SAGE Open Medical Case Reports最新文献

{"title":"Rituximab treatment in non-lupus full-house nephropathy: A case report.","authors":"Caroline Gee, Dao Le, Matthew D Nguyen, Anthony Sisk, Ramy Hanna","doi":"10.1177/2050313X251333979","DOIUrl":"https://doi.org/10.1177/2050313X251333979","url":null,"abstract":"<p><p>Non-lupus full-house nephropathy describes a pattern of \"full-house\" immunofluorescence on renal biopsy in the absence of clinical or serologic markers for systemic lupus erythematosus. It is a rare disease with a broad range of etiologies, including idiopathic, secondary, or a prodrome of systemic lupus erythematosus. Current treatment options are lacking, with mixed results in the literature for varied immunosuppressive regimens. Rituximab, a selective anti-CD20 B-cell monoclonal antibody, has shown success in immune-complex mediated glomerular diseases but has not been commonly used or studied in non-lupus full-house nephropathy. Here, we present a case of non-lupus full-house nephropathy that was refractory to first-line immunosuppressants, in which two rounds of rituximab treatment achieved a positive response. This case emphasizes the need for systemic analysis of rituximab use in non-lupus full-house nephropathy, particularly given its mixed etiologies and presentations.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251333979"},"PeriodicalIF":0.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079965","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":"Use of low-dose varenicline in hospitalized smokers: A case series low-dose varenicline in hospitalized smokers.","authors":"Rachael L Joyner, Remi E Phillips, Farid A Manshaii, James M Davis","doi":"10.1177/2050313X251338637","DOIUrl":"https://doi.org/10.1177/2050313X251338637","url":null,"abstract":"<p><p>Nicotine replacement therapy is the primary medication used to treat tobacco dependence in hospitalized patients. Recent evidence shows that varenicline is more effective than nicotine replacement, but varenicline side effects limit its use in the hospital. Low-dose varenicline has shown similar efficacy as standard dose, but has fewer side effects and thus may be useful in hospitalized patients. We assessed the effectiveness and tolerability of low-dose varenicline (1 mg each morning or 0.5 mg twice daily; patient choice) in hospitalized adult daily smokers between July 2022 and March 2023. The primary outcome was self-reported 7-day smoking abstinence at the first outpatient visit after hospitalization. Secondary outcomes included smoking reduction and medication tolerability. Of the 15 patients assessed, 8 (53.3%) reported 7-day smoking abstinence at their first post-discharge outpatient visit (mean of 14.9 days after discharge). Mean cigarettes per day decreased from 22.0 (SD 17.4) prior to hospitalization to 3.7 (SD 6.0) after hospitalization. Low-dose varenicline was well tolerated, with 80% (12) patients reporting no adverse events and 20% (3) patients reporting mild side effects not requiring a change in medication or dose. Study outcomes support the possibility that low-dose varenicline might be an effective and well-tolerated treatment for hospitalized smokers. Results from this case series are limited by the small sample size and lack of a control arm. Findings suggest that a randomized controlled trial may be warranted to assess the efficacy and tolerability of low-dose varenicline in hospitalized patients.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251338637"},"PeriodicalIF":0.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029265","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":"Chronic leg ulcers in a patient with filarial lymphedema, varicose veins and hepatitis C virus infection: Healing with local wound management and supportive care.","authors":"Malarvizhi Anandan, Sadhishkumar Paranthaman, Sadhasivam Anbusivam, Vijesh Sreedhar Kuttiatt","doi":"10.1177/2050313X251338664","DOIUrl":"https://doi.org/10.1177/2050313X251338664","url":null,"abstract":"<p><p>Chronic ulcer management is often a frustrating experience not only for the patient but for the clinician as well. Many times, conservative local wound management with good supportive care alone may bring about desirable outcomes. We report the healing of long-standing multiple leg ulcers, with dedicated long-term local wound care and supportive management, in a patient suffering from multiple comorbidities - filarial lymphedema, varicose veins and hepatitis C infection. Cutaneous ulcers in association with hepatitis C infection are rarely reported in the literature. We highlight the importance of investigating rare underlying causes that delay wound healing, apart from stressing the significance of local wound care in inducing healing.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251338664"},"PeriodicalIF":0.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996427","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":"Failure of daratumumab in the treatment of anti-synthetase syndrome: A case report.","authors":"Nam Nguyen, Valérie Leclair, Rayan Kaedbey, Marie Hudson","doi":"10.1177/2050313X251336022","DOIUrl":"https://doi.org/10.1177/2050313X251336022","url":null,"abstract":"<p><p>Anti-synthetase syndrome is a subset of idiopathic inflammatory myopathies, for which refractory disease can be difficult to treat. Daratumumab, an anti-CD38 monoclonal antibody primarily used in hematologic malignancies, has recently shown promise in very few case reports of refractory idiopathic inflammatory myopathies. We present a case of a 44-year-old man with anti-Jo1 anti-synthetase syndrome with concurrent anti-Ro52, in which myositis remained refractory to multiple immunosuppressants. Despite treatment with daratumumab, the patient did not respond and ultimately succumbed to infection. This case underscores the need for further research to better define the role of daratumumab in idiopathic inflammatory myopathies and identify predictors of treatment response.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251336022"},"PeriodicalIF":0.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044149","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":"Anti-glutamic acid decarboxylase 65: Related stiff person syndrome - A report of two cases and literature review.","authors":"Ena Elizabeth L Naoe, Redentor R Durano, Ranhel C De Roxas-Bernardino, Gerard Saranza","doi":"10.1177/2050313X251333676","DOIUrl":"https://doi.org/10.1177/2050313X251333676","url":null,"abstract":"<p><p>Stiff person syndrome is a rare neurological disorder characterized by muscular rigidity, painful spasms, and gait abnormalities. The diagnosis is primarily clinical and often requires a high index of suspicion. While the pathophysiology is not fully understood, stiff person syndrome is frequently associated with anti-glutamic acid decarboxylase 65 antibodies, and in some cases, paraneoplastic syndromes. We present two cases of anti-glutamic acid decarboxylase 65positive stiff person syndrome in the Philippines: a 53-year-old diabetic woman presenting with a classical stiff person syndrome case that responded well to symptomatic treatment, and a 62-year-old woman with a history of thyroiditis presenting with paraneoplastic stiff person syndrome that showed significant improvement on follow up after plasmapheresis and tumor excision. These cases are particularly valuable due to their rare local presentation, contributing to the limited data on stiff person syndrome in our region. This article also includes a review of the existing literature on stiff person syndrome, highlighting key diagnostic and therapeutic approaches. The findings emphasize the importance of early diagnosis and intervention, as well as expanding clinical awareness of this condition in regions where it is not widely recognized.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251333676"},"PeriodicalIF":0.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006092","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":"Intrathecal drug delivery systems: A case series advancing surgical, clinical, and technological safety with broader implications for invasive neuromodulation therapies.","authors":"Bi Mo, Sandra Sacks, Jerry Markar","doi":"10.1177/2050313X251338563","DOIUrl":"https://doi.org/10.1177/2050313X251338563","url":null,"abstract":"<p><p>Intrathecal drug delivery systems (IDDS) represent an advanced modality of invasive pharmacological neuromodulation, providing efficacious treatment for terminal malignant pain as well as select chronic noncancer pain conditions. Although intrathecal drug delivery systems offer the potential for reduced systemic adverse effects compared to conventional routes, they are not without significant complications, including infections, device dysfunction, and severe neurological injuries. Moreover, the integration of network-based smart-device applications into intrathecal drug delivery system control interfaces introduces a concomitant elevation in risks associated with software errors and cybersecurity vulnerabilities. Case 1: a 77-year-old male receiving intrathecal methadone therapy, after the failure of first- and second-line agents, developed a catheter-tip spinal granuloma resulting in irreversible paraplegia secondary to thoracic spinal cord compression. Case 2: a 37-year-old female with a history of longstanding depression experienced a severe surgical site infection attributable to suboptimal surgical techniques during intrathecal drug delivery system implantation. This complication led to septic shock and meningitis, necessitating device removal and prolonged intravenous antibiotic therapy, though she ultimately recovered without permanent neurological deficits. Case 3: a 67-year-old female encountered acute opioid withdrawal and subsequent hospitalization as a consequence of a tablet-based interrogation platform's software error in timekeeping that miscalculated her intrathecal drug delivery system refill date and recovered without enduring neurological sequelae. Invasive neuromodulation therapies, including intrathecal drug delivery systems, present multifaceted challenges that necessitate rigorous patient and therapeutic agent selection, meticulous risk factor mitigation, continuous neuromonitoring, and prompt detection of subtle neurological changes indicative of potential complications. This analysis delineates three critical domains: first, clinical vigilance and enhanced monitoring protocols are essential for the early identification of severe complications, such as granuloma formation; second, an educational paradigm shift, standardized, comprehensive surgical training in fellowship programs is required to ensure technical proficiency, optimal postoperative management, and an in-depth understanding of psychosocial factors; and third, technological leadership, the adoption of app-based management systems on consumer platforms introduces vulnerabilities including software malfunctions and cybersecurity threats, thereby necessitating that physicians advocate for stringent safety standards and robust regulatory oversight. Collectively, these strategies are indispensable for enhancing the safety and efficacy of invasive neuromodulation therapies and transforming the landscape of chronic pain management.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251338563"},"PeriodicalIF":0.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027979","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":"From door to diagnosis: A case report of a rare and life-threatening presentation of Takayasu arteritis.","authors":"Eiad Habib, Laura MacPhee, Fawad Aslam, Bhavesh Patel, Ayan Sen, Lisa LeMond, Ina Soh, Chelsea Marshall, Marie Grill, Kartik Mangipudi, Nolan McBride, Hiroshi Sekiguchi","doi":"10.1177/2050313X251335205","DOIUrl":"https://doi.org/10.1177/2050313X251335205","url":null,"abstract":"<p><p>Takayasu arteritis is a chronic, large vessel vasculitis that typically affects the aorta and its main branches. We present a case of a 33-year-old male patient who was diagnosed with Takayasu arteritis after being admitted for acute cardiogenic shock requiring inotropes. Initial transthoracic echocardiography demonstrated severe biventricular dysfunction. Computed tomography imaging of his chest showed pulmonary infarcts. Patient subsequently developed sudden lower extremity weakness and bowel incontinence, and urgent magnetic resonance imaging of his spine demonstrated thoracolumbar vascular myelopathy. Transesophageal echocardiography revealed diffuse symmetrical thickening of the walls of the aorta; findings suggestive of aortitis. Patient was initiated on intravenous corticosteroid and systemic anticoagulation. Subsequent computed tomography angiography demonstrated irregular luminal contour of the aortic arch, and complete occlusion of the left subclavian artery, abdominal aorta, superior mesenteric artery, and left renal artery. He underwent an emergent aortoiliac thrombectomy. He was transitioned to oral prednisone, tocilizumab, and azathioprine with excellent recovery.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251335205"},"PeriodicalIF":0.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009815","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":"Abnormal anus and hymen in a toddler: A case report.","authors":"Nancy D Kellogg, Lora R Spiller","doi":"10.1177/2050313X251336057","DOIUrl":"https://doi.org/10.1177/2050313X251336057","url":null,"abstract":"<p><p>A 2-year-old girl presented to the Emergency Department with genital complaints and a concern for sexual abuse. A perineal defect and absence of a segment of the posterior hymen were observed; the caregiver denied a past history of trauma. No other signs consistent with abuse or neglect were noted on examination. Pediatric surgery conducted an exam under anesthesia and confirmed a perineal fistula. While trauma is the most likely explanation for a large segmental defect in the posterior hymen, the co-occurrence of an anatomical variant of the anus and perineum in this patient raises questions about the etiology of both findings. This case underscores the importance of adequate examinations with careful inspection and documentation of anogenital structures in the newborn period.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251336057"},"PeriodicalIF":0.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046501","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":"Asymptomatic Crohn's disease presenting as perianal masses in a child: A case report and literature review.","authors":"Samia Rahman, Loretta Fiorillo","doi":"10.1177/2050313X251320194","DOIUrl":"https://doi.org/10.1177/2050313X251320194","url":null,"abstract":"<p><p>A 7-year-old male presented to our outpatient pediatric dermatology clinic for enlarging perianal masses initially suspected to be warts. Family endorsed a 2-year history of generally poor growth but denied gastrointestinal symptoms at our initial visit. Physical examination revealed three fleshy, pedunculated, violaceous masses around the anal sphincter that were rubbery in texture. Pathology indicated inflammatory polyps and further investigations confirmed the diagnosis of anal skin tags secondary to highly active and severe Crohn's disease. This case highlights the essential role of dermatologists in recognizing perianal masses as potential indicators of Crohn's disease, even when classic gastrointestinal symptoms are initially absent, as these findings can enable timely diagnosis and management.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251320194"},"PeriodicalIF":0.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043856","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":"Obstruction of the hepatic veins-a rare case of Budd-Chiari syndrome: A case report.","authors":"Joel Sabu, Kevin Jose Madapat, Namitha K Baby, Supraja Subramanian","doi":"10.1177/2050313X251324986","DOIUrl":"https://doi.org/10.1177/2050313X251324986","url":null,"abstract":"<p><p>Budd-Chiari syndrome is a disorder that is characterized by obstruction of hepatic venous outflow, with thrombosis being the primary cause of the obstruction. This case report describes a 47-year-old Indian male presenting with distension of the abdomen and umbilical swelling for 1 year. Investigations revealed hepatic venous outflow obstruction and a partial web with focal calcification in the Inferior Vena Cava. Despite using standard medical therapeutic options such as diuretics, beta-blockers, and anticoagulation, his ascites remained uncontrolled. Interventional radiology with inferior vena cava venoplasty using 10 and 14 mm angioplasty balloons was performed, leading to the resolution of inferior vena cava stenosis and improved condition. Post-procedure, the patient was put on anticoagulation therapy and was discharged in good condition. This case highlights the successful management of Budd-Chiari syndrome with inferior vena cava occlusion using a multidisciplinary approach combining interventional radiology and medical therapy.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251324986"},"PeriodicalIF":0.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043941","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}