The American Journal of Case Reports最新文献_第10页

A 44-Year-Old Alcohol-Dependent Man Who Recovered from Central Pontine Myelinolysis with Supportive Physical Therapy. 一个44岁的酒精依赖者，通过支持性物理治疗从桥脑中央髓鞘溶解中恢复。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-09 DOI: 10.12659/AJCR.937389

Makoto Tobiume, Nami Iha, Ayako Miyahira, Shingo Kariya

{"title":"A 44-Year-Old Alcohol-Dependent Man Who Recovered from Central Pontine Myelinolysis with Supportive Physical Therapy.","authors":"Makoto Tobiume, Nami Iha, Ayako Miyahira, Shingo Kariya","doi":"10.12659/AJCR.937389","DOIUrl":"https://doi.org/10.12659/AJCR.937389","url":null,"abstract":"BACKGROUND Central pontine myelinolysis (CPM) includes symmetric demyelination of the central pons. CPM is a rare neurological disorder that generally develops after rapid correction of hyponatremia in individuals having underlying conditions, such as malnutrition, alcoholism, and severe burns. It can cause severe long-term disabilities. However, there is currently no pharmacotherapy capable of promoting remyelination, a process crucial for recovery from CPM. We present the case of a patient with alcoholism and malnutrition-related CPM, which developed following rapid correction of hyponatremia but then improved remarkably with supportive physical therapy. CASE REPORT A 44-year-old alcoholic and malnourished man was admitted to an emergency hospital for disorientation due to overdrinking, but later developed bulbar palsy after hyponatremia was unexpectedly, but rapidly, corrected. Axial scans of the diffusion-weighted brain MRI revealed a characteristic lesion known as a piglet sign in the central pons. Based on his underlying conditions, present episode of sodium correction, and MRI finding, the patient was diagnosed as having CPM, which progressively worsened, resulting in locked-in syndrome after 12 days. The patient was then transferred to a long-term care unit and received simple motion exercise daily, but no specific medication. His symptoms gradually improved, achieving discontinuation of tube feeding on day 21, independent walking on day 110, and discharge after 6 months. CONCLUSIONS This report highlights the importance of physical therapy, the potential of which is often underestimated despite its broad benefits for human health, as a readily applicable intervention for patients with CPM. Further understanding of mechanisms underlying exercise-induced myelination should contribute to establishing novel therapies for a wide spectrum of brain disorders.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937389"},"PeriodicalIF":1.2,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/46/amjcaserep-23-e937389.PMC9472294.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33454532","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: 1

Sentinel Lymph Node Mapping and Staging Surgery Via Gasless Transvaginal Natural Orifice Transluminal Endoscopic Surgery: A Case Report of an Endometrial Cancer Patient and Comorbid Rheumatic Heart Disease. 无气经阴道自然腔内窥镜手术前哨淋巴结定位和分期:子宫内膜癌合并风湿性心脏病1例报告

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-08 DOI: 10.12659/AJCR.936694

Yan Li, Qiannan Hou, Zhaolin Gong, Lu Huang, Li He, Yonghong Lin

{"title":"Sentinel Lymph Node Mapping and Staging Surgery Via Gasless Transvaginal Natural Orifice Transluminal Endoscopic Surgery: A Case Report of an Endometrial Cancer Patient and Comorbid Rheumatic Heart Disease.","authors":"Yan Li, Qiannan Hou, Zhaolin Gong, Lu Huang, Li He, Yonghong Lin","doi":"10.12659/AJCR.936694","DOIUrl":"https://doi.org/10.12659/AJCR.936694","url":null,"abstract":"BACKGROUND Conventional laparoscopic surgery and transvaginal natural orifice transluminal endoscopic surgery (vNOTES) both use CO2 pneumoperitoneum to expose the surgical space. However, CO₂ pneumoperitoneum is undoubtedly dangerous for patients with rheumatic heart disease (RHD) and can cause cardiopulmonary impairments. Therefore, we selected the sentinel lymph node (SLN) mapping strategy to guide the staging surgery via gasless vNOTES for an endometrial cancer (EC)-patient with comorbid RHD. Here, we discuss whether our selected surgical method was safe and feasible for this patient. CASE REPORT A 43-year-old woman with a history of RHD, severe mitral regurgitation, and pulmonary hypertension for more than 30 years received diagnostic curettage for irregular vaginal bleeding for more than 1 month. Pathological examinations revealed the occurrence of highly differentiated intrauterine endometrioid adenocarcinoma. She was admitted to the gynecological ward of our hospital for further surgery. We performed EC staging surgery with SLN mapping via gasless vNOTES and adopted a series of effective measures to solve the intraoperative complications of surgical space exposure. Surgery was successful. The patient recovered well and was discharged 5 days after surgery. She has been followed up in the gynecological clinic for nearly 1 year. At the time of this report, she had good recovery, no recurrence and metastasis, and normal tumor markers. CONCLUSIONS For EC patients with comorbid RHD pathology, application of staging surgery with SLN mapping via gasless vNOTES was shown to be safe and feasible. This approach is expected to be highly effective for patients with contraindications to CO2 pneumoperitoneum laparoscopy.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e936694"},"PeriodicalIF":1.2,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/d6/amjcaserep-23-e936694.PMC9469034.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448124","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: 1

A Case of Segmental Arterial Mediolysis of Multiple Visceral Arteries Following Anti-COVID-19 Vaccination: Late Complication or Rare Coincidence? 1例接种抗covid -19疫苗后出现多段内脏动脉节段性动脉介质溶解:晚期并发症还是罕见巧合?

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-07 DOI: 10.12659/AJCR.937505

Akihiro Takeda, Wataru Koike, Fumihiro Okumura

{"title":"A Case of Segmental Arterial Mediolysis of Multiple Visceral Arteries Following Anti-COVID-19 Vaccination: Late Complication or Rare Coincidence?","authors":"Akihiro Takeda, Wataru Koike, Fumihiro Okumura","doi":"10.12659/AJCR.937505","DOIUrl":"https://doi.org/10.12659/AJCR.937505","url":null,"abstract":"BACKGROUND Segmental arterial mediolysis (SAM) is a rare noninflammatory, nonatherosclerotic vascular disorder characterized by arterial media disruption. In conjunction with the SARS-CoV-2 infection or anti-COVID-19 vaccination, vascular disorders have been recognized as organ-specific immune-mediated complications, and the number of reported cases is gradually increasing. CASE REPORT A 68-year-old man presented with severe upper abdominal pain and nausea 58 days after a third injection of Pfizer-BioNTech anti-COVID-19 mRNA vaccination. An abdominal dynamic computed tomography angiography showed stenosis and dilatation of multiple visceral arteries, including the middle and right colic arteries. In the omental arteries, spindle-shaped dilatation and stenosis were identified. The left epiploic artery was not visualized, suggesting the development of occlusion due to arterial dissection. Based on these findings, SAM of multiple visceral arteries was diagnosed. Because the patient's vital condition was stable, treatment by observation, with restriction of daily living, was chosen. Seventy-five days later, the pathological lesions in the affected vessels spontaneously resolved. CONCLUSIONS While coincidence could not be completely excluded in this case, anti-COVID-19 mRNA vaccination should be noted for its potential association with SAM as a possible late complication.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937505"},"PeriodicalIF":1.2,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/3a/amjcaserep-23-e937505.PMC9469033.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40355168","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: 1

Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation. 在气管造口术面罩通气期间，开放性气管造口术后皮下肺气肿。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-06 DOI: 10.12659/AJCR.937102

Abdalhai Alshoubi, Archana Mathew

{"title":"Subcutaneous Emphysema Following Open Tracheostomy During Tracheostomy Mask Ventilation.","authors":"Abdalhai Alshoubi, Archana Mathew","doi":"10.12659/AJCR.937102","DOIUrl":"https://doi.org/10.12659/AJCR.937102","url":null,"abstract":"BACKGROUND Tracheostomy is a surgical procedure that is done by creating an ostomy in the anterior wall of the trachea to facilitate airway access and ventilation. It is indicated for acute respiratory failure after prolonged intubation, upper airway obstruction, difficult airway, and extensive secretions. Early perioperative complications include bleeding, pneumothorax/pneumomediastinum from a false tract, subcutaneous emphysema, esophageal perforation, and tracheal ring fractures. CASE REPORT We present the case of a 64-year-old woman with a past medical history of hypertension, asthma, alcohol and cocaine abuse, bipolar, and, right breast cancer that was treated by chemotherapy and total mastectomy. She was diagnosed with adductor spasmodic dysphonia of unknown etiology 6 months ago and has been treated with Botulinum toxin injection, with an incomplete resolution. She was admitted to the Respiratory Intensive Care Unit with acute hypoxic respiratory failure associated with stridor secondary to laryngospasm, which was unresponsive to steroids and racemic epinephrine. She underwent an emergent open tracheostomy with a regular nonfenestrated tracheostomy tube. A few hours after surgery, she was weaned from mechanical ventilation to a tracheostomy mask oxygen and had an episode of strong cough followed by extensive neck and facial subcutaneous emphysema. CONCLUSIONS Subcutaneous emphysema is a rare complication but it can be catastrophic, especially if it is associated with pneumothorax and/or pneumomediastinum. Avoiding tight a tracheostomy tube strap and fenestrated tracheostomy tube is one of the measures that can be used to avoid this complication.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937102"},"PeriodicalIF":1.2,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/b6/amjcaserep-23-e937102.PMC9465497.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351562","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: 1

Severe Ureteral Endometriosis Complicated with Hydronephrosis: A Case Report. 重度输尿管子宫内膜异位症并发肾积水1例。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-05 DOI: 10.12659/AJCR.937172

Ying Bai, Yaqin Li, Qi Li, Weihong Zhao

{"title":"Severe Ureteral Endometriosis Complicated with Hydronephrosis: A Case Report.","authors":"Ying Bai, Yaqin Li, Qi Li, Weihong Zhao","doi":"10.12659/AJCR.937172","DOIUrl":"https://doi.org/10.12659/AJCR.937172","url":null,"abstract":"BACKGROUND Endometriosis is a disease characterized by endometrial tissue appearing outside the uterus, mainly involving the peritoneum and pelvic organs. Ureteral endometriosis (UE) is rare, typified by deep infiltrating endometriosis involving the ureter and can result in ureteral obstruction, proximal hydroureter, hydronephrosis, and impairment of renal function. Symptoms may be insidious and nonspecific and may lead to a prolonged disease course. We describe a patient with UE complicated by hydronephrosis. CASE REPORT A 42-year-old woman was admitted to the Urology Department with the incidental discovery of right hydronephrosis. After a thorough examination, she underwent right ureteral mass resection and right ureteral stump anastomosis. The pathology report indicated endometriosis. The patient was given 6 doses of gonadotropin-releasing hormone agonist immediately after surgery, followed by an intrauterine levonorgestrel-releasing system. Postoperative follow-up showed that no recurrence was observed in this year. Here, we briefly summarize the epidemiology, pathogenesis, clinical presentation, imaging, treatment, and prognosis of the disease. CONCLUSIONS UE should be listed as one of the differential diagnoses of unexplained hydronephrosis in women of childbearing age, and those with dysmenorrhea should be cognizant of this disease. Active surgical treatment and long-term management should be carried out to obtain better prognosis.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937172"},"PeriodicalIF":1.2,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/02/amjcaserep-23-e937172.PMC9460306.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40348113","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

Metastatic Recurrent Breast Cancer Identified in the Chiropractic Office: Case Report and Literature Review. 在整脊诊所发现的转移性复发性乳腺癌:病例报告和文献综述。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-04 DOI: 10.12659/AJCR.937609

Eric Chun-Pu Chu, Robert J Trager, Colin Ritchie Lai, John Sing Fai Shum

{"title":"Metastatic Recurrent Breast Cancer Identified in the Chiropractic Office: Case Report and Literature Review.","authors":"Eric Chun-Pu Chu, Robert J Trager, Colin Ritchie Lai, John Sing Fai Shum","doi":"10.12659/AJCR.937609","DOIUrl":"https://doi.org/10.12659/AJCR.937609","url":null,"abstract":"BACKGROUND Breast cancer is the most common cancer in women and the most common cause of spinal metastasis, and it may recur months to years after treatment. CASE REPORT A 41-year-old woman, recovered from breast cancer, presented to a chiropractor with acute-on-chronic 3-week history of low back pain radiating to the right leg. She had seen 2 providers previously; lumbar spondylosis had been diagnosed via radiography. Given her recent symptom progression and cancer history, the chiropractor ordered lumbar magnetic resonance imaging, revealing L5 vertebral marrow replacement, suggestive of metastasis. The chiropractor referred her to an oncologist. While awaiting biopsy and oncologic treatments, the oncologist cleared the patient to receive gentle spinal traction and soft tissue manipulation, which alleviated her back pain. The patient continued radiation and chemotherapy, with low back pain remaining improved over 18 months. A literature review identified 7 previous cases of women presenting to a chiropractor with breast cancer metastasis. Including the current case, most had spinal pain and vertebral metastasis (75%) and history of breast cancer (88%) diagnosed a mean 5±3 years prior. CONCLUSIONS This case illustrates a woman with low back pain due to recurrent metastatic breast cancer, identified by a chiropractor, and the utility of a multidisciplinary approach to pain relief during oncologic care. Our literature review suggests that although uncommon, such patients can present to chiropractors with spinal pain from vertebral metastasis and have a known history of breast cancer. Conservative therapies should be used cautiously and under oncologic supervision in such cases.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937609"},"PeriodicalIF":1.2,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/91/amjcaserep-23-e937609.PMC9453868.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40347478","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: 6

Milk-Alkali Syndrome: How Electronic Medical Record Open Notes Helped to Rule Out Cancer. 牛奶碱综合征:电子病历开放笔记如何帮助排除癌症。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-03 DOI: 10.12659/AJCR.936969

Michelle-Ashley Rizk, Nicholas Abourizk, Iuliia Kovalenko, Konstantin Golubykh, Bosky Soni, Matthew Zaccheo, Steve Zanders

{"title":"Milk-Alkali Syndrome: How Electronic Medical Record Open Notes Helped to Rule Out Cancer.","authors":"Michelle-Ashley Rizk, Nicholas Abourizk, Iuliia Kovalenko, Konstantin Golubykh, Bosky Soni, Matthew Zaccheo, Steve Zanders","doi":"10.12659/AJCR.936969","DOIUrl":"https://doi.org/10.12659/AJCR.936969","url":null,"abstract":"BACKGROUND Milk-alkali syndrome is caused by excessive consumption of calcium and absorbable alkali and typically presents as a triad of hypercalcemia, acute renal failure, and metabolic alkalosis. In the era of histamine receptor blockers and proton pump inhibitors, the incidence of milk-alkali syndrome has decreased. However, the disease has not been eliminated, due to existing calcium-containing therapies. Here, we present a case of severe milk-alkali syndrome with a challenging initial diagnosis. CASE REPORT We present the case of a 64-year-old man who came to the hospital with encephalopathy. Serologic evaluation revealed acute renal failure, severe hypercalcemia, and metabolic alkalosis. He underwent volume resuscitation, with the initiation of calcitonin. Despite our efforts, the patient developed anuria and proceeded to intermittent hemodialysis. His workup was unrevealing, including an appropriately suppressed parathyroid hormone level, low vitamin D, and normal serum protein electrophoresis and angiotensin converting enzyme levels. Considering his persistent encephalopathy, the team was unable to obtain information from the patient regarding his calcium intake. However, at home, the patient's significant other read his progress notes in the electronic medical record and reported that he consumed at least 1 bottle of calcium carbonate (Tums) every week. Once the encephalopathy resolved, the patient confirmed this information. CONCLUSIONS The search for malignancy in the setting of hypercalcemia was ceased because of the family's at-home electronic medical record use and reporting of Tums overuse. Milk-alkali syndrome, although a rarity, should not be forgotten as a cause of hypercalcemia.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e936969"},"PeriodicalIF":1.2,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/ea/amjcaserep-23-e936969.PMC9450396.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40346515","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

Hypoproteinemia Associated with a Gigantic Odontogenic Tumor: A Report of 2 Cases. 低蛋白血症伴巨大牙源性肿瘤2例报告。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-09-02 DOI: 10.12659/AJCR.937301

Tadashi Kawai, Toshimi Chiba, Kei Onodera, Naoko Tsunoda, Yuko Komatsu, Shuu Suzuki, Yuki Saito, Shintaro Kogi, Yasunori Takeda, Hiroyuki Yamada

{"title":"Hypoproteinemia Associated with a Gigantic Odontogenic Tumor: A Report of 2 Cases.","authors":"Tadashi Kawai, Toshimi Chiba, Kei Onodera, Naoko Tsunoda, Yuko Komatsu, Shuu Suzuki, Yuki Saito, Shintaro Kogi, Yasunori Takeda, Hiroyuki Yamada","doi":"10.12659/AJCR.937301","DOIUrl":"https://doi.org/10.12659/AJCR.937301","url":null,"abstract":"BACKGROUND Hypoproteinemia is caused by a decrease in protein level in the blood. This report describes 2 cases of hypoproteinemia associated with a gigantic odontogenic tumor. CASE REPORT Case 1, a 65-year-old man, visited our hospital with the chief concern of swelling in the right mandible, approximately 100 mm in diameter, and ameloblastoma was diagnosed. Abscess drainage was observed in the fistula of the tumors. Total protein and albumin levels were low before surgery. Hemimandibulectomy was performed under general anesthesia. The final pathological diagnosis based on the specimen was ameloblastic carcinoma. After surgery, the total protein and albumin levels improved and remained stable 6 months after the operation. At 21 months after surgery, there were no signs of recurrence. Case 2, a 60-year-old woman, visited our hospital with a chief concern of swelling in the left mandible, approximately 100 mm in diameter, and ameloblastoma was diagnosed. Abscess drainage was observed in the fistula of the tumors. The patient had a history of hypoproteinemia; preoperative levels of total protein and albumin were low, and edema of the body was observed before surgery. Hemimandibulectomy was performed under general anesthesia. The final pathological diagnosis based on the specimen was ameloblastoma. After surgery, the total protein and albumin levels improved, and remained stable 6 weeks after surgery. There were no signs of recurrence 9 months after surgery. CONCLUSIONS These 2 cases indicate the possibility that hypoproteinemia can be caused by plasma leakage from fistulas associated with gigantic odontogenic tumors.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937301"},"PeriodicalIF":1.2,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/22/amjcaserep-23-e937301.PMC9444163.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40340739","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

Posterior Myocardial Infarction in a 45-Year-Old Javanese Woman with a 1-Month History of COVID-19-Related Guillain-Barré Syndrome: A Challenging Emergency Diagnosis. 一名患有1个月covid -19相关格林-巴勒综合征的45岁爪哇妇女的后心肌梗死:一项具有挑战性的紧急诊断

IF 1.2

The American Journal of Case Reports Pub Date : 2022-08-31 DOI: 10.12659/AJCR.937105

Ivan Satria Pratama, Yudi Her Oktaviono, Terrence Timothy Evan Lusida

{"title":"Posterior Myocardial Infarction in a 45-Year-Old Javanese Woman with a 1-Month History of COVID-19-Related Guillain-Barré Syndrome: A Challenging Emergency Diagnosis.","authors":"Ivan Satria Pratama, Yudi Her Oktaviono, Terrence Timothy Evan Lusida","doi":"10.12659/AJCR.937105","DOIUrl":"https://doi.org/10.12659/AJCR.937105","url":null,"abstract":"BACKGROUND Guillain-Barre syndrome (GBS) is an autoimmune demyelinating disease that affects peripheral nerves and may be associated with nerve pain in the upper limbs and chest. Autonomic dysfunction in GBS can result in electrocardiography (ECG) changes that include T wave inversion, ST segment depression, or ST segment elevation. Recently, GBS was been recognized as a neurological consequence of COVID-19. This report describes the challenge of emergency diagnosis of posterior myocardial infarction (MI) in a 45-year-old Javanese woman who was known to have a 1-month history of COVID-19-related Guillain-Barre syndrome. CASE REPORT We report the case of a 45-year-old patient who presented to the Emergency Department (ED) with atypical angina. She had a history of GBS that started 2 weeks after she developed COVID-19. Since then, she frequently had pain in both legs and occasionally in the chest. Her electrocardiogram revealed subtle ST segment depression in the anteroseptal leads (V1-V4), along with ST segment elevation in the posterior leads (V7-V9). Cardiac marker (troponin I) was elevated and posterior regional wall motion abnormality was present on an echocardiogram. Coronary angiography revealed total occlusion of the first diagonal branch of the LAD, followed by deployment of drug-eluting stents to achieve good angiographic results. The patient was diagnosed with GBS and isolated posterior ST segment elevation myocardial infarction. CONCLUSIONS This report shows the importance of performing standard cardiac investigations for myocardial ischemia or infarction in patients known to have Guillain-Barre syndrome so that the patient can be treated appropriately and urgently to ensure the best possible outcome.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e937105"},"PeriodicalIF":1.2,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/e2/amjcaserep-23-e937105.PMC9444164.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40332010","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

Encephalitis with Extensive Cortical Brain Magnetic Resonance Imaging Changes Secondary to Myelin Oligodendrocyte Glycoprotein Antibody Disease. 髓鞘少突胶质细胞糖蛋白抗体病继发的脑炎伴广泛皮质脑磁共振成像改变。

IF 1.2

The American Journal of Case Reports Pub Date : 2022-08-31 DOI: 10.12659/AJCR.936361

Vivek Satyasi, Gayatra Mainali, Jahnavi Chatterjee, Sita Paudel

{"title":"Encephalitis with Extensive Cortical Brain Magnetic Resonance Imaging Changes Secondary to Myelin Oligodendrocyte Glycoprotein Antibody Disease.","authors":"Vivek Satyasi, Gayatra Mainali, Jahnavi Chatterjee, Sita Paudel","doi":"10.12659/AJCR.936361","DOIUrl":"https://doi.org/10.12659/AJCR.936361","url":null,"abstract":"BACKGROUND The relatively new autoimmune disorder, anti-myelin oligodendrocyte glycoprotein (MOG) disease is particularly interesting because of its broad range of presentations. This entity's appearance on magnetic resonance imaging (MRI) of the brain often makes identifying this disease a challenging process. Younger patients tend to present with an acute disseminated encephalomyelitis picture, with encephalopathy and multifocal neurological signs, while older patients are more likely to present with optic neuritis. We, however, report an atypical case of a patient who presented with encephalopathy, seizures, and significant cortical and subcortical gray matter involvement and was found to have anti-MOG positivity in serum. CASE REPORT A 17-month-old previously healthy boy presented to Emergency Department with fever, lethargy, vomiting, and left-sided weakness. Eventually, he required intubation due to a prolonged seizure. Continuous electroencephalogram captured several focal seizures, and MRI of the brain showed cortical and subcortical T2 hyperintensities. After extensive laboratory evaluation, he tested positive for anti-MOG antibody. He was empirically started on high-dose intravenous pulse methylprednisolone, followed by plasma exchange, given the poor response to the intravenous steroids. At the 5-month follow-up, the results of the neurological examination had dramatically improved, and MRI findings had largely resolved. CONCLUSIONS This case highlights the importance of suspecting anti-MOG antibody-mediated encephalitis, even while ruling out infectious etiologies, in children presenting with encephalopathy, seizures and MRI abnormalities. Prompt recognition would allow for less delay in treatment and hopefully improve prognosis.","PeriodicalId":205256,"journal":{"name":"The American Journal of Case Reports","volume":" ","pages":"e936361"},"PeriodicalIF":1.2,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/39/amjcaserep-23-e936361.PMC9444166.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40333120","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