American Journal of Case Reports最新文献_第5页

Otitis Media with ANCA-Associated Vasculitis Following COVID-19 mRNA Vaccination: A Case Report. 接种 COVID-19 mRNA 疫苗后出现伴有 ANCA 相关性血管炎的中耳炎：病例报告。

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American Journal of Case Reports Pub Date : 2024-09-30 DOI: 10.12659/AJCR.945301

Yuta Yoshino, Yurika Yamanaka, Aya Oda

{"title":"Otitis Media with ANCA-Associated Vasculitis Following COVID-19 mRNA Vaccination: A Case Report.","authors":"Yuta Yoshino, Yurika Yamanaka, Aya Oda","doi":"10.12659/AJCR.945301","DOIUrl":"10.12659/AJCR.945301","url":null,"abstract":"BACKGROUND SARS-CoV-2 caused a worldwide pandemic, and mRNA vaccines against the SARS-CoV-2 spike protein were developed to avoid SARS-CoV-2 infection. Short-term adverse events, such as fever, malaise, body aches, and headaches, develop within a few days following COVID-19 vaccination. Those adverse events are common and widely known as transient reactions. Recently, an association with COVID-19 vaccine as an inducer of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been noted. Furthermore, a relationship between COVID-19 vaccination and the development of autoimmune diseases has been reported and termed rheumatoid immune-mediated inflammatory disease. However, the mechanisms of the immune response following COVID-19 vaccination in relation to ANCA-associated vasculitis development remain unclear. CASE REPORT We report a case of a female patient who developed otitis media with ANCA-associated vasculitis following the third dose of COVID-19 mRNA vaccination. A 74-year-old woman presented with bilateral hearing loss and malaise for 1 month after COVID-19 vaccination. Serum myeloperoxidase-ANCA levels were confirmed to be elevated, and pure-tone audiometry revealed moderate bilateral mixed hearing loss. Treatment with steroids and rituximab led to recovery of hearing loss and a reduction in myeloperoxidase-ANCA titre. CONCLUSIONS The pathogenesis of adverse events following COVID-19 vaccination are still unclear. This report has indicated that ANCA-associated vasculitis can be related to COVID-19 mRNA vaccines. As our knowledge of autoimmune disease developing after COVID-19 vaccination is still in the accumulation phase, it is relevant to amass such case reports and use them for assistance in diagnosis in the future.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355924","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

A 72-Year-Old Diabetic Man with Carcinoma of the Ileocecal Region, Sepsis Due to Klebsiella pneumoniae, and Hepatic Portal Venous Gas. 一名 72 岁的糖尿病患者，患有回盲部癌、肺炎克雷伯氏菌引起的败血症和肝门静脉积气。

IF 1

American Journal of Case Reports Pub Date : 2024-09-29 DOI: 10.12659/AJCR.944094

Yohei Mizusawa, Hiroyuki Sawada, Hitoshi Idani, Kanyu Nakano, Masanori Yoshimitsu, Akito Shimizu, Yuta Une, Hiroaki Mashima, Masashi Yoshimoto, Yuki Katsura, Michihiro Ishida, Daisuke Satoh, Ryuichi Yoshida, Yasuhiro Choda, Yasuhiro Shirakawa, Hiroyoshi Matsukawa, Shigehiro Shiozaki

{"title":"A 72-Year-Old Diabetic Man with Carcinoma of the Ileocecal Region, Sepsis Due to Klebsiella pneumoniae, and Hepatic Portal Venous Gas.","authors":"Yohei Mizusawa, Hiroyuki Sawada, Hitoshi Idani, Kanyu Nakano, Masanori Yoshimitsu, Akito Shimizu, Yuta Une, Hiroaki Mashima, Masashi Yoshimoto, Yuki Katsura, Michihiro Ishida, Daisuke Satoh, Ryuichi Yoshida, Yasuhiro Choda, Yasuhiro Shirakawa, Hiroyoshi Matsukawa, Shigehiro Shiozaki","doi":"10.12659/AJCR.944094","DOIUrl":"10.12659/AJCR.944094","url":null,"abstract":"BACKGROUND Gas in the portal venous system, or hepatic portal venous gas, is a rare occurrence associated with ischemic colitis, inflammatory bowel disease, or any cause of bowel perforation, including from a necrotic tumor. This report presents the case of a 72-year-old man with diabetes who had carcinoma of the ileocecal region, sepsis due to Klebsiella pneumoniae, and hepatic portal venous gas. CASE REPORT A 72-year-old man with ileocecal cancer was admitted to our hospital for preoperative diabetes control. He developed a fever and septic shock, without abdominal symptoms or signs of peritoneal irritation. Klebsiella pneumoniae was detected in blood cultures. Abdominal ultrasonography showed hepatic portal venous gas, and a simple computed tomography scan revealed gas in the vasculature and hepatic portal vein in the lateral segment, which led us to believe that the ileocecal mass was the source of infection, and emergency surgery was performed. The patient was discharged from the hospital on postoperative day 34 with good progress despite dehydration due to high-output syndrome. CONCLUSIONS Sepsis due to necrosis of ileocecal cancer is often difficult to diagnose because it is not accompanied by abdominal symptoms, as in our case. However, abdominal ultrasound is useful because it allows for a broad evaluation. This report has demonstrated and highlighted that the findings of hepatic portal venous gas on imaging should be regarded seriously, requiring urgent investigation to identify the cause and commence treatment in cases of infection or sepsis.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355906","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

Complicated Meckel's Diverticulum Presenting as Pneumoperitoneum in an Adolescent. 青少年腹腔积气并发梅克尔憩室

IF 1

American Journal of Case Reports Pub Date : 2024-09-29 DOI: 10.12659/AJCR.945206

Christopher Nemeh, Peter Keefe, Alexander Chalphin, Marty C McGraw, Erica M Fallon

{"title":"Complicated Meckel's Diverticulum Presenting as Pneumoperitoneum in an Adolescent.","authors":"Christopher Nemeh, Peter Keefe, Alexander Chalphin, Marty C McGraw, Erica M Fallon","doi":"10.12659/AJCR.945206","DOIUrl":"10.12659/AJCR.945206","url":null,"abstract":"BACKGROUND The finding of pneumoperitoneum frequently leads to operative management for diagnosis and treatment. The etiology of pneumoperitoneum includes perforated viscus, such as perforated peptic ulcers, small or large intestinal perforations, appendicitis, and complicated sigmoid diverticulitis. We describe the preoperative, intraoperative, and postoperative course of a patient with perforated Meckel’s diverticulitis presenting with pneumoperitoneum. This unusual presenting finding highlights that Meckel’s diverticulum should be included in the differential diagnosis in adolescents and young adults presenting with pneumoperitoneum. CASE REPORT We describe a case of an 18-year-old male who presented with 1 day of abdominal pain, found to have pneumoperitoneum during workup, attributed to perforated Meckel’s diverticulum. CT scans of the abdomen and pelvis were performed, confirming pneumoperitoneum, an inflamed segment of distal ileum, and a non-visualized appendix, which made the diagnosis difficult. Perforated Meckel’s diverticulum, likely due to infection, was confirmed by diagnostic laparoscopy. The Meckel’s diverticulum was then exteriorized and removed by segmental small bowel resection with primary anastomosis. The final pathology report confirmed perforated Meckel’s diverticulum with gastric oxyntic-type mucosa. CONCLUSIONS This case illustrates an uncommon presentation of Meckel’s diverticulum in an adolescent with pneumoperitoneum. Pneumoperitoneum requires broadening the diagnosis to include other causes, including Meckel’s diverticulum, especially in the setting of an acute abdomen. This case highlights that a high index of suspicion should be kept for Meckel’s diverticulum, even in adolescents and young adults with pneumoperitoneum.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355919","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

Resolution of Migraine with Aura Post-PFO Closure in a Young Female: A Case Report. 一名年轻女性的先兆偏头痛在 PFO 关闭术后得到缓解：病例报告

IF 1

American Journal of Case Reports Pub Date : 2024-09-28 DOI: 10.12659/AJCR.944848

Endin Nokik Stujanna, Gea Pandhita, Radityo Prakoso

{"title":"Resolution of Migraine with Aura Post-PFO Closure in a Young Female: A Case Report.","authors":"Endin Nokik Stujanna, Gea Pandhita, Radityo Prakoso","doi":"10.12659/AJCR.944848","DOIUrl":"10.12659/AJCR.944848","url":null,"abstract":"BACKGROUND Migraine, a prevalent primary headache disorder, often disrupts daily life, particularly when accompanied by visual auras. While the etiology of migraines remains elusive, emerging evidence suggests a correlation with cardiovascular anomalies. CASE REPORT This case involves a 35-year-old woman experiencing migraine with aura. Imaging studies, including MRI/A, revealed small-vessel ischemic damage in the right frontal region and historical microbleeds in the right occipital area. The patient's RoPE score was a high 9 out of 10, and a grade 4 (severe) PFO was diagnosed following a TEE+bubble test. A transfemoral PFO closure was successfully performed using a 25-mm Amplatzer PFO occluder device via an antegrade transvenous approach without fluoroscopy. The patient was discharged in stable condition, with no migraine episodes reported at 5-month follow-up. The detection of PFO in young migraineurs, particularly those with aura, is crucial and warrants thorough investigation during their assessment and treatment. CONCLUSIONS This case underscores the importance of incorporating cardiac evaluations in the diagnostic regimen for young individuals presenting with migraine and aura to uncover and rectify potential contributory structural heart defects like PFO. After PFO closure, this patient's significant improvement, evidenced by the absence of migraine recurrence, highlights the potential therapeutic benefit of addressing cardiac anomalies in such patients. It is important to note that current evidence does not support PFO closure as a treatment for migraines unless there are findings suggestive of ischemic stroke.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355927","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

Neuroinflammation-Induced SIADH in West Nile Virus Infection: An Uncommon Neurological and Endocrine Manifestation. 西尼罗河病毒感染中神经炎症诱发的 SIADH：一种不常见的神经和内分泌表现。

IF 1

American Journal of Case Reports Pub Date : 2024-09-28 DOI: 10.12659/AJCR.944957

Justin David Tse, Jackson Wang

{"title":"Neuroinflammation-Induced SIADH in West Nile Virus Infection: An Uncommon Neurological and Endocrine Manifestation.","authors":"Justin David Tse, Jackson Wang","doi":"10.12659/AJCR.944957","DOIUrl":"10.12659/AJCR.944957","url":null,"abstract":"BACKGROUND West Nile virus (WNV) is a vector-borne flavivirus that is typically transmitted by Aedes and Anopheles mosquitos. WNV infection typically presents with symptoms consistent with viral meningitis, which include fever, headache, and meningeal signs. WNV infections are typically self-resolving, with symptoms lasting 3-10 days. Although uncommon, patients with WNV infection can be afflicted with hyponatremia, although the etiology is unclear. Because of encephalitis, neuroinflammation may be involved in the deterioration of adrenal signaling, leading to salt wasting. CASE REPORT We present the case of a 75-year-old man who presented with headache, neck pain, photophobia, and viral illness symptoms. He was found to be profoundly hyponatremic, concerning for SIADH. He had a sodium drop to 117 mmol/L, leading to further lethargy and confusion. He received 3% saline, fluid restriction, and salt tablets, and more common causes of SIADH were ruled out. MRI revealed the absence of the posterior pituitary bright spot. He was subsequently found to have positive WNV titers and improved with continued supportive treatment. CONCLUSIONS WNV presents a unique challenge to providers due to its difficult diagnosis and association with hyponatremia. There is no clear role for specific medical treatment such as corticosteroids vs IV immunoglobulins. Supportive care is recommended for those testing positive for WNV. Clinicians should consider the possibility of viral infections, such as WNV, in patients living in endemic areas who present with unexplained hyponatremia, cognitive symptoms, and relevant history.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355923","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

Misidentified Metastases: Diagnosing and Managing Pyogenic Liver Abscesses in a Breast Cancer Survivor. 误诊转移瘤：诊断和处理一名乳腺癌幸存者的化脓性肝脓肿。

IF 1

American Journal of Case Reports Pub Date : 2024-09-27 DOI: 10.12659/AJCR.944117

Nkechi Ukoha, Inemesit Akpan, Raissa Nana Sede Mbakop, Eunice Hama

{"title":"Misidentified Metastases: Diagnosing and Managing Pyogenic Liver Abscesses in a Breast Cancer Survivor.","authors":"Nkechi Ukoha, Inemesit Akpan, Raissa Nana Sede Mbakop, Eunice Hama","doi":"10.12659/AJCR.944117","DOIUrl":"10.12659/AJCR.944117","url":null,"abstract":"BACKGROUND Pyogenic liver abscesses are collections of pus of varying sizes within the liver. They are rare and often overlooked in developed countries, and if left untreated, they can be life-threatening. Therefore, early detection and treatment are crucial for favorable outcomes. Due to the atypical presentation, a high level of suspicion is necessary, as seen in our patient's case. CASE REPORT This report pertains to a 76-year-old woman who was diagnosed with sepsis resulting from multiple hepatic abscesses. Initially, the abscesses were mistaken for metastatic breast cancer liver disease due to her history of breast cancer in remission for 3 years. However, further imaging and biopsy revealed the initial diagnosis to be incorrect. She had initially presented with nonspecific abdominal pain and diarrhea. The initial computed tomography (CT) scan of the abdomen indicated the development of extensive hepatic lesions, thought to be associated with breast cancer, but subsequent magnetic resonance imaging (MRI) suggested liver abscesses. Ultrasound-guided aspiration confirmed the presence of liver abscesses, and subsequent culture of the aspirate revealed the growth of Streptococcus intermedius. The patient responded well to a 4-week course of antibiotic therapy. CONCLUSIONS This case report reviews the clinical presentation, risk factors, diagnosis, and management of multiple pyogenic liver abscesses, and shows the importance of using sound clinical reasoning in addressing diagnostic challenges of this nature.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355921","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

Aspiration Pneumonia Leading to Clostridium ramosum Bacteremia in a Neutropenic Patient: Case Report and Management Strategy. 一名中性粒细胞减少的患者因吸入性肺炎导致拉姆斯梭菌菌血症：病例报告与处理策略。

IF 1

American Journal of Case Reports Pub Date : 2024-09-27 DOI: 10.12659/AJCR.944958

Carrie S Schultz, Tatjana Gavrancic

{"title":"Aspiration Pneumonia Leading to Clostridium ramosum Bacteremia in a Neutropenic Patient: Case Report and Management Strategy.","authors":"Carrie S Schultz, Tatjana Gavrancic","doi":"10.12659/AJCR.944958","DOIUrl":"10.12659/AJCR.944958","url":null,"abstract":"BACKGROUND Clostridium ramosum is an anaerobic, spore-producing, gram-positive rod, enteric pathogen that is difficult to identify and is rarely pathogenic. We present a case of Clostridium ramosum bacteremia secondary to aspiration pneumonia in a 65-year-old immunocompromised man on chemotherapy for follicular lymphoma. CASE REPORT We report the case of a 65-year-old man, on active chemotherapy for follicular lymphoma, presenting with a fever of 38.3°C, nonproductive cough, fatigue, and confusion. Physical examination was unremarkable except for +2 lower-extremity pitting edema. CT abdomen pelvis showed left lower-lung consolidation and CT chest angiogram showed that the consolidation was concerning for infarct verses abscess and segmental/subsegmental pulmonary emboli despite anticoagulation use. Blood cultures later grew Clostridium ramosum, which was successfully treated with IV piperacillin-tazobactam. Subsequent outpatient imaging demonstrated resolution of the lung consolidation. CONCLUSIONS Our case highlights the rare diagnosis of Clostridium ramosum bacteremia secondary to aspiration pneumonia in an immunocompromised patient and our approach to management. We highlight the difficulties in identification of Clostridium ramosum, rare pathogenicity, risk factors, and potential sources.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355907","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 Redo Surgical Replacement of a Flail Bioprosthetic Aortic Valve: A Case Report. 成功重做生物人工主动脉瓣置换术：病例报告

IF 1

American Journal of Case Reports Pub Date : 2024-09-26 DOI: 10.12659/AJCR.945043

Aakash Angirekula, Adam Franco, Kirit Patel

{"title":"Successful Redo Surgical Replacement of a Flail Bioprosthetic Aortic Valve: A Case Report.","authors":"Aakash Angirekula, Adam Franco, Kirit Patel","doi":"10.12659/AJCR.945043","DOIUrl":"10.12659/AJCR.945043","url":null,"abstract":"BACKGROUND In the last 2 decades, the use of bioprosthetic valves for surgical aortic valve replacements has surged, now accounting for over 85% of all such surgeries. However, their limited durability has led to an increase in aortic valve reoperations and re-interventions. Here, we describe a unique case involving a patient with severe aortic regurgitation and cardiogenic shock, caused by a bioprosthetic aortic valve with a flail leaflet, which was replaced via a surgical approach. CASE REPORT A 58-year-old man with a history of atrial fibrillation, stent placement in the left anterior descending artery, and 2 aortic valve replacements presented to the Emergency Department with severe chest pain and shortness of breath. A chest X-ray showed significant pulmonary vascular and interstitial congestion, and cardiac catheterization displayed nonobstructive coronary artery disease. A transesophageal echocardiogram (TEE) revealed severe regurgitation in the prosthetic aortic valve, resulting in the patient being sent for emergency aortic valve replacement. An intraoperative TEE showed evidence of prosthetic valve failure with complete prolapse of the noncoronary cusp. The prosthetic aortic valve's noncoronary cusp leaflet was found flailing into the left ventricular outflow tract, while the other 2 leaflets seemed normal. The valve was replaced and a new Medtronic Avalus size 27 mm valve was seated. Postoperatively, the patient developed a complete heart block requiring placement of a permanent dual-chamber pacemaker. CONCLUSIONS Flailed leaflets in bioprosthetic aortic valves are a rare complication of aortic valve replacement. Redo surgical valve replacement is a viable treatment for bioprosthetic failure due to leaflet flail.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355929","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

Refractory Iron-Deficiency Anemia and Vascular Malformation Concomitant with Aortic Stenosis: Heyde Syndrome. 难治性缺铁性贫血和伴有主动脉狭窄的血管畸形：海德综合征。

IF 1

American Journal of Case Reports Pub Date : 2024-09-26 DOI: 10.12659/AJCR.944440

Risa Hirata, Tomoyo Nishi, Masahiko Nakamura, Masaki Tago

{"title":"Refractory Iron-Deficiency Anemia and Vascular Malformation Concomitant with Aortic Stenosis: Heyde Syndrome.","authors":"Risa Hirata, Tomoyo Nishi, Masahiko Nakamura, Masaki Tago","doi":"10.12659/AJCR.944440","DOIUrl":"10.12659/AJCR.944440","url":null,"abstract":"BACKGROUND Heyde syndrome is characterized by anemia due to angiodysplasia, aortic valve stenosis, and acquired von Willebrand syndrome. However, the awareness regarding Heyde syndrome in clinical practice is low. We report the case of an older woman with severe refractory iron-deficiency anemia and severe aortic stenosis who was diagnosed with Heyde syndrome. CASE REPORT A 70-year-old woman who had been experiencing exertional dyspnea for 3 months prior to presentation was diagnosed with iron-deficiency anemia, with a hemoglobin level of 69 g/L. She did not experience any episodes of bleeding, such as nosebleeds, gum bleeding, abnormal bleeding, or melena. Upper and lower gastrointestinal endoscopy revealed no evidence of bleeding, and oral iron supplementation failed to improve the anemia. Auscultation of the chest identified an ejection systolic murmur. Chest and abdominal computed tomography showed no significant lesions or active bleeding. Capsule endoscopy of the small intestine revealed capillary dilation. Echocardiography detected severe aortic valve stenosis. Blood test results revealed a deficiency in large von Willebrand factor multimers. Therefore, Heyde syndrome was diagnosed. Aortic valve replacement surgery was performed, which resulted in an improvement in anemia and the associated symptoms. CONCLUSIONS In cases of unexplained and treatment-resistant iron-deficiency anemia, especially if careful auscultation detects aortic stenosis, Heyde syndrome should be considered a differential diagnosis. Furthermore, screening for angiodysplasia in the gastrointestinal tract and prompt diagnosis through measurement of large von Willebrand factor multimers are imperative when investigating potential sources of bleeding.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355926","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

Complex Interplay of COVID-19 ARDS with Guillain-Barré Syndrome and Cerebral Infarction: A Case Study. COVID-19 ARDS 与格林-巴利综合征和脑梗塞的复杂相互作用：病例研究。

IF 1

American Journal of Case Reports Pub Date : 2024-09-25 DOI: 10.12659/AJCR.944390

Daiki Morikawa, Shigeki Fujitani, Tomoyuki Shirahige, Yuta Hagiwara, Kenichiro Morisawa, Toru Yoshida

{"title":"Complex Interplay of COVID-19 ARDS with Guillain-Barré Syndrome and Cerebral Infarction: A Case Study.","authors":"Daiki Morikawa, Shigeki Fujitani, Tomoyuki Shirahige, Yuta Hagiwara, Kenichiro Morisawa, Toru Yoshida","doi":"10.12659/AJCR.944390","DOIUrl":"10.12659/AJCR.944390","url":null,"abstract":"BACKGROUND Coronavirus disease (COVID-19) can cause various complications. We report a case of severe COVID-19 acute respiratory distress syndrome (ARDS) in a patient receiving veno-venous extracorporeal membrane oxygenation (V-V ECMO), complicated by Guillain-Barre syndrome (GBS) and cerebral infarction, as well as pulmonary embolism. CASE REPORT A 55-year-old Japanese man with a history of ulcerative colitis was admitted for COVID-19. His respiratory status worsened and progressed to ARDS, requiring intubation on hospital day (HD) 3. On HD 16, contrast computed tomography revealed PE. On HD 18, his respiratory condition worsened, and V-V ECMO was initiated. On HD 23, V-V ECMO was successfully discontinued. He regained consciousness on HD 44, but he had quadriplegia. Deep-tendon reflexes were absent in all limbs. Cranial nerve involvement, specifically bilateral facial nerve weakness, was noted. Magnetic resonance imaging showed bilateral scattered cerebral infarctions on HD 76. Nerve conduction studies indicated severe axonal neuropathy. Cerebrospinal fluid examination showed albuminocytologic dissociation. The antibody to the ganglioside GD1a was positive. These findings were consistent with the diagnosis of GBS. He received immunoglobulin treatment on HD 89, and his neurological findings slightly improved. CONCLUSIONS This study emphasized that in COVID-19, neurological complications are not rare, are difficult to diagnose, and are prone to delays in detection.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355918","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