Journal of Medical Case Reports最新文献

{"title":"Dynamic stabilization in adolescent idiopathic scoliosis with a 5-year follow-up: a case report.","authors":"Lei Luo, Liehua Liu, Pei Li, Chen Zhao, Lichuan Liang, Yongjian Gao, Qiang Zhou","doi":"10.1186/s13256-025-05326-8","DOIUrl":"10.1186/s13256-025-05326-8","url":null,"abstract":"<p><strong>Background: </strong>Although instrumented fusion is the most widely accepted surgical treatment for adolescent idiopathic scoliosis, it leads to permanent spinal motion loss and an increased risk of adjacent segment degeneration. Consequently, there is great interest in finding nonfusion methods to correct scoliosis in patients with adolescent idiopathic scoliosis. The aim of this manuscript is to report a case of adolescent idiopathic scoliosis (Lenke 5C) treated by dynamic stabilization without fusion using the Dynesys system.</p><p><strong>Case presentation: </strong>The patient was a 17-year-old East Asian female. Before the operation, the major lumbar curve was 32.2° and the lumbosacral curve was 18.5°, with the Risser sign at grade 4. The procedure was performed using the Wiltse approach. The extent of fixation was from the cephalic horizontal vertebra to sacrum. The scoliosis was corrected by the unequal length of the spacers on the concave/convex side. We obtained a good correction of scoliosis, which was maintained during the 5-year follow-up. We also observed less intraoperative blood loss, faster postoperative recovery, and more motion preservation.</p><p><strong>Conclusion: </strong>In this case, dynamic stabilization was demonstrated to be technically feasible for the treatment of thoracolumbar/lumbar moderate scoliosis. The benefits are related to less damage to the soft tissues, reduced blood loss, and motion preservation. However, further studies are needed to determine the effectiveness of the described surgical strategy.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"295"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540474","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":"Essential thrombocythemia as an initial presentation of polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome with complete response to the bortezomib, cyclophosphamide, dexamethasone regimen: a case report.","authors":"Alireza Zangooie, Zahra Moradi, Reza Asgari, Amirhosein Maharati, Zahra Salehi, Abolghasem Allahyari","doi":"10.1186/s13256-025-05338-4","DOIUrl":"10.1186/s13256-025-05338-4","url":null,"abstract":"<p><strong>Background: </strong>Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome is a rare paraneoplastic disorder often presenting with atypical manifestations, making diagnosis challenging. This case is novel due to the rare presentation of essential thrombocythemia as the initial manifestation of polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome. Furthermore, it highlights the remarkable therapeutic response, achieving a complete remission following treatment with the bortezomib, cyclophosphamide, dexamethasone regimen, underscoring this combination therapy's efficacy in managing such complex cases.</p><p><strong>Case presentation: </strong>A 65-year-old Iranian woman presented with fatigue, headache, and thrombocytosis, leading to a diagnosis of essential thrombocythemia. Over time, her condition progressed with the development of neuropathy and persistence of thrombocytosis, which warranted further investigation. Imaging revealed multiple lymphadenopathies, sclerotic bone lesions, and ascitic fluid, raising suspicion for a plasma cell dyscrasia. Bone marrow biopsy, lymph node biopsy, and elevated vascular endothelial growth factor levels confirmed the diagnosis of polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome. The patient was treated with bortezomib, cyclophosphamide, dexamethasone chemotherapy regimen, resulting in complete symptom relief, normalization of the complete blood count, and significant improvement in imaging findings.</p><p><strong>Conclusion: </strong>This case highlights the need to recognize atypical polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome presentations, such as essential thrombocythemia, for timely diagnosis and underscores the bortezomib, cyclophosphamide, dexamethasone regimen's efficacy in achieving complete remission.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"301"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540527","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":"Fiberoptic bronchoscopy-guided endotracheal intubation in prone position for a patient with a thoracic spinal stab wound: a case report.","authors":"Jianwei Zhou, Kailai Zhu, Chuanguang Wang, Ye Zhu","doi":"10.1186/s13256-025-05354-4","DOIUrl":"10.1186/s13256-025-05354-4","url":null,"abstract":"<p><strong>Background: </strong>Position changes in patients with thoracic spinal stab wounds may cause displacement of embedded sharp objects, increasing the risk of spinal cord or surrounding tissue injury. Management of these cases under anesthesia requires a carefully planned approach to minimize movement and ensure patient safety.</p><p><strong>Case presentation: </strong>A 59-year-old Han Chinese male was admitted to the hospital due to \"back pain and bleeding caused by stab wounds for 2 hours.\" The patient was at high risk of secondary spinal cord injury and aspiration due to an embedded foreign object and a full stomach state. Fiberoptic bronchoscopy-guided endotracheal intubation was successfully performed in the prone position under mild sedation.</p><p><strong>Conclusion: </strong>This case highlights the feasibility and safety of awake fiberoptic bronchoscopy-guided intubation in the prone position and provides valuable insights for managing similar high-risk scenarios in clinical practice.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"294"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540529","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":"Occurrence of cerebral CO₂ embolism during laparoscopic adrenalectomy: a case report and review of the literature.","authors":"Miaomiao Xu, Jiejie Zhou, Xuemei Cheng, Yunfei Han, Kangli Hui","doi":"10.1186/s13256-025-05305-z","DOIUrl":"10.1186/s13256-025-05305-z","url":null,"abstract":"<p><strong>Background: </strong>CO₂ embolism has been documented in a range of laparoscopic procedures, and cerebral CO₂ embolism is an extremely rare but lethal incidence of CO₂ embolism, which may ultimately result in coma, stroke, disability, and mortality.</p><p><strong>Case presentation: </strong>This paper presents an uncommon case of cerebral CO₂ embolism that occurred during laparoscopic surgery, along with a thorough examination of existing literature. The patient (56-year-old Chinese female) experienced a loss of consciousness, generalized tonic-clonic seizures, and neurological impairments after undergoing a laparoscopic partial adrenalectomy. Multiple low-density lesions were detected by brain magnetic resonance imaging. The patient exhibited improvement and gradual recovery after undergoing therapies such as continuous hyperbaric oxygen therapy, hypothermic brain protection, hormone therapy, and anticoagulation.</p><p><strong>Conclusion: </strong>We emphasize that cerebral CO₂ embolism is a significant complication that must be given great importance in laparoscopic surgery. The comprehension of cerebral CO₂ embolism, and effective communication between surgeons and anesthesiologists, play a crucial role in its diagnosis and avoiding inadequate treatment.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"299"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540531","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":"Valproate-induced hyperammonemic encephalopathy: the role of clinical pharmacists in medication safety-a case report.","authors":"Wei Chen, Dong Wang, Wei Fu, Jinpeng Wang, Min Chen, Jun Li, Fei Li","doi":"10.1186/s13256-025-05294-z","DOIUrl":"10.1186/s13256-025-05294-z","url":null,"abstract":"<p><strong>Background: </strong>Sodium valproate, a commonly prescribed antiepileptic drug in clinical practice, has been occasionally linked to hyperammonemia, although the precise mechanisms underlying this adverse effect remain poorly understood. This article reports a case of hyperammonemic encephalopathy induced by sodium valproate in a patient with epilepsy. Through a comprehensive analysis and discussion of appropriate interventions, we aim to offer valuable insights for optimizing antiepileptic drug therapy in clinical settings, thereby preventing adverse drug reactions and ensuring optimal treatment outcomes for patients.</p><p><strong>Case presentation: </strong>A 37-year-old Chinese male presented with a complex neurological history. He underwent emergency neurosurgical intervention under general anesthesia 4 years prior to admission for resection of intracranial vascular malformation, evacuation of intracranial hematoma, and decompressive craniectomy following a ruptured right cerebral vascular malformation with hemorrhage, complicated by left frontal-temporal-parietal epidural hematoma and cerebral herniation. Postoperatively, the patient remained in a confusional state. Approximately 2 weeks before the current admission, he developed febrile episodes accompanied by intermittent seizures, leading to hospitalization. The patient was diagnosed with cerebral hemorrhage sequelae and secondary epilepsy, for which sodium valproate therapy was initiated. Despite antiepileptic treatment, seizure control was inadequate, and the patient's consciousness level progressively deteriorated. Therapeutic drug monitoring revealed a trough valproate concentration of 62 μg/mL, while serial blood ammonia measurements demonstrated a progressive elevation, peaking at 248.1 μmol/L. On the basis of these findings, a diagnosis of sodium valproate-induced hyperammonemic encephalopathy was established. Consequently, sodium valproate was discontinued and replaced with levetiracetam, accompanied by ammonia-lowering therapy. Following this therapeutic adjustment, the patient's clinical course showed marked improvement: blood ammonia levels decreased to 75.2 μmol/L within 5 days, seizure activity diminished, consciousness level improved, and the patient's condition stabilized.</p><p><strong>Conclusion: </strong>The clinical pharmacy team demonstrated exceptional vigilance in promptly identifying the adverse drug reactions and establishing effective interdisciplinary communication with the attending physicians. This timely intervention and collaborative approach significantly contributed to the optimization of pharmacotherapy, thereby ensuring medication safety and providing a solid foundation for the patient's favorable therapeutic outcome.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"302"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540533","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":"Evaluating the technetium-99 m pertechnetate flow protocol for Graves' disease: methodological insights: a case series.","authors":"Jaber Abdulwahab Asiri, Rami Abdullah Alghamdi, Ahmed Ali AlRizqi, Shahad Khalaf Alrasheed, Abdulaziz Alaythan, Bander Mukhlef Alshammri, Mohammed Abdullah Alshehri, Mohammed Hadi Alarjani, Zyad Alshehri, Nahed Nasser ALFawaz, Rayan Saad Albalawi","doi":"10.1186/s13256-025-05365-1","DOIUrl":"10.1186/s13256-025-05365-1","url":null,"abstract":"<p><strong>Background: </strong>Graves' disease is the most prevalent cause of hyperthyroidism globally, with technetium-99m pertechnetate widely utilized in its diagnosis. Dynamic scintigraphy using technetium-99m pertechnetate has shown promise for early detection of Graves' disease, particularly in subclinical presentations, but lacks standardized evaluation. This study aims to explore the utility of a dynamic technetium-99m pertechnetate scintigraphy protocol in hyperthyroidism, focusing on its diagnostic advantages and potential clinical applications.</p><p><strong>Case presentation: </strong>The cases described involved adult male and female patients aged 34-40 years of Saudi Middle Eastern ethnicity.</p><p><strong>Conclusions: </strong>Dynamic flow imaging using technetium-99m pertechnetate represents a promising diagnostic approach for Graves' disease, particularly in challenging subclinical cases. This protocol has the potential to refine diagnostic accuracy and guide treatment decisions. Further validation through larger studies is warranted to establish its clinical utility.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"297"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540528","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":"Insidious meningitis induced by brucellosis: a case report.","authors":"Raghad Mahmoud Alsuliman, Heba Haj Saleh, Huda Hossin, Ibrahim Labbad","doi":"10.1186/s13256-025-05352-6","DOIUrl":"10.1186/s13256-025-05352-6","url":null,"abstract":"<p><strong>Background: </strong>Brucellosis is a rare etiology for chronic neurological infections, posing a diagnostic challenge for patients due to the potential for atypical symptoms.</p><p><strong>Case presentation: </strong>We are presenting a rare case report of Brucella meningitis. A 25-year-old unmarried Syrian female without any prior medical history presented with a progressive headache that had persisted for over 10 months, accompanied by nausea and vomiting that worsened when lying down. Initially, the diagnosis was attributed to idiopathic intracrainal hypertension due to the absence of systemic symptoms and an incorrect cerebrospinal fluid test. A comprehensive re-evaluation was performed, and Wright test was positive and Brucella antibodies were detected in both blood and cerebrospinal fluid samples. This ultimately confirmed the diagnosis of Brucella meningitis.</p><p><strong>Conclusion: </strong>Our report emphasizes the importance of considering atypical bacteria as a cause for neuro-infection, and a wide investigation should be conducted to reach an accurate diagnosis and reevaluation of tests when necessary.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"292"},"PeriodicalIF":0.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475586","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 rhabdomyolysis in an infant due to fatty acid oxidation disorder: a case report.","authors":"Amelie Krug, Pascale Perlot, Aurelie Empain, Catheline Vilain, Anne Monier, Kaoutar Tazi, Corinne De Laet","doi":"10.1186/s13256-025-05350-8","DOIUrl":"10.1186/s13256-025-05350-8","url":null,"abstract":"<p><strong>Background: </strong>Rhabdomyolysis can develop from numerous etiologies, both acquired and hereditary. Consequences of rhabdomyolysis may be grave, therefore identifying and treating the etiology is crucial.</p><p><strong>Case presentation: </strong>We herein report the occurrence of severe rhabdomyolysis in a previously healthy 14-month-old infant presenting to the emergency department with fever, hypotonia, and generalized discomfort. Analysis revealed extremely high creatine phosphokinase levels (> 100,000 UI/L). Metabolic myopathy was suspected, however, primary metabolic analyses were normal. Carnitine palmitoyltransferase II deficiency was diagnosed following genetic analysis, identifying a homozygous NM_000098.3, c.338C > T, p.[Ser113Leu] missense variant. Prophylactic measures were established to prevent relapse and genetic counseling provided for the sibship.</p><p><strong>Conclusion: </strong>This case highlights the difficulty of diagnosing carnitine palmitoyltransferase II deficiency in an infant and the importance of genetic analysis to establish the diagnosis, despite a normal acylcarnitine profile.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"291"},"PeriodicalIF":0.9,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368985","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":"Artifacts affecting dual-energy X-ray absorptiometry and bone mineral density measurements: a case report and review of the literature.","authors":"Kevin White, Mohamed K M Shakir, Christopher Nguyen, Thanh D Hoang","doi":"10.1186/s13256-025-05353-5","DOIUrl":"10.1186/s13256-025-05353-5","url":null,"abstract":"<p><strong>Introduction: </strong>It is important to recognize artifacts of dual-energy X-ray absorptiometry because they may alter bone mineral density measurements. To prevent erroneous decisions and misdiagnosis regarding treatment and follow-up, bone mineral density measurement adjustments are needed.</p><p><strong>Case presentation: </strong>We present three cases in which artifacts altered the measurements of bone mineral density in the lumbar field of a dual-energy X-ray absorptiometry scan. The first case was oral contrast in the transverse colon in a 55-year-old white Hispanic American woman; the second case was kyphoplasty in lumbar spine in a 73-year-old white Hispanic American woman; and the third case was spinal fusion with vertebroplasty in a 70-year-old white European American man.</p><p><strong>Conclusion: </strong>Clinicians who interpret dual-energy X-ray absorptiometry imaging should routinely reexamine the scans and be attentive toward potential artifact involvement and other alternative origins of unreliable data.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"290"},"PeriodicalIF":0.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340201","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":"Metastatic colon involvement from primary adrenal gland angiosarcoma: a case report.","authors":"Sarra Ben Rejeb, Safia Sakly, Rym Bahloul, Taieb Jomni, Kalthoum Dridi","doi":"10.1186/s13256-025-05345-5","DOIUrl":"10.1186/s13256-025-05345-5","url":null,"abstract":"<p><strong>Introduction: </strong>Angiosarcoma is a rare and aggressive malignancy accounting for 1-2% of soft tissue sarcomas. Primary adrenal angiosarcomas are exceptionally rare, with fewer than 60 cases reported.To our knowledge, this is the first documented case of an adrenal angiosarcoma presenting as a colonic metastasis.</p><p><strong>Case report: </strong>A 68-year-old Caucasian North African woman with a history of adrenalectomy for a right adrenal tumor presented with gastrointestinal bleeding, and endoscopy revealed a hemorrhagic ulcerative lesion in the sigmoid colon. Histopathological examination revealed a malignant vascular tumor. Immunohistochemistry showed positivity for CD31, erythroblastosis virus E26 transforming sequence related gene, and pan-cytokeratin, consistent with angiosarcoma. In light of her history, a review of the adrenalectomy specimen confirmed the diagnosis of primary adrenal angiosarcoma.</p><p><strong>Conclusion: </strong>This case underscores the necessity of thorough pathological evaluation, use of vascular markers, and interdisciplinary collaboration to improve diagnosis and management.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"287"},"PeriodicalIF":0.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336687","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}