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

Low-Energy Trauma: Severe Liver Injury in an Elderly Patient from a Seated Fall. 低能量创伤：一位老年患者因坐姿跌倒造成严重肝损伤。

IF 1

American Journal of Case Reports Pub Date : 2024-12-27 DOI: 10.12659/AJCR.946094

Naoko E Katsuki, Hitoshi Eguchi, Risa Hirata, Hidetoshi Aihara, Masaki Tago

{"title":"Low-Energy Trauma: Severe Liver Injury in an Elderly Patient from a Seated Fall.","authors":"Naoko E Katsuki, Hitoshi Eguchi, Risa Hirata, Hidetoshi Aihara, Masaki Tago","doi":"10.12659/AJCR.946094","DOIUrl":"10.12659/AJCR.946094","url":null,"abstract":"BACKGROUND Appropriate management of patients who have fallen is crucial for reducing damage and mortality. We report the case of a patient who fell from a seated position, which caused traumatic liver injury, with gastrointestinal symptoms as the primary patient concern. CASE REPORT A woman in her 80s who was living independently fell from a seated position during the daytime. She presented to our clinic the next day, reporting vomiting and loose stools. Her vital signs included blood pressure of 100/48 mmHg and a pulse rate of 76 beats/minute, with tenderness over the right chest wall. She was suspected of having a fracture in the absence of X-ray imaging and was advised to rest and treated with analgesia on demand. Subsequent laboratory results showed levels of hemoglobin, alanine transaminase, and lactate dehydrogenase of 98 g/L, 659 U/L, and 429 U/L, respectively. At the hospital, a computed tomography scan revealed severe liver injury and rib fractures. Vascular embolization or surgery was not performed, and hematogenous pleural effusion was drained once via thoracentesis. The hematoma did not enlarge, and the patient's ability to perform activities of daily living gradually improved. She was discharged after 10 days of hospitalization. CONCLUSIONS The patient presented with gastrointestinal symptoms, leading to a delayed diagnosis of severe liver injury. Low-energy trauma can cause fatal injuries, and physicians should assess patients who fall for the risk of organ injuries, while being mindful of potential biases. Additionally, non-specific symptoms after trauma can be associated with organ injury.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e946094"},"PeriodicalIF":1.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898864","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

Metapneumovirus-Induced Myocarditis Complicated by Klebsiella pneumoniae Co-Infection: A Case Report. 偏肺病毒所致心肌炎合并肺炎克雷伯菌感染1例。

IF 1

American Journal of Case Reports Pub Date : 2024-12-27 DOI: 10.12659/AJCR.946119

Shih-Hung Wang, Mei-Hui Lee, Yuarn-Jang Lee, Yung-Ching Liu

{"title":"Metapneumovirus-Induced Myocarditis Complicated by Klebsiella pneumoniae Co-Infection: A Case Report.","authors":"Shih-Hung Wang, Mei-Hui Lee, Yuarn-Jang Lee, Yung-Ching Liu","doi":"10.12659/AJCR.946119","DOIUrl":"10.12659/AJCR.946119","url":null,"abstract":"BACKGROUND Human metapneumovirus (hMPV), classified in the Pneumoviridae family, is primarily known for causing lower respiratory tract infections in children, the elderly, and immunocompromised individuals. However, rare instances have shown that hMPV can also affect other systems, such as the cardiovascular system, leading to conditions like myocarditis. CASE REPORT We describe a 68-year-old man with a medical history of diabetes, hypertension, and liver cirrhosis who presented to the Emergency Department (ED) exhibiting symptoms of fever, cough, and dyspnea. His condition deteriorated rapidly, progressing to septic shock and requiring increased oxygen support, which led to his transfer to the medical intensive care unit (MICU). Diagnostic evaluations, including cardiac echocardiography and coronary angiography (CAG), confirmed the presence of myocarditis while excluding acute myocardial infarction. Despite aggressive interventions, including extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP) therapy, the patient's condition worsened, and he died 3 days after admission. Polymerase chain reaction (PCR) testing of a throat swab confirmed hMPV infection, with Klebsiella pneumoniae simultaneously identified via sputum culture. The bacterial susceptibility report indicated that the bacteria were sensitive to piperacillin/tazobactam, which had been administered since the patient arrived at our ED, which suggests that the bacterial infection alone cannot fully explain the patient's condition. CONCLUSIONS Compared to previously reported cases of hMPV-related myocarditis, this case is the first to demonstrate notably adverse outcomes associated with the concurrent presence of bacterial infection. The rapid progression and poor outcome despite aggressive treatment emphasize the need for early diagnosis and management of such co-infections.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e946119"},"PeriodicalIF":1.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898868","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

An Accessory Right Hepatic and Cystic Arteries Derived from the Superior Mesenteric Artery: A Cadaveric Case Report. 源自肠系膜上动脉的右肝和囊性副动脉：一例尸体病例报告。

IF 1

American Journal of Case Reports Pub Date : 2024-12-26 DOI: 10.12659/AJCR.945606

Matthew J Folkman, Alexander N Hasselbach, Sarah C Porter, Hamoun Delaviz, Wendy Lackey-Cornelison, Adel Maklad

{"title":"An Accessory Right Hepatic and Cystic Arteries Derived from the Superior Mesenteric Artery: A Cadaveric Case Report.","authors":"Matthew J Folkman, Alexander N Hasselbach, Sarah C Porter, Hamoun Delaviz, Wendy Lackey-Cornelison, Adel Maklad","doi":"10.12659/AJCR.945606","DOIUrl":"10.12659/AJCR.945606","url":null,"abstract":"BACKGROUND The configuration of the hepatic arteries is known to vary substantially between individuals. Here, we report a rare retroperitoneal configuration of an accessory hepatic artery existing alongside a left and right hepatic artery branching from the proper hepatic artery. During routine dissection, we discovered an anomalous configuration of the hepatic arteries that does not fit the commonly used categorizations for abnormal hepatic vasculature. We briefly discuss potential implications of this finding. CASE REPORT The left and right hepatic arteries branch directly from the common hepatic artery and supply the liver. The accessory hepatic artery arises directly from the superior mesenteric artery, travels posterior to the portal triad, and enters the porta hepatis. It was found to travel posterior to the neck of the pancreas, duodenum, and portal triad at the same depth as the inferior vena cava, suggesting that the accessory right hepatic artery was traveling retroperitoneally, posterior to the opening of the lesser sac. The accessory hepatic artery exclusively supplies the cystic arteries. Considering existing classification schemes, our case most closely resembles Michels's type 6 and Hiatt's type 3, but most specifically López-Andújar's type 6. To the best of our knowledge, this is one of the first reported cases of a retroperitoneal accessory right hepatic artery. CONCLUSIONS Knowledge of the possible variations of the hepatic arteries is important to reduce the risk of iatrogenic injury and improve patient outcomes in surgery, especially in laparoscopic cases or pancreatoduodectomies where more unique variants may be especially difficult to identify or easier to injure. Future research should explore the frequency of retroperitoneal accessory right hepatic arteries, as their unique course may be easily missed.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945606"},"PeriodicalIF":1.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898857","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

Efficacy of Neoadjuvant Therapy for ROS1-Positive Locally-Advanced Lung Adenocarcinoma: A Case Report. ros1阳性局部晚期肺腺癌新辅助治疗疗效1例报告。

IF 1

American Journal of Case Reports Pub Date : 2024-12-24 DOI: 10.12659/AJCR.945446

Rong Chen, Guirong Wang, Jinlong Zhao, Yiqun Liu

{"title":"Efficacy of Neoadjuvant Therapy for ROS1-Positive Locally-Advanced Lung Adenocarcinoma: A Case Report.","authors":"Rong Chen, Guirong Wang, Jinlong Zhao, Yiqun Liu","doi":"10.12659/AJCR.945446","DOIUrl":"10.12659/AJCR.945446","url":null,"abstract":"BACKGROUND ROS1 fusion-positive locally-advanced lung adenocarcinoma is a rare malignant tumor with no clear neoadjuvant therapy guidelines and a poor prognosis. This report describes a 49-year-old man with a ROS1 fusion-positive locally-advanced lung adenocarcinoma with a pathological complete response (pCR) to the tyrosine kinase inhibitor crizotinib combined with chemotherapy. CASE REPORT A 49-year-old Chinese man visited the hospital with a cough and phlegm that began over 20 days ago. Computed tomography (CT) revealed a 4.5-cm diameter mass in the lower lobe of the left lung with enlarged lymph nodes fused together in the left hilum, staging stage IIIA (cT2bN2aM0). Given the pathological diagnosis of adenocarcinoma of lung from the transbronchial lung biopsy (TBLB), the patient subsequently underwent chemotherapy with the lobaplatin and paclitaxel regimen. Subsequently, genetic tests using fluorescence quantitative polymerase chain reaction (PCR) assay for biopsy pathology showed ROS1 fusion-positivity. Based on this, after completing 1 cycle of chemotherapy, the patient continued with daily oral treatment with 500 mg of crizotinib. A follow-up CT after 30 days of crizotinib therapy showed the tumor had vanished. Radical surgery confirmed pCR, and the patient continues crizotinib maintenance therapy with no signs of recurrence on subsequent chest CTs. CONCLUSIONS This case serves to underscore the excellent efficacy of neoadjuvant therapy in a patient with ROS1 fusion-positive locally-advanced lung adenocarcinoma. Neoadjuvant lobaplatin/paclitaxel combined with crizotinib can be considered for such patients, but attention should be paid to the difficulty of surgery, timing selection, and formulation of management guidelines.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945446"},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883071","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

Selective IgA Deficiency and Aseptic Liver Abscess as Initial Indicators of Crohn's Disease in a Young Woman: A Case Study. 选择性IgA缺乏和无菌性肝脓肿作为年轻女性克罗恩病的初始指标：一个案例研究

IF 1

American Journal of Case Reports Pub Date : 2024-12-24 DOI: 10.12659/AJCR.944829

Axelle Amiel, Théo Van Gucht, Marion Bolliet, Lucie Aussenac-Belle, Patrice David, Laurianne Plastaras, Martin Martinot

{"title":"Selective IgA Deficiency and Aseptic Liver Abscess as Initial Indicators of Crohn's Disease in a Young Woman: A Case Study.","authors":"Axelle Amiel, Théo Van Gucht, Marion Bolliet, Lucie Aussenac-Belle, Patrice David, Laurianne Plastaras, Martin Martinot","doi":"10.12659/AJCR.944829","DOIUrl":"10.12659/AJCR.944829","url":null,"abstract":"BACKGROUND Hepatic lesion in a young woman can lead to multiple diagnostic hypotheses, mainly infection and tumor. Crohn's disease (CD) is hardly evoked by clinicians but is reportedly associated with liver damage, especially diffuse granulomas and aseptic abscess. IgA deficiency has been associated with celiac disease or inflammatory bowel disease, including CD. In this report, we present the diagnosis of CD in a fit 23-year-old woman following detection of aseptic liver abscess associated with a previously unknown selective IgA deficiency. CASE REPORT A young 23-year-old woman with no previous medical history other than appendicitis 1 year ago was hospitalized with persistent fever for 2 weeks associated with C-reactive protein increase (142 mg/L). Abdominal computed tomodensitometry and MRI showed a 4-cm liver abscess (segment IV). Biopsy revealed an aseptic epithelioid gigantocellular granuloma with caseous-free necrosis and granulomas rich in eosinophilic polynuclei. Furthermore, colonoscopy detected an inflammation in the colonic and ileal mucosa, with focal ulcerations, suggestive of CD. Immunological assessment led to the diagnosis of selective IgA deficiency. Anti-TNF and immunosuppressor therapies led to a rapid recovery and regression of hepatic lesions. CONCLUSIONS CD should be considered in aseptic liver abscess cases. Considering the association between IgA deficiency and CD, IgA (and IgG/IgM) should be assessed in patients with CD. Further research is necessary to confirm if specific manifestations such as aseptic liver abscess frequently occur in patients with CD related to IgA deficiency.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944829"},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886167","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

Successful Management of HPV-Associated Vulvar Cancer During Pregnancy: A Case Report and Treatment Approach. 妊娠期hpv相关外阴癌的成功治疗：一例报告和治疗方法。

IF 1

American Journal of Case Reports Pub Date : 2024-12-23 DOI: 10.12659/AJCR.942305

Monika Englert-Golon, Stefan Sajdak, Klaudia Dolińska-Kaczmarek, Zuzanna Gruchała, Karolina M Kowalska, Rafał Moszyński

{"title":"Successful Management of HPV-Associated Vulvar Cancer During Pregnancy: A Case Report and Treatment Approach.","authors":"Monika Englert-Golon, Stefan Sajdak, Klaudia Dolińska-Kaczmarek, Zuzanna Gruchała, Karolina M Kowalska, Rafał Moszyński","doi":"10.12659/AJCR.942305","DOIUrl":"10.12659/AJCR.942305","url":null,"abstract":"BACKGROUND Human Papilloma Virus (HPV)-associated Vulvar Squamous Cell Carcinomas (VSCC) present more frequently in young women than HPV- independent tumors. Due to its association with HPV infection, the incidence of vulvar cancer is increasing in young women; however, during pregnancy, it is still extremely rare. CASE REPORT We present the case of a 36-year-old pregnant woman at 23 weeks of pregnancy, diagnosed with HPV 16-associated VSCC, Federation of Gynecology and Obstetrics (FIGO) stage IB. Information on the coexistence of VSCC with pregnancy is unique, so it seems extremely important to disseminate it to develop the most effective treatment regimen. Additionally, making any decisions regarding therapeutic methods during pregnancy encounters great ethical problems. The size of the tumor was 0.5 cm with a depth of invasion 0.3 cm. The patient underwent therapy and gave birth by cesarean section at 38 weeks of pregnancy because of orthopedic indications. Surgical removal of the vulvar tumor was performed, including a margin of 1.5 cm of healthy tissue. Due to the patient's lack of consent, the sentinel node biopsy was not performed. No recurrence has been observed for 9 years. CONCLUSIONS The poorer prognosis of HPV-associated VSCC is independent of age and stage, with worse outcomes even in early-stage disease. For this reason, it is essential to sensitize clinicians to the possibility of such a diagnosis and to pay attention to the possibility of taking effective treatment during pregnancy, but safe for the fetus.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e942305"},"PeriodicalIF":1.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883074","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

Multifaceted Cervical Endometriosis: A Post-Surgical Diagnosis in a Complex Gynecological Case. 多面宫颈子宫内膜异位症：一个复杂妇科病例的术后诊断。

IF 1

American Journal of Case Reports Pub Date : 2024-12-23 DOI: 10.12659/AJCR.945246

Qingyuan Wang, Wenjun Shan, Qiyin Zhu, Wenyan Wang

{"title":"Multifaceted Cervical Endometriosis: A Post-Surgical Diagnosis in a Complex Gynecological Case.","authors":"Qingyuan Wang, Wenjun Shan, Qiyin Zhu, Wenyan Wang","doi":"10.12659/AJCR.945246","DOIUrl":"10.12659/AJCR.945246","url":null,"abstract":"BACKGROUND Endometriosis is a condition where uterine lining tissue grows outside the uterine cavity, commonly on the ovaries and pelvic peritoneum, but can also occur in rare locations such as the cervix, lungs or pleura. Cervical endometriosis is typically diagnosed retrospectively through post-surgical pathology as it was in this case. This article presents a case of cervical endometriosis with recurrent vaginal bleeding, reviews recent literature to aid in clinical diagnosis and treatment. CASE REPORT A 42-year-old woman presented with a 5-year history of recurrent vaginal bloody discharge. Clinical evaluations revealed a cyst on the posterior wall of the cervix, suspected to be an endometriotic cyst, along with a uterine diverticulum and an endometrial polyp. The patient underwent surgical excision of the cyst, repair of the uterine diverticulum, and removal of the endometrial polyp. Postoperative pathology confirmed the diagnosis of an endometriotic cyst of the cervix. The patient was subsequently treated with oral Dienogest. An 8-month follow-up showed no complaints of discomfort, with gynecological examinations indicating good recovery and no abnormalities detected on ultrasound. CONCLUSIONS Cervical endometriotic cysts are rare but can lead to serious complications if not properly diagnosed and managed. Clinicians should remain vigilant for abnormal symptoms such as recurrent vaginal bleeding and pelvic pain. Timely and appropriate treatment measures, including surgical intervention and hormonal therapy, should be implemented to reduce the risk of complications and monitor for potential malignant transformation. Regular follow-ups are crucial to ensure early detection of any recurrence or progression.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945246"},"PeriodicalIF":1.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878280","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

Pediatric Sublingual Dermoid Cyst: Diagnostic Challenges and Surgical Management in a 13-Year-Old Boy. 小儿舌下皮样囊肿：诊断挑战和手术治疗在一个13岁男孩。

IF 1

American Journal of Case Reports Pub Date : 2024-12-22 DOI: 10.12659/AJCR.945473

Klaudia Szala, Aleksandra Kątnik, Jacek Pająk, Bogusława Orzechowska-Wylęgała

{"title":"Pediatric Sublingual Dermoid Cyst: Diagnostic Challenges and Surgical Management in a 13-Year-Old Boy.","authors":"Klaudia Szala, Aleksandra Kątnik, Jacek Pająk, Bogusława Orzechowska-Wylęgała","doi":"10.12659/AJCR.945473","DOIUrl":"10.12659/AJCR.945473","url":null,"abstract":"BACKGROUND Ranulas are typical causes of sublingual cysts in children. However, our case was histopathologically confirmed to be a dermoid cyst. Epidermoid and dermoid cysts of the floor of the mouth account for <0.01% of all oral cavity lesions and 0.29% of head and neck tumors in children. Salivary congestive cysts (ranulas) involve the sublingual salivary glands or the common duct of the sublingual and submandibular salivary glands. This report describes a 13-year-old boy presenting with a sublingual cyst, diagnosed by histopathology as a dermoid cyst. Treatment is based on surgical removal of the cyst, sometimes along with the altered salivary gland. CASE REPORT A 13-year-old boy was admitted to the Department of Otolaryngology with the Subdivision of Maxillofacial Surgery for the diagnosis of a tumor localized under the tongue. A significant growth of the tumor during a 3-month period was noticed, with appearance of a mass effect, speech disorders, and difficulties in eating. Significant elevation of the floor of the mouth and tongue was shown. The presence a ranula was indicated. Surgical excision was performed using intra-oral excision. Histopathological examination revealed a diagnosis of dermatoid cyst. CONCLUSIONS This case highlights the importance of detailed histopathological diagnosis of lesions and the usefulness of imaging methods like magnetic resonance imaging (MRI), ultrasound (US) or computed tomography (CT). Our patient had a dermoid cyst, which appears rarely among children in the floor of the mouth. This shows the significance of their proper differentiation, as some may be misdiagnosed as ranula.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945473"},"PeriodicalIF":1.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873039","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

Hydroxychloroquine as a Promising Therapy for Systemic IgG4-Related Disease: A Case Report. 羟氯喹作为全身igg4相关疾病的一种有希望的治疗方法：一例报告

IF 1

American Journal of Case Reports Pub Date : 2024-12-21 DOI: 10.12659/AJCR.944731

Rienke Fijn, Nicky Janssens, Evelien Bodar, Marianne Marloes Nagtegaal, Faiz Karim

{"title":"Hydroxychloroquine as a Promising Therapy for Systemic IgG4-Related Disease: A Case Report.","authors":"Rienke Fijn, Nicky Janssens, Evelien Bodar, Marianne Marloes Nagtegaal, Faiz Karim","doi":"10.12659/AJCR.944731","DOIUrl":"10.12659/AJCR.944731","url":null,"abstract":"BACKGROUND IgG4-related disease (IgG4-RD) is a systemic fibro-inflammatory disease potentially affecting every part of the human body. Because of variability in clinical presentation, IgG4-RD can be challenging to diagnose. Untreated disease can lead to irreversible organ damage such as fibrosis. Early recognition and therapy are therefore essential. The first step in the treatment of IgG4-RD is glucocorticoid therapy, but the relapse rate after tapering is high. Other agents that are commonly used are disease-modifying antirheumatic drugs (DMARDs) and rituximab. Hydroxychloroquine is not common in the treatment of IgG4-RD, but can be promising. CASE REPORT We here describe a case of a patient with systemic IgG4-RD with manifestation in the pancreas, lung, and salivary glands. Initial treatment consisted of prednisone, with good response. Because of relapse after tapering, prednisone was restarted in combination with azathioprine. However, azathioprine had to be discontinued because of adverse effects. While tapering prednisone, new pulmonary manifestations emerged and hydroxychloroquine was started. This led to an excellent clinical response with no additional adverse effects. CONCLUSIONS This case report on IgG4-RD demonstrates a good response to treatment with hydroxychloroquine. Hydroxychloroquine is believed to have anti-inflammatory and anti-fibrotic effects, which may favorably influence the treatment of IgG4-RD. Therefore, hydroxychloroquine may be a good treatment option in IgG4-RD. Larger cohorts are required to study the efficacy of hydroxychloroquine in IgG4-RD.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944731"},"PeriodicalIF":1.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873038","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

Timely Application of Plasma Exchange to Correct Acute Pancreatitis Related to Serum Triglyceride Levels: A Report of 6 Cases and a Literature Review. 及时应用血浆置换治疗与血清甘油三酯水平相关的急性胰腺炎6例报告并文献复习

IF 1

American Journal of Case Reports Pub Date : 2024-12-21 DOI: 10.12659/AJCR.944763

Rongfei Liu, Jiamin Lu, Duo Zhang, Wei Lu, Zizhou Yu, Xupeng Shao, Na Xie, Liyun Duan, Shuai Xing, Xiaoyue Wang, Xue Zhao, Peng Lv, Kailiang Fan

{"title":"Timely Application of Plasma Exchange to Correct Acute Pancreatitis Related to Serum Triglyceride Levels: A Report of 6 Cases and a Literature Review.","authors":"Rongfei Liu, Jiamin Lu, Duo Zhang, Wei Lu, Zizhou Yu, Xupeng Shao, Na Xie, Liyun Duan, Shuai Xing, Xiaoyue Wang, Xue Zhao, Peng Lv, Kailiang Fan","doi":"10.12659/AJCR.944763","DOIUrl":"10.12659/AJCR.944763","url":null,"abstract":"BACKGROUND Hypertriglyceridemia (HTG) is associated with circulating free fatty acids that can cause acute pancreatitis. Therapeutic plasma exchange (TPE) is a rapid and effective method of reducing triglyceride levels. This case series presents 6 cases of acute pancreatitis associated with hypertriglyceridemia with a rapid response to therapeutic plasma exchange. CASE REPORT Six patients diagnosed with hypertriglyceridemia-induced acute pancreatitis (HTG-AP) were hospitalized and received therapeutic plasma exchange at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine. Upon admission, laboratory tests and abdominal computed tomography (CT) were performed, and all signs and test results were consistent with the diagnosis of hypertriglyceridemia and acute pancreatitis (AP). Among them, 4 patients were discharged after therapeutic plasma exchange. Anaphylaxis and ketoacidosis occurred in 2 cases during therapeutic plasma exchange. CONCLUSIONS High levels of triglyceride can lead to acute pancreatitis events. After therapeutic plasma exchange treatment for hypertriglyceridemia-induced acute pancreatitis, triglyceride levels decrease significantly, and adverse reactions during therapeutic plasma exchange should be actively watched for. However, there are no clear criteria for applying therapeutic plasma exchange, and more studies are needed to assess the value and risks of this treatment option. This case series shows the importance of evaluating triglyceride levels in patients with acute pancreatitis and the role of therapeutic plasma exchange.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944763"},"PeriodicalIF":1.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873040","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