American Journal of Case Reports最新文献

{"title":"Air Rifle Injury: Rare Bullet Lodgement in the Right Ventricle and Successful Surgical Removal.","authors":"Yan Efrata Sembiring, Fan Maitri Aldian, Amy Rosalie Sukamto","doi":"10.12659/AJCR.948109","DOIUrl":"10.12659/AJCR.948109","url":null,"abstract":"<p><p>BACKGROUND Air rifles, frequently used in sports, can cause complex, violent, and traumatic cardiac injury associated with significant morbidity and mortality. Unlike firearm projectiles, air rifle pellets lack rotational movement but can achieve velocities of 100 to 230 m/s. CASE REPORT A 21-year-old man was referred to our hospital after sustaining an air rifle injury to the right chest. He presented 10 h after injury with chest pain but was hemodynamically stable. Physical examination revealed decreased breath sounds and tenderness in the right hemithorax. Chest X-ray showed right-sided hemothorax and pulmonary contusion, prompting chest tube placement, with initial drainage of 500 cc hemorrhagic fluid. Transthoracic echocardiography identified a hyperechoic mass in the right ventricle, with mild pericardial effusion. Computed tomography confirmed the projectile was lodged in the posterior right ventricle, 0.8 cm from the tricuspid annulus. Emergency surgery was performed and successfully extracted an intact 3×3×5 mm air gun pellet. Postoperatively, the patient experienced a brief tonic-clonic seizure, which was managed with midazolam and propofol. He received prophylactic ceftriaxone, intravenous phenytoin, vitamin B6, and folic acid and oral aspirin, ibuprofen, and omeprazole. The patient showed improvement by postoperative day 3 and was discharged on day 4. Weekly follow-ups and an EEG 1 month after discharge showed normal results. At the 2-month follow-up, the patient remained asymptomatic. CONCLUSIONS Awareness of cardiac penetrating wounds, bullet trajectory, and clinical signs, along with a multidisciplinary approach and patient-family involvement, is crucial for favorable outcomes and long-term follow-up.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948109"},"PeriodicalIF":0.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973104","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":"Pancreatic Inflammation Induced by Immune Checkpoint Inhibitors in Melanoma Treatment: A Case Report.","authors":"Abdo I El Tawil, Beatriz A Mendes, Leandro A F Machoski, Micheli F Domingos, Noelle S Wassano, Sérgio O Ioshii, Eduardo J B Ramos","doi":"10.12659/AJCR.948580","DOIUrl":"10.12659/AJCR.948580","url":null,"abstract":"<p><p>BACKGROUND Immunotherapy has seen an exponential increase recently, as has the study of its associated adverse effects. Although a wide range of reactions to immunotherapy has been described, reports of immune-mediated focal pancreatitis remain rare. Autoimmune pancreatitis related to immune checkpoint inhibitors occurs because of the hyperactivation of T lymphocytes, which act against pancreatic cells, causing inflammation. CASE REPORT This case report describes a previously healthy 41-year-old man with a diagnosis of metastatic melanoma with inguinal lymph node metastasis. The patient underwent 1 year of adjuvant treatment with nivolumab and had excellent tolerance. After a 1-year suspension of this treatment, nodal and peritoneal recurrence occurred, leading to the initiation of combined therapy with ipilimumab and nivolumab, followed by maintenance nivolumab, resulting in a complete response. After 10 cycles of nivolumab, PET-CT and MRI identified a lesion in the head of the pancreas, which was suspected to be a primary neoplasm. The patient was asymptomatic, with normal tumor markers and elevated amylase and lipase levels. An endoscopic ultrasound-guided biopsy was performed to rule out primary pancreatic cancer, revealing moderately active chronic inflammation associated with immunotherapy. Nivolumab treatment was interrupted for 2 weeks, during which pancreatic enzyme levels improved. Treatment was resumed thereafter. The patient continued with monthly nivolumab applications, maintaining a complete response. without changes in imaging or laboratory test results. CONCLUSIONS This case is atypical for autoimmune pancreatitis owing to the absence of corticosteroid intervention, self-limiting nature of inflammation, and lack of inflammatory recurrence despite the continued use of immunotherapy.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948580"},"PeriodicalIF":0.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972872","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 Malignant Arrhythmia in Apical Hypertrophic Cardiomyopathy: A Case Report.","authors":"Ramesh Acharya, Gerardo Gutierrez-Sierra, Vishakh Prakash, Suchita Acharya, Sandesh Murali, Mehran Abolbashari","doi":"10.12659/AJCR.948875","DOIUrl":"10.12659/AJCR.948875","url":null,"abstract":"<p><p>BACKGROUND Apical hypertrophic cardiomyopathy (ApHCM) is a rare variant that is less frequently associated with sarcomere mutations and lacks specific diagnosis and risk stratification guidelines. CASE REPORT We present the case of a 41-year-old man with a complex medical history, including type I diabetes mellitus and alcohol use disorder, who presented with nausea and vomiting following alcohol consumption. Initial evaluations revealed significant electrolyte imbalances and non-sustained ventricular tachycardia (NSVT). Echocardiography indicated severe apical hypertrophy consistent with ApHCM. The patient developed polymorphic ventricular tachycardia, which progressed to ventricular fibrillation (VF), necessitating cardiopulmonary resuscitation (CPR) and intensive care. An implantable cardioverter-defibrillator (ICD) was successfully implanted for secondary prevention. CONCLUSIONS This report focuses on the clinical presentation and management of ApHCM, emphasizing the challenges of arrhythmogenic risks and the potential for refractory ventricular arrhythmias. Surgical interventions, such as apical myectomy, can improve functional capacity. This case underscores the critical need for tailored management strategies in patients with ApHCM, particularly in those with substance use disorders, where standard therapies may be contraindicated.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948875"},"PeriodicalIF":0.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972616","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":"Comprehensive Cytogenetic Analysis Reveals Mosaicism in Newborn with Negative Prenatal Down Syndrome Screening: A Case Report.","authors":"Irina Puppo, Alla Vardanyan, Gohar Shahsuvaryan, Susanna Petrosyan, Narek Pepanyan, Inessa Nazaryan","doi":"10.12659/AJCR.948522","DOIUrl":"10.12659/AJCR.948522","url":null,"abstract":"<p><p>BACKGROUND Down syndrome, or trisomy 21, is one of the most common chromosomal disorders associated with intellectual disability. Prenatal screening is a proactive approach to identify fetuses with common chromosomal abnormalities. Mosaicism is one of the causes of false-negative results in prenatal screening for Down syndrome. CASE REPORT We present a case of a newborn with tissue-specific and intercellular mosaicism for trisomy 21. Postnatal karyotyping of phytohemagglutinin-stimulated lymphocytes confirmed trisomy 21 in all analyzed metaphases. However, fluorescence in situ hybridization on unstimulated lymphocyte nuclei and buccal smears revealed mosaicism, with approximately 20% of cells from both tissues displaying disomy for chromosome 21. The intercellular karyotypic discordance observed in this case shows that mosaicism can be more complex than what is detectable by conventional karyotyping, and that it can be related to the biological particularities of the analyzed cells and restriction of a widely used cell division stimulator, rather than to technical limitation. CONCLUSIONS Our findings underscore the critical importance of combining karyotyping with fluorescence in situ hybridization on unstimulated lymphocytes and buccal smear cells to improve the accuracy of cytogenetic diagnosis in newborns with suspected Down syndrome. Such in-depth cytogenetic analyses provide essential information for genetic counseling, research on genotype-phenotype correlations, and evaluation of age-acquired mosaicism and its association with age-related comorbidities in patients with trisomy 21. Comprehensive identification of the biological causes underlying false-negative results in prenatal screening can help overcome the limitations of current technological platforms and support the refinement of diagnostic algorithms.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948522"},"PeriodicalIF":0.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973049","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":"Extranodal Rosai-Dorfman Disease in a Pediatric Patient: A Case Report.","authors":"Lili Miles, Caroline Baughn, Gleidson Messias Silva, Dorothea L Douglas, Lei Shao","doi":"10.12659/AJCR.948533","DOIUrl":"https://doi.org/10.12659/AJCR.948533","url":null,"abstract":"<p><p>BACKGROUND Sinus histiocytosis with massive lymphadenopathy (also known as Rosai-Dorfman disease [RDD]), was originally recognized in 1969 by Rosai and Dorfman. RDD is characterized by the accumulation of activated histiocytes in various tissues and organs, but most commonly in lymph nodes. RDD is subclassified into 2 forms. The more common form, nodal RDD, and the rare form, extranodal RDD, which is based on the presence of extranodal tissue involvement. Most extranodal RDD cases also involve lymph nodes. Primary, exclusively extranodal RDD is rare, and is exceedingly uncommon in young pediatric patients. These cases have rarely been reported in the medical literature. CASE REPORT This 16-month-old previously healthy boy presented with right-forearm pain, following a right-wrist injury. Imaging studies revealed an aggressive lesion of the distal radius with the presence of an adjacent soft-tissue component. The core-needle tissue biopsy suggested osteomyelitis. Because the patient was not responsive to antibiotics, he underwent curettage with washout for the management of presumed osteomyelitis. RDD was diagnosed based on the curettage material. Subsequent imaging studies confirmed the isolated right-radius bone lesion without any other organ or tissue involvement. He received observation management with surveillance imaging every 6 months. Thirty-six months later, he was healthy, without pain, and had normal right-wrist function. CONCLUSIONS Primary osseous RDD in children is exceedingly rare and can cause diagnostic challenges. Our case serves as a reminder that despite the diagnostic challenge, keeping RDD in the differential diagnosis, especially in young patients, can avoid misdiagnosis and mismanagement.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948533"},"PeriodicalIF":0.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973089","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 Rheumatoid Arthritis in a Patient with Aplastic Anemia and Ulcerative Colitis: A Case Report.","authors":"Amira M Elfergani, Aixa Toledo-Garcia","doi":"10.12659/AJCR.949020","DOIUrl":"https://doi.org/10.12659/AJCR.949020","url":null,"abstract":"<p><p>BACKGROUND Rheumatoid arthritis (RA) is a prevalent systemic autoimmune disease characterized by chronic inflammatory arthritis and extra-articular involvement. Managing RA in patients with concurrent hematologic disorders, such as aplastic anemia, presents unique therapeutic challenges due to the immunosuppressive effects of disease-modifying antirheumatic drugs (DMARDs). This case report highlights a multidisciplinary approach to the complex treatment of RA in a patient with aplastic anemia and ulcerative colitis. CASE REPORT A woman in her early 50s with a history of ulcerative colitis and aplastic anemia presented with worsening inflammatory arthritis and was diagnosed with rheumatoid arthritis (RA). Hydroxychloroquine was initially selected over methotrexate due to its relatively lower risk of bone marrow suppression, an important consideration in patients with underlying aplastic anemia. However, despite its relatively favorable hematologic safety profile, the patient developed thrombocytopenia on hydroxychloroquine, necessitating its discontinuation. Sarilumab was introduced but led to recurrent anemia and thrombocytopenia. A transition to IV tocilizumab resulted in clinical stability and symptom control. Inflammatory markers remain within normal limits, indicating no active inflammation. However, the patient continues to have thrombocytopenia and anemia, requiring ongoing hematologic monitoring. CONCLUSIONS This case underscores the complexity of RA management in patients with serious hematologic conditions. Tocilizumab proved to be an effective and well-tolerated treatment option, demonstrating the importance of individualized therapy and close hematologic monitoring. Further research is needed to optimize treatment strategies for RA in patients with concurrent aplastic anemia.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949020"},"PeriodicalIF":0.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972874","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":"Submucosal Cecal Lipoma Mimicking Malignancy in a 51-Year-Old Man: A Diagnostic Challenge in Routine Colonoscopy.","authors":"Meiling Sun, Lifeng Wang","doi":"10.12659/AJCR.947482","DOIUrl":"https://doi.org/10.12659/AJCR.947482","url":null,"abstract":"<p><p>BACKGROUND Benign submucosal tumors of the large bowel include lipomas and smooth muscle tumors, which can be a diagnostic challenge since they appear as nodules or masses on colonoscopy. This report describes the case of a 51-year-old man with a submucosal lipoma of the cecum diagnosed as an incidental finding during routine colonoscopy. CASE REPORT On April 29, 2024, a 51-year-old male patient was found during colonoscopy to have a submucosal mass in the cecum, with surface ulceration, raising suspicion of malignancy. However, endoscopic biopsy showed no evidence of malignant components. For further evaluation and treatment, the patient underwent laparoscopic right hemicolectomy on May 7, 2024. Postoperative pathology results confirmed that the submucosal mass in the cecum was a lipoma. CONCLUSIONS Even though modern gastrointestinal endoscopy has made significant advancements, the diagnosis of a benign or malignant nature in some gastrointestinal submucosal masses remains a challenge in clinical practice today. It is worth noting that benign submucosal masses of the cecum can also present with various colonoscopy findings that look like malignant tumors, with or without symptoms.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947482"},"PeriodicalIF":0.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972911","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":"Two Cases of Charcot-Marie-Tooth Disease Diagnosed in a 53-Year-Old Mother and a 24-Year-Old Daughter.","authors":"Junying Zhu, Shimiao Dai, Yao Li, Miaomiao Ma, Ming Chu, ZhiQiang Lin, Litao Sun, Ji-Chang Zhou","doi":"10.12659/AJCR.947400","DOIUrl":"https://doi.org/10.12659/AJCR.947400","url":null,"abstract":"<p><p>BACKGROUND Charcot-Marie-Tooth disease (CMT) is the most common hereditary peripheral neuropathy, affecting an estimated 17.7-40 per 100 000 population. CMT exhibits diverse clinical manifestations, including gradually progressive bilateral atrophy, weakness of the lower-extremity muscles, sensory abnormalities, and abnormal nerve conduction velocities or amplitudes. It is important to note that other complications tend to occur during the progression of CMT disease. This report describes the late diagnosis of CMT in a 53-year-old mother and her 24-year-old daughter to highlight the risk of CMT patients complicated with respiratory and digestive diseases. CASE REPORT In this report, we describe the late diagnosis of CMT1E in 2 patients who carried the same missense point mutation in the peripheral myelin protein 22 gene {PMP22; [c.117G>C; p.(Trp39Cys)]}. Case 1 (daughter), in addition to CMT1E, was also diagnosed with respiratory disorders, hiatal hernia, gastroesophageal reflux disease (GERD), and chronic atrophic gastritis. Similarly, Case 2 (mother), who was diagnosed with CMT1E, also had a hiatal hernia, GERD, and chronic atrophic gastritis. Our report emphasized a potential association between CMT and digestive diseases and provides new insights into the prognosis of CMT. CONCLUSIONS This report presents 2 cases of respiratory dysfunction and multiple digestive diseases in a 53-year-old mother and her 24-year-old daughter, with the late diagnosis of CMT. These findings emphasize the importance of comprehensive patient care and provide a reference for future research into multidisciplinary approaches to the diagnosis and treatment of CMT.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947400"},"PeriodicalIF":0.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972985","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":"Rapid Progression of Primary Hepatic Neuroendocrine Carcinoma: A Case Report Demonstrating Drastic Oncological Behavior.","authors":"Rina Kobayashi, Tomohide Hori, Makoto Yamawaki, Shigeki Nakayama, Satoru Umegae, Takao Iwanaga, Ryutaro Nishikawa, Takahiro Shimoyama, Sakurako Suzuki, Shinichiro Atsumi, Hiroshi Hasegawa, Shigehito Nakashima, Kunihiro Higuchi, Kentaro Onishi, Ryotaro Sakaguchi, Shoichi Morita, Haruka Miyao, Saki Aota, Hikaru Ohtani, Takayuki Yamamoto","doi":"10.12659/AJCR.948500","DOIUrl":"https://doi.org/10.12659/AJCR.948500","url":null,"abstract":"<p><p>BACKGROUND Primary hepatic neuroendocrine neoplasms (PHNENs), including primary hepatic neuroendocrine carcinoma (PHNEC), are extremely rare. PHNENs typically exhibit slow growth, although mixed neuroendocrine-non-neuroendocrine neoplasms have poor prognoses. PHNENs are also challenging to diagnose. CASE REPORT A 73-year-old man underwent plain computed tomography (CT), which incidentally detected a 42-mm solitary hepatic tumor. Serum levels of protein induced by vitamin K absence or antagonist-II (PIVKA-II) were elevated at 138 mAU/mL. Thirteen days later, magnetic resonance imaging (MRI) revealed an enlarged hepatic tumor with tumor thromboses extending into the hepatic and portal veins. No early-phase enhancement was observed. At 18 days, Doppler ultrasound and dynamic CT evaluated the tumor as hypovascular, and a newly swollen solitary lymph node appeared. At 39 days, positron emission tomography (PET)/CT revealed strong uptake in the primary liver tumor and metastatic lymph nodes, with additional distant lymph node metastases emerging. At 49 days, a metastatic cervical lymph node was surgically resected. At 61 days, PHNEC was definitively diagnosed based on histopathological and immunohistochemical assessments. The Ki-67 labeling index was >90%. At 67 days, he was hospitalized to begin chemotherapy, but CT revealed end-stage disease. Palliative treatment was required, and the patient died of cancer 82 days after the initial diagnosis. CONCLUSIONS We have presented a thought-provoking case of PHNEC with rapid oncological progression. To clarify clinical implications (eg, atypical imaging features and diagnostic pitfalls), detailed imaging findings are provided. We anticipate that this case will be informative for clinicians in this field.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948500"},"PeriodicalIF":0.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972907","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":"Semaglutide Overdose in a Diabetic Patient: Suicidal Behavior and Multiorgan Failure.","authors":"Doron Zamir, Yaniv S Ovadia, Ofer Ben-Bassat, Mariana Zamir, Stephen D H Malnick","doi":"10.12659/AJCR.947682","DOIUrl":"https://doi.org/10.12659/AJCR.947682","url":null,"abstract":"<p><p>BACKGROUND Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have gained popularity in recent years. Consequently, Semaglutide prescription rates have increased for both its indicated and off-label uses. A possible link between GLP-1 RAs and suicidal behavior has been proposed. CASE REPORT We describe a rare case of suicide-related behavior, adverse outcomes, and a self-injected Semaglutide overdose in a 67-year-old man with diabetes mellitus and overweight. The patient had been on a weekly 1-mg Semaglutide regimen for 1 year prior to hospitalization. He presented with multiorgan failure, hypoglycemia, cholestatic liver dysfunction, and 2 duodenal ulcers, and reported weakness, appetite loss, epigastric pain, severe diarrhea, and melena over 2 weeks, and syncope the day before admission. His clinical status improved gradually, including duodenal ulcers upon discharge. In further questioning, the patient recalled feeling moody and injecting his monthly Semaglutide prescription all at 1 time, 14 days before admission. The self-injection of an overdose 4 times greater than permitted may be considered suicidal behavior for 6 reasons: (1) Semaglutide treatment began more than 1 year before the event; (2) The patient was experienced in self-injecting; (3) A single injection is limited to the weekly recommended dose; (4) If multiple injections exceed the pre-filled monthly amount, an overdose might occur; (5) Semaglutide application by pen is very safe; and (6) He reported being dysphoric prior to the event. CONCLUSIONS Patients receiving GLP-1 Ras, such as Semaglutide, should be screened for common mental disorders in clinical practice. Also, we suggest multiorgan failure should be excluded in Semaglutide-treated patients with acute illness onset.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947682"},"PeriodicalIF":0.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972944","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}