American Journal of Case Reports最新文献

{"title":"Granulomatosis with Polyangiitis Presenting as Pancreatic Pseudotumor and Peripancreatic Lymphadenitis: Diagnostic Challenges and Review of 55 Cases.","authors":"Camille Beniada, Yann Coattrenec, Sahar Mack, Alexis Ricoeur, Volkan Adsay, Giacomo Puppa, Jörg D Seebach","doi":"10.12659/AJCR.945741","DOIUrl":"10.12659/AJCR.945741","url":null,"abstract":"<p><p>BACKGROUND The spectrum of anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) encompasses granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA). These pathologies predominantly affect small to medium-sized vessels, with frequent involvement of the ear, nose, and throat (ENT) sphere, lungs, and kidneys. Pancreatic involvement, an exceedingly rare manifestation of AAV, manifests as pancreatitis, a pancreatic mass, or a cystic lesion. This study reports a new case of pancreatic GPA and reviews the literature to characterize its clinical, radiological, and histological features. CASE REPORT A 54-year-old woman with severe epigastric pain, vomiting, and weight loss presented with a pancreatic mass and peripancreatic lymphadenitis on imaging studies, raising high suspicion for cancer. Repeated endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsies were inconclusive. Distal pancreatectomy with splenectomy was performed. Histopathology demonstrated granulomatous inflammation with necrosis and vasculitis, and anti-PR3 ANCA testing was positive. A diagnosis of GPA was made and treatment with corticosteroids and rituximab resulted in clinical remission. We identified 54 additional cases of pancreatic AAV in the literature and analyzed their clinical features. CONCLUSIONS In cases of unexplained pancreatitis or pancreatic masses/pseudocysts, AAV should be considered. A targeted evaluation - including ANCA testing, imaging, biopsies, and a systematic search for ENT, lung, kidney, and skin manifestations - is essential to identify key clinical, serological, and radiological clues of pancreatic AAV. We propose to classify this as type 4 autoimmune pancreatitis. A corticosteroid-based regimen, with or without additional immunosuppressants, offers effective disease control, making pancreatic surgery unnecessary.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945741"},"PeriodicalIF":1.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192317","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":"Histoplasma-Induced Esophageal Ulcers in HIV/AIDS Patient: A Case Report.","authors":"Taylor Brooke Kenneda, Teagan L Willard, Ryan Demkowicz, Megan Willard","doi":"10.12659/AJCR.948028","DOIUrl":"10.12659/AJCR.948028","url":null,"abstract":"<p><p>BACKGROUND Patients with HIV/AIDS can develop opportunistic infections of the esophagus. While Candida frequently causes infectious esophagitis in this population, other opportunistic infections, like cytomegalovirus and herpes simplex virus, can cause esophagitis, and in some cases, esophageal ulcers. Less frequent opportunistic infections of the esophagus include histoplasmosis. CASE REPORT A 58-year-old man with a history of HIV presented to the hospital with esophageal dysphagia. He had a history of disseminated histoplasmosis and was on itraconazole. Upper endoscopy done for the dysphagia revealed large, deeply cratered esophageal ulcers, a common cause of esophageal dysphagia. Ulcer biopsies were obtained, with routine staining negative for HIV, cytomegalovirus, yeast, or fungal organisms. He was started on acid suppressive therapy, with no improvement in dysphagia. Laboratory test results were significant for subtherapeutic levels of itraconazole therapy and positive urine Histoplasma antigen. These new findings raised concern for histoplasmosis being the cause of the patient's esophageal ulcers. Therefore, the team conducted specialized Grocot-Gomori methenamine silver staining on tissue from the esophageal ulcers, which revealed Histoplasma. For disseminated histoplasmosis treatment, he was admitted for intravenous amphotericin, and his outpatient dose of itraconazole was adjusted. Dysphagia subsequently improved, and follow-up upper endoscopy revealed esophageal ulcers had resolved. CONCLUSIONS This case underscores Histoplasma capsulatum as a rare but significant cause of esophageal ulceration in patients with HIV/AIDS. Proper diagnostic approaches, including specialized staining techniques, are critical when routine examinations fail to identify a pathogen. In patients with HIV/AIDS, clinicians should be keen to consider alternate, less common, causes of esophageal ulcers.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948028"},"PeriodicalIF":1.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182793","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":"Cerebral Venous Thrombosis Following a Lumbar Puncture in a Patient Using NuvaRing.","authors":"Rida Altaf, Mousa Thalji, Jose Serriera, Madison French, Mario Madruga, Stephen J Carlan","doi":"10.12659/AJCR.947368","DOIUrl":"10.12659/AJCR.947368","url":null,"abstract":"<p><p>BACKGROUND Lumbar puncture (LP) is a key diagnostic tool for various pathologies but can lead to complications, including post-LP headache (PLPH). Post-LP cerebral venous thrombosis (CVT) is a rare but serious complication with an annual incidence of 1.16 to 2.02 per 100 000 population. It is more common in females, with a ratio of 3: 1 compared to males. Exogenous estrogen use is an antecedent risk factor for thrombosis. CASE REPORT A 29-year-old woman, gravida 0 with a 3-year history of using etonogestrel/ethinyl estradiol vaginal ring (NuvaRing) for contraception, presented to the emergency room with 2 days of fever, altered mental status, and body aches. Her initial imaging showed no abnormalities, including head computed tomography (CT), CT angiography, and head magnetic resonance imaging (MRI). An LP was negative. A persistent headache prompted placement of an epidural blood patch 6 days later, and a subsequent MRI revealed a thrombus in the superior sagittal sinus and a cortical infarct. Use of the NuvaRing was discontinued, and the patient was treated with anticoagulants. Follow-up imaging showed chronic venothrombotic changes but no new thrombosis. The diagnosis of the condition leading to the original admission and workup was never determined. CONCLUSIONS Post-LP cerebral venous thrombosis can be life-threatening if not promptly diagnosed and treated. Persistent headaches, new neurological deficits, and unexplained symptoms after LP should prompt investigation for cerebral venous thrombosis. Early diagnosis with MRI with magnetic resonance venography (MRV) and appropriate anticoagulation therapy are crucial for managing this complication. The combination of a NuvaRing and LP temporally associated with a CVT is unreported and likely increased her risk of thrombosis.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947368"},"PeriodicalIF":1.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180403","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":"Management of Pharyngeal Perforation with Cervical Spine Injury Following Blunt Trauma on Electric Vehicle Accident.","authors":"Yinkui Wang, Dengfeng Wang, Tinglao Chen, Xiaoli Zhu","doi":"10.12659/AJCR.947274","DOIUrl":"10.12659/AJCR.947274","url":null,"abstract":"<p><p>BACKGROUND Cases of pharyngeal perforation (PP) associated with cervical spine injury following blunt trauma are extremely rare. CASE REPORT A 58-year-old woman was hit by a car while riding an electric bicycle. She presented with neck pain and dyspnea on admission to the hospital. The CT scan showed suspected fractures of the 5th and 6th cervical vertebrae without evidence of cervical emphysema. Serial blood tests revealed a rapidly decreasing hemoglobin level. An urgent surgical exploration of the neck was performed. Intraoperative findings included complete tears of the anterior and posterior longitudinal ligaments of the cervical spine, rupture of the 5th and 6th cervical intervertebral discs, and a longitudinal laceration of the posterior pharyngeal wall. The patient underwent surgical management, which included PP repair and cervical spine infusion via an anterior cervical approach. The buccopharyngeal fascia was sutured to the prevertebral fascia to seal the connection between the PP and the prevertebral space. The patient recovered well after surgery. The 3-month postoperative follow-up showed a stable cervical spine and good healing of the PP. CONCLUSIONS We present the first case of PP associated with severe cervical spine injury following blunt trauma. Direct laryngoscopy is essential to establish the presence of PP and to assess the size and location of the injury. In this rare case, suturing the buccopharyngeal fascia and prevertebral fascia to isolate the PP and spinal implant was effective in preventing implant infection and surgical failure potentially caused by salivary leakage.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947274"},"PeriodicalIF":1.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175187","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":"Rare Abdominal Pain Onset in Guillain-Barré Syndrome: A Case Report of Acute Motor Sensory Axonal Neuropathy.","authors":"Muhammad Aidil Idham Sharom, Julina Md Noor, Mohd Fazrul Mokhtar","doi":"10.12659/AJCR.946737","DOIUrl":"10.12659/AJCR.946737","url":null,"abstract":"<p><p>BACKGROUND Guillain-Barre syndrome (GBS) typically presents with ascending weakness and sensory disturbances. However, initial symptoms like abdominal pain are rare and can make diagnosis more challenging, as this is not a common feature of GBS. This diagnostic delay can be particularly significant in severe GBS subtypes like acute motor and sensory axonal neuropathy (AMSAN), with only a few reported cases presenting in this atypical manner. CASE REPORT A 42-year-old man experienced 3 days of persistent abdominal pain that progressively disrupted his normal activities. Soon after, he developed weakness and loss of sensation, beginning in his lower limbs and eventually spreading to the upper limbs. His condition rapidly deteriorated, resulting in respiratory failure that required intubation. Upon examination, muscle weakness and sensory loss were noted, leading to a diagnosis of AMSAN. This was confirmed by nerve conduction studies, MRI, and cerebrospinal fluid analysis. The patient initially received intravenous immunoglobulin (IVIG) but showed minimal improvement after 8 days. He then underwent plasma exchange, consisting of 5 treatment cycles. After 64 days in the hospital, including 39 days in the intensive care unit (ICU), he was discharged and able to walk with assistance. CONCLUSIONS This case highlights the importance of recognizing the atypical presentations of GBS, particularly the AMSAN subtype. The patient's initial presentation of severe abdominal pain, followed by rapid neurological deterioration, underscores the need for clinicians to maintain a high index of suspicion for GBS even when symptoms diverge from the classic ascending paralysis.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946737"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162760","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":"Comparative Analysis of Pure VWF and VWF/FVIII Complex in Orthopedic Surgery for Type 2B von Willebrand Disease.","authors":"Pierre Chamouni, Virginie Barbay, Paul Billoir, Veronique Le Cam Duchez","doi":"10.12659/AJCR.947187","DOIUrl":"10.12659/AJCR.947187","url":null,"abstract":"<p><p>BACKGROUND This report describes a 55-year-old man with hypertension, hypercholesterolemia, type 2B von Willebrand disease (VWD2B), and thrombocytopenia requiring 2 surgical total hip replacements managed with pure von Willebrand factor (VWF) concentrate (Wilfactin®) and VWF/Factor VIII (FVIII) complex concentrate (Voncento®). VWD2B is a rare, autosomal-dominant, inherited disorder of primary hemostasis caused by VWF alterations that increase its affinity for the GP1b receptor on circulating platelets. In some families, thrombocytopenia of varying severity is observed. This can worsen the hemorrhagic phenotype and require adapted management. Specific laboratory tests and genetic studies are used to confirm the diagnosis of VWD2B, particularly before surgery in which VWF concentrates may be required. CASE REPORT This patient underwent 2 hip replacement interventions, 3.5 months apart, performed by the same surgical team. Hemorrhage prevention was achieved using Wilfactin® for the first hip replacement procedure and required 9 injections of Wilfactin® (352.9 IU/kg). For the second hip replacement, which took place 3.5 months after, we used Voncento® to prevent bleeding and required 8 injections of Voncento® (282.3 IU/kg). Both treatments were effective in terms of bleeding prevention. No thrombotic event was reported. The hospital stay duration was identical for both interventions. CONCLUSIONS Here, we report a real-life comparison of Wilfactin® and Voncento® in the same patient and in the same peri-operative management conditions. This study confirms the efficacy and safety of these VWF concentrates in preventing bleeding without thrombotic risks and highlights the benefits of close laboratory monitoring to personalize treatment and optimize management.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947187"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175186","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":"Diagnosis and Management of Autoimmune Hepatitis After Hepatitis A in a Young Woman.","authors":"Siddharth Patel, Cory Dixon, Niti Chokshi, Susana Giraldo, Mrudula Thiriveedi, Virginia Dailey","doi":"10.12659/AJCR.946795","DOIUrl":"10.12659/AJCR.946795","url":null,"abstract":"<p><p>BACKGROUND Hepatitis A (Hep A) is a common cause of viral hepatitis in developing nations. Autoimmune hepatitis is characterized by subacute to chronic liver inflammation, which can lead to liver cirrhosis if untreated. Both conditions remain uncommon in the United States. Development of autoimmune hepatitis following viral Hep A is extremely rare. However, viral infections, including Hep A, have been implicated in triggering autoimmune diseases through immune system activation, molecular mimicry, and inflammatory cytokine surges. Early recognition of this phenomenon is crucial for timely intervention and improved outcomes. CASE REPORT A 32-year-old Hispanic woman with a history of Hep A presented to the emergency room with chief concerns of intermittent epigastric abdominal pain and jaundice for 2 weeks. Physical exam revealed scleral icterus with right upper-quadrant tenderness. Although abdominal imaging was concerning for gallbladder wall thickening, the degree of hyperbilirubinemia (10 mg/dL) and ALT (2100 U/L) elevation were out of proportion to that commonly seen with cholecystitis. The patient's condition deteriorated despite supportive treatment. Further investigations detected IgG against Hep A, positive anti-nuclear antibodies, and anti-smooth muscle antibodies. The liver biopsy confirmed autoimmune hepatitis. The patient showed rapid clinical improvement after initiation of intravenous steroids and was ultimately discharged home. CONCLUSIONS Autoimmune hepatitis developing after acute Hep A is rare. High clinical suspicion and prompt treatment with systemic steroids are key for rapid clinical improvement and preventing complications. Recognizing viral infections as potential autoimmune triggers may help guide earlier diagnosis and intervention.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946795"},"PeriodicalIF":1.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152161","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 61-Year-Old Man with Perforation of the Left Ventricle and Pericardium 3 Days After Insertion of a Cardiac Pacemaker Lead.","authors":"Shanqing Bao, Ke Yang, Yuanhong Li, Tenglong Wang, Chengxin Zhang","doi":"10.12659/AJCR.947341","DOIUrl":"10.12659/AJCR.947341","url":null,"abstract":"<p><p>BACKGROUND The use of implantable cardiac devices, including permanent pacemakers, has become routine, and reported complications are rare. However, in some cases, a cardiac pacemaker lead can perforate the ventricular or atrial wall. However, patients can present with nonspecific and heterogeneous clinical manifestations, leading to potential delays in diagnosis. We present a case of a 61-year-old man with perforation of the left ventricle and pericardium diagnosed 3 days after the insertion of a cardiac pacemaker lead. CASE REPORT A 61-year-old man with symptomatic second-degree type II sinoatrial block underwent uneventful dual-chamber permanent pacemaker implantation. On the evening of the third day following the pacemaker implantation procedure, the patient presented with persistent chest pain and was admitted to the hospital. Emergency chest computed tomography demonstrated that the right ventricular pacemaker lead had penetrated the left ventricle and pericardium. The patient underwent surgery on the fourth day of admission, and the pacing lead was secured to the left ventricular myocardium via a small incision in the left intercostal space. The surgical procedure was completed successfully, and the patient was discharged on the third postoperative day, without any complications. CONCLUSIONS Cardiac perforation due to the lead is a rare but potentially fatal complication of pacemaker implantation. We present a patient who presented with a left ventricular and pericardium perforation 3 days after pacemaker implantation. This clinical case underscores the necessity for screening for perforation in patients treated with cardiac implantable electronic devices prior to discharge.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947341"},"PeriodicalIF":1.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162804","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 4-Week-Old Female Infant with Type 3 von Willebrand Disease Presenting with Nosebleeds and Uncontrolled Bleeding Following Surgical Frenectomy: A Clinical Case.","authors":"Aleksandra Zima, Teresa Iwaniec, Joanna Zdziarska, Tomasz Sacha, Zbigniew Żuber","doi":"10.12659/AJCR.946625","DOIUrl":"10.12659/AJCR.946625","url":null,"abstract":"<p><p>BACKGROUND Congenital von Willebrand disease can be autosomal recessive or dominant and is classified into types 1, 2, and 3, based on laboratory findings. Severe von Willebrand factor deficiency (type 3 von Willebrand disease) is a rare, congenital deficiency of plasma coagulation factor, the symptoms of which can manifest as early as during the first weeks of a child's life. This report describes the case of a 4-week-old female infant with congenital von Willebrand disease presenting with nosebleeds and uncontrolled bleeding following surgical frenectomy. CASE REPORT A 4-week-old female newborn experienced prolonged bleeding episodes, repeated nosebleeds, and gastrointestinal bleeding following the procedure of inferior labial frenulum cutting (frenectomy). During hematology diagnostics at the neonatal ward, the cause of the described manifestations was identified. In the tested parameters of the coagulation system, the activity of von Willebrand factor in the patient was <1% (below detectable levels). In addition, a secondary decrease in the child's serum FVIII activity (2.1%) was observed. We confirmed type 3 von Willebrand disease. CONCLUSIONS Although type 3 of the disease is an extremely rare disorder within the coagulation cascade, it is important to be aware of the symptoms that can signal a bleeding diathesis, also in children in the first weeks of life. In every patient, regardless of age, in the presence of bleeding and abnormalities in the results of hemostasis system tests, plasma coagulation disorders should be investigated.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946625"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152158","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":"Neurological and Cardiac Adverse Events in Cervical Cancer Treatment: A Case of Postoperative Sintilimab-Induced Encephalitis and Myocarditis.","authors":"Haiyu Guo, Huanlei Wu, Jun Li, Ruichao Li","doi":"10.12659/AJCR.947730","DOIUrl":"10.12659/AJCR.947730","url":null,"abstract":"<p><p>BACKGROUND Immune checkpoint inhibitors (ICIs) have shown considerable promise in enhancing patient outcomes and improving survival rates, offering a new frontier in cancer treatment. As a result, their use in clinical practice has become more widespread. However, the adverse effects associated with ICIs can compromise treatment efficacy. Among these, immune-related neurological adverse events are relatively uncommon, with an incidence rate of approximately 17%. Central nervous system (CNS) symptoms, although less frequent (around 6%), are particularly concerning due to their higher risk compared to peripheral nervous system involvement. Additionally, in recent years, the incidence of cardiac toxicity has been increasing, often indicated by elevated cardiac biomarkers, but most cases are asymptomatic. CASE REPORT This report presents a case of a middle-aged woman with cervical cancer who developed both encephalitis and myocarditis during postoperative consolidation therapy with an immune checkpoint inhibitor. A thorough evaluation, including laboratory tests, imaging studies, and an assessment of the patient's medical history and clinical presentation, excluded infection and paraneoplastic encephalitis as potential causes. She was treated with high-dose corticosteroids and intravenous immunoglobulin (IVIG), resulting in gradual resolution of her central nervous system symptoms and normalization of cardiac biomarkers. CONCLUSIONS Although the incidences of immune-related encephalitis and myocarditis are generally low, they can be very severe. With the increasing use of ICIs in clinical practice, the incidence of immune-related neurological symptoms may rise. This highlights the need for increased vigilance in clinical applications, including early preventive measures and prompt diagnosis and treatment to mitigate the adverse effects of these therapies, thereby maximizing patient benefits.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947730"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144019","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}