SAGE Open Medical Case Reports最新文献

{"title":"A rare case report of panhypopituitarism and suspected pituitary apoplexy secondary to Rathke cleft cyst.","authors":"Towfeeq Ashchi, Panida Charnvitayapong, Moiz Khan, Khaled Deeb, Sierra Scott","doi":"10.1177/2050313X261458654","DOIUrl":"10.1177/2050313X261458654","url":null,"abstract":"<p><p>Rathke cleft cysts are typically benign and asymptomatic lesions of the sellar region, with apoplexy and panhypopituitarism being uncommon presentations. We report the case of a 78-year-old male who presented with acute metabolic encephalopathy and panhypopituitarism secondary to a likely Rathke cleft cyst measuring less than 10 mm. Magnetic resonance imaging and clinical findings were consistent with a pituitary tumor, likely Rathke cleft cyst, causing suspected pituitary apoplexy, and subsequent panhypopituitarism, likely the cause of the patient's symptoms that developed and worsened over the next 6 months leading up to diagnosis. Despite the small cyst size, the patient developed central hypothyroidism, central adrenal insufficiency, and hypogonadism, all of which improved with hormone replacement therapy. The patient's improvement with medical management led to the decision not to pursue surgical intervention. Rathke cleft cyst apoplexy-inducing panhypopituitarism remains exceedingly rare; the largest published series identified only 21 confirmed cases over a decade-long period. This case highlights that even small Rathke cleft cysts can lead to significant endocrine dysfunction and underscores the need for vigilant follow-up.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261458654"},"PeriodicalIF":0.6,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412745","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":"Linezolid as a potential alternative to glycopeptide in treating <i>Enterococcus faecium</i> suspected cyst infection in a hemodialysis patient with autosomal-dominant polycystic kidney disease: A case report.","authors":"Takahito Inagaki, Mai Otsu, Akitoshi Takuma, Kenji Momo","doi":"10.1177/2050313X261460553","DOIUrl":"10.1177/2050313X261460553","url":null,"abstract":"<p><p>Autosomal-dominant polycystic kidney disease is a clinically significant disorder associated with progressive renal impairment. In these patients, cyst infection is an important but variably occurring complication, and optimal antibiotic selection remains challenging owing to the limited available evidence and restricted antibiotic penetration into cysts. An 81-year-old Japanese man with autosomal-dominant polycystic kidney disease undergoing maintenance hemodialysis presented with fever and a suspected cyst infection. Blood cultures showed the fluoroquinolone-resistant <i>Enterococcus faecium</i>. Vancomycin was contraindicated due to allergy, and teicoplanin was ineffective. Oral linezolid was initiated, resulting in clinical improvement. However, treatment was discontinued after 15 days of therapy (on hospital day 27) because of grade 1 thrombocytopenia. This case contributes to the limited clinical evidence in this field and highlights the potential role of linezolid in the management of <i>Enterococcus faecium</i> suspected cyst infections in autosomal-dominant polycystic kidney disease when glycopeptides are ineffective or contraindicated.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261460553"},"PeriodicalIF":0.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391696","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":"Concurrent diabetic ketoacidosis, acute pancreatitis, and subsequent ruptured acalculous cholecystitis in a patient receiving semaglutide: A case report.","authors":"Chuan-Tai Chiu, Ya-Hui Hu, Chia-Hui Chang","doi":"10.1177/2050313X261463142","DOIUrl":"10.1177/2050313X261463142","url":null,"abstract":"<p><p>A 70-year-old male with type 2 diabetes presented to the emergency department with severe abdominal pain and dyspnea after 24 weeks of treatment with weekly subcutaneous semaglutide (1 mg). He was diagnosed with acute pancreatitis and diabetic ketoacidosis (DKA) and admitted to the intensive care unit. Following 5 days of stabilization and symptom relief, he was transferred to a general ward. However, the patient subsequently developed a high-grade fever persisting for 3 days, accompanied by severe leukocytosis, despite normalized serum lipase levels. A repeat abdominal computed tomography scan revealed acute acalculous cholecystitis complicated by gallbladder rupture. The patient underwent emergency percutaneous transhepatic gallbladder drainage and antibiotic therapy, leading to gradual recovery. This clinical course illustrates a rare cascade of severe complications in a patient receiving a glucagon-like peptide-1 (GLP-1) receptor agonist. Specifically, when new-onset systemic symptoms emerge following the initial stabilization of a critical illness, clinicians should maintain vigilance for repeating imaging studies. This rare case highlights the need for further investigation into whether the pharmacological effects of GLP-1 receptor agonists, such as biliary stasis, might act as a predisposing factor for complex biliary complications in the setting of severe physiological stress.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261463142"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376577","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":"Neonatal Sweet syndrome associated with a rectovestibular fistula in a 5-week-old female: A case report.","authors":"Damy Horth, Isabelle Auger, Marie-Claude Dionne","doi":"10.1177/2050313X261463921","DOIUrl":"10.1177/2050313X261463921","url":null,"abstract":"<p><p>Sweet syndrome is an uncommon neutrophilic dermatosis in the pediatric population. As in adults, it is frequently associated with underlying conditions, including infectious diseases, neoplasias, inflammatory bowel disease, and autoimmune or autoinflammatory disorders. Genetic causes, such as chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature syndrome, should also be considered, particularly in neonates. We report a case of a 5-week-old female infant with a confirmed Sweet syndrome associated with a rectovestibular fistula-an unusual association, with only three cases previously reported in the literature. To our knowledge, this is the first reported case in a non-Japanese neonate.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261463921"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376625","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":"Auricular and periauricular hidradenitis suppurativa: Increasing awareness of atypical sites.","authors":"Claire Fortman, David Seiter","doi":"10.1177/2050313X261463889","DOIUrl":"10.1177/2050313X261463889","url":null,"abstract":"<p><p>Hidradenitis suppurativa is typically found in intertriginous areas such as the axillae and groin. As incidence rates rise, however, hidradenitis suppurativa is increasingly identified in unexpected locations. As this phenomenon has been underreported, these patients experience diagnostic delays and inappropriate or inadequate treatment. This case involves a man in his 60s who presented with an inflamed earlobe that had waxed and waned without diagnosis or treatment for many years. Recognition of the signs and symptoms of hidradenitis suppurativa led to diagnosis, effective therapy, and improved quality of life; however, due to diagnostic delay related to the atypical location, tunneling and scarring had already developed. This case highlights auricular and periauricular hidradenitis suppurativa to promote earlier recognition and timely intervention to limit progression of this highly morbid disease.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261463889"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391665","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":"Takotsubo syndrome triggered by perioperative and post-resuscitation stress: Case report.","authors":"Roshan Tom, Sean O'Leary, Kathy Kuang, Ariadna Robledo, Beth Teegarden","doi":"10.1177/2050313X261464290","DOIUrl":"10.1177/2050313X261464290","url":null,"abstract":"<p><p>Takotsubo syndrome or \"broken heart syndrome,\" is an uncommon but increasingly recognized condition that can mimic acute coronary syndrome and is characterized by transient regional left ventricular dysfunction, often with apical ballooning. Perioperative physiological stress, catecholamine surges, and vasopressor exposure are recognized triggers. This case describes suspected perioperative takotsubo syndrome in a high-risk surgical patient and emphasizes the need for vigilance and early recognition. A 66-year-old woman with hypertension, type B aortic dissection, prior stroke, carotid disease, hyperlipidemia, and tobacco use presented with a left intertrochanteric fracture requiring operative repair. During anesthesia induction, she developed profound hypotension and bradycardia refractory to fluids and vasopressors, resulting in procedure cancellation. Her initial echocardiogram demonstrated normal systolic function without regional wall motion abnormalities. Surgery was rescheduled the following day; however, she experienced pulseless electrical activity arrest postoperatively. Advanced cardiovascular life support with epinephrine achieved return of spontaneous circulation. A post-arrest echocardiogram demonstrated new mid-apical hypokinesis with an ejection fraction of 35%-40%, most consistent with takotsubo syndrome in the clinical context. She was treated with guideline-directed medical therapy, including beta-blockade and an ACE inhibitor, with subsequent stabilization and discharge. Formal coronary angiography was not performed, and the patient was lost to cardiology follow-up, limiting definitive exclusion of obstructive coronary artery disease and confirmation of left ventricular recovery. This case illustrates the multifactorial perioperative contributors to takotsubo syndrome and highlights the importance of recognizing warning features, including recurrent hypotension, catecholamine exposure, labile hemodynamics, and high-risk cardiovascular comorbidity.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261464290"},"PeriodicalIF":0.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369720","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":"Delayed diagnosis of pancake kidney (completely fused pelvic renal ectopia) in a 49-year-old woman presenting with lower urinary tract symptoms in a low-resource setting: A case report.","authors":"James Sumawe","doi":"10.1177/2050313X261464739","DOIUrl":"10.1177/2050313X261464739","url":null,"abstract":"<p><p>Complete fused renal ectopia, also known as pancake kidney, is a rare congenital renal fusion anomaly characterized by complete fusion of both kidneys within the pelvis. Most patients remain asymptomatic and diagnosis is often incidental. I report a 49-year-old woman from a low-resource setting who presented with lower urinary tract symptoms and dyspareunia. Initial management was directed toward recurrent cystitis; however, further evaluation with computed tomography and intravenous urography revealed a pancake kidney located in the pelvis with two distinct collecting systems and normally draining ureters. No evidence of obstructive uropathy, renal mass lesion, or associated complications was identified. This case highlights the diagnostic challenge posed by nonspecific clinical presentation and limited access to advanced imaging in low-resource settings, which may contribute to delayed or incidental diagnosis of congenital renal anomalies.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261464739"},"PeriodicalIF":0.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369745","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 diagnostic headache: A rare case of adult onset primary leptomeningeal medulloblastoma.","authors":"Sophia Raefsky, Neal Nathan, Meshari Alharthi, Jessica Bloom, Vanessa Goodwill, Kari Hird, Nikdokht Fari, William Ueng, Jessica Schulte","doi":"10.1177/2050313X261459345","DOIUrl":"10.1177/2050313X261459345","url":null,"abstract":"<p><p>Headache is a common reason for consulting inpatient neurology and the most common outpatient reason for referral to neurology clinics. Idiopathic intracranial hypertension is a common cause of secondary chronic headaches. Presence of typical patient traits and comorbid risk factors such as obesity could lead to bias and misdiagnosis without investigation into other etiologies. Primary leptomeningeal medulloblastoma in adults is an extremely rare cause of headache that initially mimicked idiopathic intracranial hypertension in this case. A 25-year-old male with months of intractable headaches developed confusion, vision changes, and weakness. Headaches were initially attributed to idiopathic intracranial hypertension, so spinal imaging was not attained at other hospitals, and he was first treated with cerebrospinal fluid diversion and optic nerve sheath fenestration. However, he later developed decompensated hydrocephalus and myelopathy. Imaging at our hospital showed extensive leptomeningeal enhancement in the brain, spinal cord, and cauda equina. A lumbar intradural mass was biopsied with pathology showing nodular/desmoplastic and anaplastic/large cell medulloblastoma, consistent with disseminated isolated leptomeningeal medulloblastoma. This case highlights that when headaches are refractory, the differential diagnosis should be expanded, and comprehensive work-up should be pursued. Leptomeningeal metastasis is a rare cause of intractable headaches. Further, isolated leptomeningeal medulloblastoma is rare. Early recognition, comprehensive neuroimaging, and prompt tissue biopsy are critical to facilitating an accurate diagnosis and optimizing therapeutic opportunities. Rapid clinical and radiographic response to proton craniospinal irradiation and the Packer protocol suggests this regimen is effective for adult-onset primary leptomeningeal medulloblastoma.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261459345"},"PeriodicalIF":0.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369693","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":"Normocalcemic pseudohypoparathyroidism type 1B complicated by hypokalemia: A case report.","authors":"Linjia Guo, Qiuying Li, Yingqi Liu, Xinyue Yu, Saijia Li, Fei Yan","doi":"10.1177/2050313X261458043","DOIUrl":"10.1177/2050313X261458043","url":null,"abstract":"<p><p>Pseudohypoparathyroidism (PHP) is a heterogeneous group of disorders defined by resistance to parathyroid hormone (PTH), typically stemming from GNAS locus abnormalities. This report describes an unusual case of a 32-year-old Han Chinese male with sporadic PHP Type 1B (PHP1B) who presented with paroxysmal numbness and significant hypokalemia. Despite elevated PTH levels, the patient maintained normocalcemia and showed no evidence of globus pallidus calcification on brain imaging. Diagnosis was confirmed using methylation-specific multiplex ligation-dependent probe amplification, which identified characteristic GNAS imprinting defects: a gain of methylation at the NESP55 exon and loss of methylation at the AS, XL, and A/B exons. With a normal copy number, no detectable GNAS mutations, and a negative family history, the case was classified as sporadic PHP1B. This rare presentation highlights the broad phenotypic spectrum of PHP and emphasizes the clinical importance of monitoring diverse electrolyte disturbances, such as hypokalemia, even when calcium levels appear normal.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261458043"},"PeriodicalIF":0.6,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353582","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":"Treatment of gastrocnemius spasms induced by foot injury using negative pressure wound therapy: A case report.","authors":"An Wei, Hao Xing, Zehui Jiang","doi":"10.1177/2050313X261460559","DOIUrl":"10.1177/2050313X261460559","url":null,"abstract":"<p><p>Soft tissue injuries of the foot are common in scenarios such as traffic accidents and construction site incidents, involving damage to the plantar fat pad, blood vessels, nerves, and important tendon tissues. The treatment of these injuries faces significant challenges. A 46-year-old male patient suffered soft tissue injuries to the plantar and calcaneus of his right foot due to trauma, without any fractures. Following injury, the patient developed spasms in the right gastrocnemius muscle for unknown reasons. Nevertheless, after undergoing several sessions of negative pressure wound therapy to treat the soft tissue injury on the foot, the spasms in the gastrocnemius muscle resolved, and the soft tissue damage on the plantar and calcaneus of the right foot was effectively treated. This research presents a case of utilizing negative pressure wound therapy to treat a trauma patient with a foot injury-induced gastrocnemius spasms. By explaining and discussing the changes in spasm symptoms post-treatment, the clinical significance and potential mechanism of negative pressure wound therapy in managing foot soft tissue injuries causing gastrocnemius spasms are investigated.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"14 ","pages":"2050313X261460559"},"PeriodicalIF":0.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346195","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}