World Journal of Clinical Cases最新文献

{"title":"Immunoglobulin G4-related lung disease mistaken for pulmonary tuberculosis: A case report.","authors":"Jia-Lian Zhou, Xi-Yu Zhou, Wen-Juan Li, Shun Feng","doi":"10.12998/wjcc.v13.i27.108261","DOIUrl":"10.12998/wjcc.v13.i27.108261","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin G4-related disease (IgG4-RD) is a persistent and progressive autoimmune condition marked by inflammation and fibrotic changes in the affected tissues. Cases of IgG4-RD causing pulmonary lesions are relatively rare, and some may be misdiagnosed as pulmonary tuberculosis.</p><p><strong>Case summary: </strong>In this report, we present an uncommon instance of IgG4-related lung disease, which was diagnosed through lung tissue biopsy conducted <i>via</i> puncture. A 67-year-old male was hospitalized with a two-month history of cough and sputum production. Chest computed tomography (CT) revealed infiltrative pulmonary tuberculosis in both upper lungs. However, the initial diagnosis was unclear, and the patient received HZRE quadruple therapy for tuberculosis at a local hospital. After 45 days of anti-tuberculosis treatment, the patient's cough and sputum worsened, and he began coughing up blood, prompting transfer to our hospital. Serum tests revealed elevated IgG4 levels. A biopsy of a right lung showed localized fibrous and extensive plasma cell infiltration, with 30-40 IgG4-positive cells per high-power field, and an IgG4/IgG ratio of 40%. These findings led to a diagnosis of IgG4-related lung disease. Following treatment with prednisone and mycophenolate mofetil, follow-up lung CT scans showed significant lesion improvement.</p><p><strong>Conclusion: </strong>The chest CT findings of IgG4-RD are diverse and nonspecific, often leading to misdiagnosis as pulmonary tuberculosis, especially in primary care settings with limited diagnostic resources. We confirmed the diagnosis of IgG4-related lung disease through histological examination.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"108261"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided platelet-rich plasma injection improves pain, function and symmetry in lumbar myofascial pain syndrome: A case report.","authors":"Shao-Long Ai, Xiao-Na Xiang, Xi Yu, Na Li, Xu-Yang Zhang, Kai-Bo Zhang, Hong-Ying Jiang, Qian Wang, Hong-Chen He","doi":"10.12998/wjcc.v13.i27.108998","DOIUrl":"10.12998/wjcc.v13.i27.108998","url":null,"abstract":"<p><strong>Background: </strong>Myofascial pain syndrome (MPS) is a common musculoskeletal disease associated with myofascial trigger point (MTrP). Muscle injury is one of the common causes of MPS. Currently, there is no effective treatment for MPS.</p><p><strong>Case summary: </strong>A 24-year-old female with chronic lower back MPS secondary to quadratus lumborum (QL) injury underwent comprehensive evaluation using validated scales: Pain severity (visual analog scale, McGill Pain Questionnaire), functional disability (Oswestry Disability Index, Roland Morris Disability Questionnaire), and quality of life [short form 36 (SF-36)]. Objective assessments included sEMG of bilateral QL muscles, Myoton mechanical property analysis, and magnetic resonance imaging volumetric measurements. The patient received four ultrasound-guided platelet-rich plasma (PRP) injections at 4-week intervals, with follow-up evaluations conducted at 1, 3, and 6 months post-treatment.</p><p><strong>Conclusion: </strong>Ultrasound-guided PRP injections alleviated pain, restored function, and improved quality of life in post-traumatic MPS. sEMG demonstrated neuromuscular symmetry restoration in MTrP-affected muscles, supporting the therapeutic potential of PRP.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"108998"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enterococcal autoprobiotics in the complex treatment of colorectal cancer patient receiving chemotherapy: Two case reports and review of literature.","authors":"Elena I Ermolenko, Natalia V Baryshnikova, Sergei A Kovalis, Nadezhda S Novilova, Victoria V Orlova, Anastasia S Ilyina, Victor A Kashchenko, Galina F Leontieva, Alexander N Suvorov","doi":"10.12998/wjcc.v13.i27.107704","DOIUrl":"10.12998/wjcc.v13.i27.107704","url":null,"abstract":"<p><strong>Background: </strong>According to the literature, significant disorders of gut microbiota are consistently observed in patients with colorectal cancer (CRC). Disorders of gut microbiota composition are manifesting clinically as abdominal pain, dyspeptic symptoms (such as rumbling, bloating, and altered bowel habits, including both constipation and diarrhea), and overall reduced quality of life. Also, negative changes in the microbiota may be associated with a more frequent development of postoperative complications and complications during chemotherapy.</p><p><strong>Case summary: </strong>Two patients with CRC underwent surgery (laparoscopic left hemicolectomy) and were prescribed chemotherapy regimen consisted of cisplatin, leucovorin, and fluorouracil. Along with prescribed chemotherapy patients took autoprobiotic enterococci. A fecal sample was collected for autoprobiotic preparation, ensuring that the patient had not taken antibiotics, probiotic supplements, or probiotic-containing foods for at least 10 days. An autoprobiotic contained an indigenous strain of <i>Enterococcus faecium</i> (<i>E. faecium</i>) was formulated. The patients received the autoprobiotic strain <i>E. faecium</i> (liquid form with a concentration of 8 Lg CFU/mL) orally at a dose of 50 mL twice daily during 10 days, regardless of meal times, from the first day of cytostatic treatment, throughout the first course of chemotherapy. As a result, autoprobiotic intake improved patient well-being and prevent side effects associated with the use of cytostatics.</p><p><strong>Conclusion: </strong>The use of autoprobiotics in the treatment of CRC is a promising area to reduce the risks of postoperative complications, increase the tolerability of the basic chemotherapeutic regimen, as well as improve the quality of life.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"107704"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disappearing intraesophageal foreign body: A case report.","authors":"Hong-Wei Qiao, Yi-Fei Ye, Lin-Xi Nie, Shuai Bai, Gui-Zhi Du","doi":"10.12998/wjcc.v13.i27.108693","DOIUrl":"10.12998/wjcc.v13.i27.108693","url":null,"abstract":"<p><strong>Background: </strong>Foreign body ingestion is a common emergency in clinical practice. While the majority of cases are resolved following successful removal, rare and unexpected complications can arise, such as the spontaneous displacement of a foreign body during the procedure. This report describes a unique case where a foreign body initially lodged in the esophagus was dropped during the procedure, leading to aspiration and migration to the airway.</p><p><strong>Case summary: </strong>A 69-year-old Chinese woman presented with a 6-hour history of throat pain and tightness after consuming rabbit meat. She had no fever or bloody stools but had a history of hypertension. Initial imaging, including a neck computed tomography scan, indicated a foreign body in the upper esophagus. Esophageal endoscopy was performed, during which the patient's vital signs remained stable. The procedure showed a 14-cm mucosal erosion with food debris and a visible foreign body located in the gastric fundus. The foreign body was removed with forceps but unexpectedly dropped into the hypopharynx. Subsequent upper gastrointestinal endoscopy did not identify the foreign body. On awakening from anesthesia, the patient exhibited hypoxia and coarse breath sounds, but without coughing. A chest X-ray indicated that the foreign body had migrated into the airway. An emergency fiberoptic bronchoscopy was performed, successfully retrieving the foreign body. The patient recovered without complications.</p><p><strong>Conclusion: </strong>Endoscopic removal of an esophageal foreign body can cause silent aspiration in elderly patients with absent cough reflexes, necessitating bedside imaging and prompt intervention.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"108693"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioresorbable biliary stents: A step forward.","authors":"Li-Bo Zhang, Yan Wang, Xiao-Jun Yang","doi":"10.12998/wjcc.v13.i27.108391","DOIUrl":"10.12998/wjcc.v13.i27.108391","url":null,"abstract":"<p><p>The case report by Elsayed <i>et al</i> presented a multidisciplinary approach to treating recurrent biliary strictures following proximal bile duct injury. Bioresorbable biliary stents, an innovative option for managing biliary strictures in recent years, are a key part of this approach. Unlike traditional metal/plastic stents, bioresorbable stents made from materials like polylactic acid (PLA) or polycaprolactone gradually degrade in the body. This eliminates the need for endoscopic removal, reducing patient trauma and costs. Nondegradable stents often lead to complications such as restenosis, migration, or infection. In contrast, bioresorbable stents can have their degradation rate tailored to the bile duct healing process (<i>e.g.</i>, PLA stents remained unobstructed for 25.7 weeks in a porcine model), minimizing long-term complications. We analyzed the advantages and disadvantages of bioresorbable stents, outlined future research directions, and aimed to offer valuable insights for clinical practice.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"108391"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary signet ring cell carcinoma of the female urethra: A case report.","authors":"Pan Xu, Shan-Shan Ling, E Hu, Bi-Xia Yi","doi":"10.12998/wjcc.v13.i27.107158","DOIUrl":"10.12998/wjcc.v13.i27.107158","url":null,"abstract":"<p><strong>Background: </strong>Primary signet ring cell carcinoma of the urethra in women is an exceedingly rare malignancy. It was first reported in postmenopausal women in 1987, and only five patients have been reported to date.</p><p><strong>Case summary: </strong>A 61-year-old woman presented with irregular vaginal bleeding, and subsequent evaluation identified a tumor located in the distal urethra. Upon diagnosis of primary urethral carcinoma, she underwent a distal urethrectomy. Histopathological analysis demonstrated that the tumor consisted of a combination of intestinal adenocarcinoma and signet ring cell carcinoma. At the 12-month postoperative follow-up, there was no evidence of disease recurrence.</p><p><strong>Conclusion: </strong>This case report highlights the exceptional rarity of female urethral signet ring cell carcinoma, emphasizing the importance of early clinical detection and the necessity for precise and conservative surgical intervention.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"107158"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of pancreatic histology and likelihood of postoperative pancreatic fistula using extracellular volume fraction from contrast-enhanced computed tomography.","authors":"Akihiro Nakamura, Takafumi Ogawa, Kuniya Tanaka, Yuki Takahashi, So Murai, Yuki Tashiro, Akane Wada, Yasuo Ueda, Yosuke Sasaki, Yuzo Minegishi, Kenichi Matsuo, Toshiko Yamochi","doi":"10.12998/wjcc.v13.i27.109243","DOIUrl":"10.12998/wjcc.v13.i27.109243","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic fibrosis, which decreases risk of postoperative pancreatic fistula (POPF), can be estimated using extracellular volume fraction (ECVf).</p><p><strong>Aim: </strong>To investigate the correlation between ECVf and pancreatic histology, as well as the usefulness of ECVf in predicting POPF.</p><p><strong>Methods: </strong>In 71 patients who underwent pancreatic resection, we caluculated pancreatic ECVf by comparing absolute enhancements of the pancreas and aorta between pre-contrast and equilibrium phases. Areas of fibrosis, fat, acini, and islets were calculated based on resection specimens.</p><p><strong>Results: </strong>ECVf correlated with fibrosis (<i>r</i> = 0.724; <i>P</i> < 0.001) and negatively correlated with acini (<i>r</i> = -0.510; <i>P</i> < 0.001). Among 48 patients who underwent pancreatoduodenectomy, 21 developed POPF. Main pancreatic duct diameter ≤ 2 mm and ECVf < 36% were selected as risk factors by multivariate analysis [respective odds ratios (OR) and <i>P</i> values, 4.26 and <i>P</i> = 0.048; OR = 11.07 and <i>P</i> = 0.036]. Using these factors as a risk score (0-2 points), POPF occurred in 0%, 50%, and 70% of patients with 0, 1, and 2 points, respectively.</p><p><strong>Conclusion: </strong>ECVf is useful in predicting acinar loss and pancreatic fibrosis, and ECVf < 36% may be a risk factor for POPF.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"109243"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and surgical management of giant broad ligament myoma with cystic degeneration: A case report.","authors":"Xue Huang, Qiang Yao, Yi-Cheng Wu, Shi-Cong Liu","doi":"10.12998/wjcc.v13.i27.108923","DOIUrl":"10.12998/wjcc.v13.i27.108923","url":null,"abstract":"<p><strong>Background: </strong>Leiomyomas or fibroids commonly originate from the uterus; extrauterine leiomyomas are rare and most often arise from the broad ligament. Diagnosing broad ligament leiomyomas becomes particularly challenging when they undergo degenerative changes because their clinical and radiological features often mimic those of ovarian tumors. We report a rare case of a giant broad ligament fibroid with cystic degeneration, which was initially mistaken for an ovarian mass.</p><p><strong>Case summary: </strong>A 49-year-old woman presented with mild abdominal distension and pain as the only symptoms. Upon abdominal examination, a large mass measuring approximately 30 cm and extending from the pelvic cavity to just below the xiphoid process was identified. Both transvaginal ultrasound and contrast-enhanced computed tomography suggested an ovarian origin of the mass. However, laparotomy confirmed that the mass originated from the right broad ligament. The mass was separated from the uterus and bilateral ovaries, with no involvement of the uterus or ovaries. The mass was completely resected with respecting the patient's desire to retain her uterus and adnexa. Postoperative histopathological examination confirmed leiomyoma with cystic degeneration.</p><p><strong>Conclusion: </strong>Broad ligament myomas mimic ovarian tumors; accurate diagnosis and careful operation are critical to avoid complications and ensure safety.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"108923"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red yeast rice with monacolin K for the improvement of hyperlipidemia: A narrative review.","authors":"Kevan English","doi":"10.12998/wjcc.v13.i27.105415","DOIUrl":"10.12998/wjcc.v13.i27.105415","url":null,"abstract":"<p><p>Low-density lipoprotein cholesterol (LDL-C) is the most causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Red yeast rice (RYR) is a nutraceutical widely used as a lipid-lowering dietary supplement. The main cholesterol-lower agents in RYR are monacolins, particularly monacolin K, a weak reversible inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, whose daily consumption (up to 10 mg/day) reduces LDL-C plasma levels up to 34% within 6-8 weeks when compared to placebo. The reduction in LDL-C is often accompanied by lower levels of plasma apolipoprotein B, total cholesterol, matrix metalloproteinases 2 and 9, high-sensitivity C-reactive protein, non-high-density lipoprotein cholesterol, and blood pressure. RYR has also demonstrated favorable reductions of up to 45% compared to placebo in the risk of ASCVD events in secondary prevention studies. The mechanism of action is similar to statins. When consumed appropriately, RYR is associated with only minimal side effects. Mild myalgia may be seen in patients who cannot tolerate low-dose statins. In individuals with no additional ASCVD risk factors, RYR is a safe and effective supplement in treating mild to moderate hyperlipidemia.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"105415"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the enigma of salivary uric acid in periodontitis: Independent association, mechanistic insights, and future trajectories.","authors":"Dan-Dan Shi, Jing Ding, Ju Tian","doi":"10.12998/wjcc.v13.i27.108117","DOIUrl":"10.12998/wjcc.v13.i27.108117","url":null,"abstract":"<p><p>This article explores the association between salivary uric acid (UA) and periodontitis, systematically analyzing its dual roles and research progress. Studies indicate that UA acts as a primary antioxidant in saliva under physiological conditions (accounting for 70%), protecting periodontal tissues by scavenging reactive oxygen species. However, when gum disease becomes severe, UA can switch roles and fuel inflammation, worsening tissue damage. Lorente <i>et al</i>'s research found an independent inverse correlation between salivary UA levels and periodontitis severity (odds ratio = 6.14, <i>P</i> = 0.001), establishing 111 nmol/mL as a diagnostic threshold (area under the curve = 66%). Nevertheless, limitations include sample heterogeneity and failure to distinguish between gingivitis and periodontitis. Mechanistically, three hypotheses are proposed: The Antioxidant Depletion Hypothesis (UA oxidation consumption leading to feedback loops), the Microbial Metabolic Hijacking Hypothesis (pathogens utilizing UA as a carbon source to disrupt redox balance), and the Epithelial Barrier Dysfunction Hypothesis (UA deficiency causing downregulation of tight junction proteins). Future research should prioritize longitudinal cohorts to validate predictive value, integrate multi-omics to explore dysregulated signatures, and develop UA supplementation or targeted antioxidant therapies. This study provides novel insights into periodontitis diagnosis and mechanisms, advancing the application of salivary biomarkers in precision periodontics.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 27","pages":"108117"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}