacroiliac joint. Diagnosis was confirmed via joint fluid aspiration, which identified S. enteritidis. The patient was treated with intravenous ceftriaxone and amikacin, transitioning to oral antibiotics for 6 weeks. Symptoms resolved within 72 hours of treatment initiation, with full recovery of mobility and sustained symptom-free status at 1-year follow-up.</p><p><strong>Conclusion: </strong>This case underscores the importance of timely diagnosis and tailored treatment for septic sacroiliitis caused by atypical pathogens. It also highlights the need to consider Salmonella in patients presenting with sacroiliac joint pain and a recent history of gastrointestinal infection, even in the absence of traditional risk factors, ensuring optimal clinical outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"315"},"PeriodicalIF":0.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564860","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":"Coexistence of mediastinal teratoma and intrapulmonary bronchogenic cyst: a case report.","authors":"Sepehr Sadrizadeh, Ali Sadrizadeh, Mohammad Hadi Sadeghian","doi":"10.1186/s13256-025-05391-z","DOIUrl":"10.1186/s13256-025-05391-z","url":null,"abstract":"<p><strong>Background: </strong>Mediastinal masses are relatively common in pediatric populations, but their coexistence with bronchogenic cysts is extremely rare. Such cases present diagnostic and therapeutic challenges owing to overlapping features and the need for precise identification to guide appropriate management. Reporting this unusual combination enhances awareness and contributes to the understanding of their clinical presentation and treatment.</p><p><strong>Case presentation: </strong>A 15-year-old female of Iranian ethnicity presented with a 3-month history of persistent, nonproductive cough unresponsive to standard medical treatments. The patient had no significant past medical history. Diagnostic imaging, including chest X-ray and computed tomography scans, revealed two separate thoracic lesions suggestive of mediastinal and pulmonary masses. The patient also underwent surgical resection via left posterolateral thoracotomy. Histopathological examination confirmed a mature cystic teratoma in the mediastinum, containing various tissue types, and an infected bronchogenic cyst within the lung, characterized by alveolar hemorrhage and abscess formation. Postoperative recovery was uneventful, and follow-up imaging demonstrated no residual abnormalities.</p><p><strong>Conclusion: </strong>This case revealed the importance of comprehensive diagnostic evaluation in pediatric patients with persistent respiratory symptoms. Although rare, the simultaneous occurrence of mediastinal mature teratomas and bronchogenic cysts should be considered in differential diagnoses to enable timely surgical intervention. Recognizing this coexistence can lead to favorable outcomes and informs clinicians about the potential complexity of thoracic masses in adolescents.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"320"},"PeriodicalIF":0.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564858","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":"Timely diagnosis of emphysematous pyelitis by point-of-care ultrasound in an outpatient setting prevented infection spread: a case report and review of the literature.","authors":"Octavio J Salgado, Angela M Vidal, Abhilash Koratala, Zoila K Salazar-Torres, Hermel M Espinosa","doi":"10.1186/s13256-025-05361-5","DOIUrl":"10.1186/s13256-025-05361-5","url":null,"abstract":"<p><strong>Background: </strong>Emphysematous pyelitis represents the initial stage of emphysematous pyelonephritis, a rare and potentially life-threatening necrotizing renal infection caused by gas-forming bacteria. Diabetes mellitus and/or lithiasis constitute significant risk factors for such conditions. Renal point-of-care ultrasound is an invaluable diagnostic tool for the early detection of gas within the kidney and urinary tract. The present case provides an illustrative example of the crucial importance of routinely using renal point-of-care ultrasound in every patient with a suspected urinary tract infection in an outpatient setting.</p><p><strong>Case presentation: </strong>A 55 year-old hypertensive, non-diabetic female patient of Wayuu indigenous ethnicity was evaluated for mild-to-moderate right flank pain accompanied by slight fever at night. She was referred to the renal outpatient clinic with a presumptive urinary tract infection. In the context of a systemic review for symptoms, the patient reports expulsion of gas bubbles during urination. She was evaluated by ultrasound, which detected gas in the pyelocaliceal system. A computed tomography scan confirmed this. The patient was admitted to the hospital and started on intravenous therapy with ceftriaxone. Urine culture revealed the presence of E. coli > 100 CFU sensitive to ceftriaxone. The response to antibiotherapy was favorable, with remission of clinical symptoms and moderate leukocytosis observed at the time of admission.</p><p><strong>Conclusion: </strong>Routine point-of-care ultrasound evaluation should be part of the physical evaluation of every patient presenting with a suspected upper urinary tract infection in the renal outpatient clinic.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"319"},"PeriodicalIF":0.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564861","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":"A novel sequence of the PHKG2 mutation associated with the first case of glycogen storage diseases type IXc in Syria: a case report and review of literature.","authors":"Seba Harh, Shaza Shahoud, Shady Daher, Diana Alasmar","doi":"10.1186/s13256-025-05383-z","DOIUrl":"10.1186/s13256-025-05383-z","url":null,"abstract":"<p><strong>Background: </strong>Glycogen storage diseases are a group of inherited metabolic disorders that affect the body's ability to break down and/or store glycogen. Type IX glycogen storage disease is an inherited disorder caused by a deficiency of phosphorylase kinase, which leads to various symptoms. We report the first reported case in Syria of glycogen storage disease type IXc caused by a novel phosphorylase B kinase catalytic subunit gamma 2 gene mutation, emphasizing the importance of early diagnosis and genetic counseling.</p><p><strong>Case presentation: </strong>A 6-month-old Syrian male infant of Arab ethnicity presented with developmental delay, hepatomegaly, and hypoglycemia. Genetic testing identified a previously unreported phosphorylase B kinase catalytic subunit gamma 2 variant (c.801G > A p.( =)), classified as a variant of uncertain significance. Liver biopsy and clinical features were consistent with glycogen storage disease type IXc.</p><p><strong>Discussion: </strong>This report expands the current understanding of phosphorylase B kinase catalytic subunit gamma 2-related glycogen storage disease type IXc by documenting a novel synonymous mutation with potential clinical significance. It underscores the critical role of early genetic testing in consanguineous populations, not only for accurate diagnosis but also for guiding family counseling and long-term management.</p><p><strong>Conclusion: </strong>The identification of this novel mutation contributes to expanding the known phosphorylase B kinase catalytic subunit gamma 2 mutation spectrum and stresses the need for genetic counseling in similar populations.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"317"},"PeriodicalIF":0.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564857","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":"Recurrent giant retroperitoneal dedifferentiated liposarcoma requiring challenging multiorgan resection: a case report.","authors":"Cesar Prugue, Emma Bao, Camden Pereira, Bing Yi","doi":"10.1186/s13256-025-05379-9","DOIUrl":"10.1186/s13256-025-05379-9","url":null,"abstract":"<p><strong>Background: </strong>Dedifferentiated liposarcoma is a rare, aggressive subtype of liposarcoma known for its high recurrence rate and local invasiveness. This case demonstrates the challenges in managing a rapidly recurring dedifferentiated liposarcoma and underscores the need for improved surveillance and additional treatment options.</p><p><strong>Case presentation: </strong>A 57-year-old non-Hispanic white male presented in November 2023 with a 2-month history of intermittent fevers, nonproductive cough, and lower abdominal discomfort. Imaging revealed a 12 cm × 12 cm × 16 cm retroperitoneal mass, confirmed to be a high-grade dedifferentiated liposarcoma. Initial surgical resection in December 2023 removed the tumor, which was densely adhered to the left kidney. Despite adjuvant chemotherapy, follow-up imaging in July 2024 showed tumor recurrence with a 15 cm × 14 cm × 21 cm multiloculated cystic mass extending from the spleen to the lower pole of the kidney, as well as a 12 cm × 6 cm × 15 cm mass inferior to the left kidney. Owing to the extensive local invasion, a second surgery in August 2024 required a left nephrectomy, splenectomy, hemicolectomy, and distal pancreatectomy. The tumor's proximity to the abdominal aorta and invasion into the psoas muscle posed significant surgical challenges, requiring careful resection.</p><p><strong>Conclusion: </strong>This case highlights the aggressive nature of high-grade dedifferentiated liposarcoma and its resistance to chemotherapy. Surgical resection remains the primary treatment option, but the recurrence emphasizes the need for more effective therapies. The case further illustrates the complexity of multiorgan involvement in recurrent dedifferentiated liposarcoma and the critical role of experienced oncologic surgeons in managing these cases. More research is necessary to develop alternative treatments that can better control tumor progression and improve patient outcomes.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"313"},"PeriodicalIF":0.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560391","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":"Venous gas in the intrahepatic portal in an obstetric patient with preeclampsia: a case report.","authors":"Carlos Mendiola-Villalobos, María Del Carmen García-Pantoja, Ignacio Rodríguez-Guevara, Marian Elizabeth Phinder-Puente, Nora Noemí Hernández Velázquez, Orlando R Pérez-Nieto, Ernesto Deloya-Tomas, Raúl González-Toribio, Christian Alberto Herrera Venegas","doi":"10.1186/s13256-025-05371-3","DOIUrl":"10.1186/s13256-025-05371-3","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is a severe pregnancy-related disorder associated with significant maternal and fetal morbidity. Its novelty in this case lies in the rare postdelivery complications of hepatic portal venous gas and emphysematous gastritis, conditions not previously linked to preeclampsia.</p><p><strong>Case presentation: </strong>We report the case of a 37-week-and-5-day pregnant Hispanic woman of Mexican origin (Gravida 2, Para 1) presenting with severe preeclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. She underwent an emergency cesarean section due to severe-range hypertension that did not spontaneously resolve. Postdelivery, the patient developed hepatic portal venous gas and emphysematous gastritis. These findings were confirmed through diagnostic imaging, including a computed tomography scan, which showed intrahepatic gas and air within the gastric wall. Despite these findings, the patient remained clinically stable. Conservative management, including supportive care and close monitoring, was implemented, leading to gradual improvement over several days. The patient was discharged in good condition, without further complications.</p><p><strong>Conclusions: </strong>This case underscores the need for awareness of rare complications, such as hepatic portal venous gas and emphysematous gastritis, in postpartum patients with preeclampsia. A thorough evaluation, including workup for alternative diagnoses such as acute fatty liver of pregnancy, is essential. Early recognition and tailored management are crucial to ensuring favorable outcomes in such rare clinical scenarios.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"312"},"PeriodicalIF":0.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560394","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":"A surgical approach for aortic root aneurysm repair: a case report.","authors":"Feridoun Sabzi, Aghigh Heydari, Javad Azimivaghar, Atefeh Asadmobini","doi":"10.1186/s13256-025-05367-z","DOIUrl":"10.1186/s13256-025-05367-z","url":null,"abstract":"<p><strong>Background: </strong>The Bentall procedure is the standard treatment for aortic root aneurysm associated with aortic valve disease, but it carries risks of both early perioperative complications and long-term prosthetic-valve-related issues. To overcome these limitations, we applied a novel surgical technique combining Dacron graft wrapping of the aortic root with autologous pericardial valve reconstruction.</p><p><strong>Case presentation: </strong>We report a 59-year-old Iranian male with a history of aortic root aneurysm, recurrent peptic ulcers, and intolerance to warfarin. He presented to the emergency department following a car accident, complaining of severe chest pain and displaying anterior chest wall bruising. Transthoracic echocardiography revealed a small intramural hematoma and aneurysmal dilation of the ascending aorta. Emergency surgery was performed using the described novel approach due to suspicion of an intramural aortic aneurysm. The patient's postoperative course was uneventful, and at 6-month follow-up, he remained clinically stable with only minimal residual aortic regurgitation.</p><p><strong>Conclusions: </strong>This case highlights the potential of combining Dacron root wrapping with autologous pericardial valve reconstruction as a viable alternative to conventional prosthetic valve replacement, especially in patients with contraindications to long-term anticoagulation.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"308"},"PeriodicalIF":0.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560387","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":"Spontaneous recanalization following subtotal proximal LAD occlusion: a case report.","authors":"Pedro Pallangyo, Smita V Bhalia, George Longopa, Happiness L Kusima, Henry A Mayala, Zabella S Mkojera, Makrina Komba, Peter R Kisenge","doi":"10.1186/s13256-025-05369-x","DOIUrl":"10.1186/s13256-025-05369-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Owing to the activation of the endogenous fibrinolytic system, spontaneous restoration of coronary blood flow in the infarcted artery may seldom occur without thrombolysis or primary coronary intervention. Spontaneous reperfusion is associated with less myocardial damage, a tremendous in-hospital outcome, and a better overall prognosis compared with patients requiring reperfusion therapy to achieve a thrombolysis in myocardial infarction grade 3 patency. We present an intriguing case of spontaneous recanalization succeeding a subtotal left anterior descending occlusion in a 46-year-old male from Tanzania with neither positive history of cardiovascular disease nor apparent coronary artery disease risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;A 46-year-old man of African origin was referred from central Tanzania for revascularization. He had presented with a 2-day history of ongoing central chest pain, crushing in nature and radiating to the left arm. His past medical history was unremarkable and had no apparent risk factors for coronary artery disease. Cardiac markers were found to be elevated, while electrocardiographic and echocardiographic evaluation revealed features in keeping with anterior wall myocardial infarction. He was prescribed the standard precatheterization medications and subsequently underwent an urgent coronary angiography. Catheterization revealed a 99% occlusion of the proximal left anterior descending with a thrombolysis in myocardial infarction grade 1 flow. Due to an intraprocedural machine fault and a lack of technical support, percutaneous coronary intervention could not be done in the same setting, and the patient was referred to Dar es Salaam for revascularization. The patient continued to be symptomatic for 5 days postcatheterization but came to Jakaya Kikwete Cardiac Institute (JKCI) free from symptoms on the ninth day since the onset of chest pain. He had stable hemodynamics and was in Killip class I. Cardioselective enzymes, a 12-lead electrocardiogram, and two-dimensional echocardiography done at this point revealed essentially normal findings, but the patient underwent a second catheterization for revascularization of a tight proximal left anterior descending lesion. Unexpectedly, coronary angiography revealed a patent left anterior descending vessel. Based on the clinical presentation, cardiac markers, and electrocardiographic and angiographic evolution, a diagnosis of spontaneous recanalization following subtotal proximal left anterior descending occlusion was entertained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Spontaneous recanalization in patients with significant coronary lesions may seldom occur and portend a favorable prognosis. In light of the increasing incidence of acute coronary syndrome in Sub-Saharan Africa, it is crucial for primary physicians to recognize this potentially fatal entity timely and offer or refer for appropriate reperfusion therapy promptly. Parallel to t","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"309"},"PeriodicalIF":0.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560393","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":"Hybrid video-assisted thoracoscopic resection of a massive mediastinal solitary fibrous tumor: overcoming challenges: a case report.","authors":"Salahaldeen Deeb, Nouraldeen Deeb, Bashar Douden, Izzeddin Bakri, Motaz Natsheh, Yousef Abu Asbeh, Anas Alasafrah","doi":"10.1186/s13256-025-05377-x","DOIUrl":"10.1186/s13256-025-05377-x","url":null,"abstract":"<p><strong>Background: </strong>Solitary fibrous tumors are uncommon mesenchymal neoplasms, with an incidence of less than one case per million people annually. This case is notable for its presentation in a young patient and is the first reported instance of a pleural solitary fibrous tumor causing atrial compression. The successful use of a hybrid surgical approach for resection adds to its novelty.</p><p><strong>Case presentation: </strong>A 34-year-old Palestinian female patient presented with an 8-month history of progressive chest pain, palpitations, and mild shortness of breath. Imaging revealed a large mediastinal mass (14.5 × 12.5 × 6 cm) compressing the heart, particularly the left ventricle. Computed-tomography-guided core biopsy confirmed a solitary fibrous tumor on histopathology. Risk stratification using the Demicco model classified the tumor as low risk, with a mitotic index of 1-2 per 10 high-power fields and < 5% necrosis. The patient underwent a hybrid surgical approach combining video-assisted thoracoscopic surgery with thoracotomy to achieve complete resection. Postoperative recovery was uneventful, with resolution of symptoms and no recurrence at 1-month follow-up.</p><p><strong>Conclusions: </strong>This case highlights the rarity of large mediastinal solitary fibrous tumors with significant compression of mediastinal structures. It demonstrates the importance of innovative surgical techniques, multidisciplinary care, and long-term surveillance for managing these rare tumors.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"310"},"PeriodicalIF":0.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560389","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 tolvaptan-associated hyperglycemia: a case report.","authors":"Huihuan Sun, Ping Yang, Lijuan Chen, Ying Zhang, Shudong Liu, Wenxiu Sun","doi":"10.1186/s13256-025-05356-2","DOIUrl":"10.1186/s13256-025-05356-2","url":null,"abstract":"<p><strong>Background: </strong>Tolvaptan-associated hyperglycemia has rarely been described in literature.</p><p><strong>Case presentation: </strong>A 95-year-old East Asian (Chinese) male patient with hyponatremia started on tolvaptan treatment at a dosage of 15 mg per day. The patient had a serum sodium concentration of 124.5 mmol/L at baseline; this concentration increased to 138.3 mmol/L over the ensuing 5 months of treatment. Moreover, the patient's fasting blood glucose dramatically increased from 6.3 to 17.2 mmol/L with tolvaptan treatment, and his glycated hemoglobin A1c increased from 5.8% to 9.4%. Tolvaptan was withdrawn owing to hyperglycemia, and insulin pump treatment was started. The serum sodium concentration decreased to 123 mmol/L after tolvaptan withdrawal. The higher levels of blood glucose, insulin, and C-peptide did not return to their previous levels for 5 months after the withdrawal of tolvaptan.</p><p><strong>Conclusion: </strong>We reported a rare case of tolvaptan-associated chronic severe hyperglycemia with a Naranjo probability scale score of 6. Our findings increase clinical knowledge and indicate the need for proactive blood glucose monitoring during prolonged tolvaptan use in clinical practice.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"314"},"PeriodicalIF":0.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560392","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}