{"title":"Over eight years of transfusion independence with continuous erythropoietin receptor activator and Roxadustat in transfusion-dependent low-risk myelodysplastic syndrome.","authors":"Tatsuyoshi Ikenoue, Yoshiyuki Furumatsu, Tetsuya Kitamura","doi":"10.1093/omcr/omaf092","DOIUrl":"10.1093/omcr/omaf092","url":null,"abstract":"<p><p>We report a case of a 65-year-old Japanese woman with low-risk myelodysplastic syndrome (MDS) on hemodialysis who achieved transfusion independence for over eight years with combined epoetin beta pegol (continuous erythropoietin receptor activator, CERA) and roxadustat. Transfusion-dependent since 2008, she showed a temporary response to darbepoetin and CERA, initiated in August 2016. Roxadustat was added in January 2020, leading to sustained transfusion independence. No serious adverse events, such as progression to acute leukemia or clinically significant thyroid dysfunction, were observed during this period.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 7","pages":"omaf092"},"PeriodicalIF":0.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643804","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 case report of disconnected pancreatic duct syndrome: an underrecognized complication of acute necrotizing pancreatitis.","authors":"Oumaima Mesbah, Kaoutar Imrani, Safae Lanjeri, Khaoula Boumeriem, Nabil Mouatassim Billah, Ittimade Nassar","doi":"10.1093/omcr/omaf101","DOIUrl":"10.1093/omcr/omaf101","url":null,"abstract":"<p><p>Disconnected pancreatic duct syndrome (DPDS) is a rare condition characterized by a disruption of the pancreatic duct, separating viable pancreatic tissue from the gastrointestinal tract. It often follows acute or chronic pancreatitis, abdominal trauma, or pancreatic surgery, leading to ductal necrosis or disintegration. DPDS presents significant diagnostic and management challenges, especially in cases with delayed onset. The authors report a complex case of recurrent pancreatic fluid collections after necrotizing pancreatitis, highlighting the potential for delayed DPDS manifestation. Advanced imaging techniques, including endoscopic ultrasonography, contrast-enhanced CT, and MRCP, were used for diagnosis. Due to failure of conservative treatment, a distal pancreatectomy was performed, resolving the issue and preventing complications such as infection, sepsis, or pancreatic fistula. This case underscores the importance of early recognition of DPDS on imaging, facilitating timely treatment and reducing the risk of long-term complications.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 7","pages":"omaf101"},"PeriodicalIF":0.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643795","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}
Philip Desamour, Sakhr Alshwayyat, Lucila Alvarez, Noor Almasri, Hamdah Hanifa
{"title":"Catastrophic antiphospholipid syndrome in a young patient: a case report of severe multi-organ and cardiovascular involvement.","authors":"Philip Desamour, Sakhr Alshwayyat, Lucila Alvarez, Noor Almasri, Hamdah Hanifa","doi":"10.1093/omcr/omaf102","DOIUrl":"10.1093/omcr/omaf102","url":null,"abstract":"<p><p>Catastrophic Antiphospholipid Syndrome (CAPS) is a rare serious form of APS characterized by thrombosis in multiple organs and a cytokine storm. We report a complex case of a 28-year-old female that tested positive for COVID-19 with a medical history of deep vein thrombosis, pulmonary embolus and systemic lupus erythematosus, with underlying APC, complicating her case of CAPS in multiple organs. Computed Tomography (CT) PE reveled extensive pulmonary emboli and an elevated right/left ventricular ratio (RV/LV). CT of the abdomen and pelvis showed gastritis, ascites and anasarca, fluid accumulation and small bilateral pleural effusions. Urinalysis showed low levels of albumin, urine protein 4+ g, and hyperlipidemia. Laboratory test indicated that the patient has developed a worsening non oliguric acute kidney injury and renal biopsy revealed necrotizing. This is a complex case that contributes to the understanding of CAPS and highlights the challenges of its diagnosis and management.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 7","pages":"omaf102"},"PeriodicalIF":0.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643798","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}
Muhammad Umar Farooq, Shabana Kausar, Muhammad Fawad Tahir, Munaum Ali Khan, Adnan Nasir, Tanesh Ayyalu, Mohammad Hammad Jaber Amin
{"title":"Massive left ventricular Pseudoaneurysm four weeks post-myocardial infarction and percutaneous coronary intervention: a case report.","authors":"Muhammad Umar Farooq, Shabana Kausar, Muhammad Fawad Tahir, Munaum Ali Khan, Adnan Nasir, Tanesh Ayyalu, Mohammad Hammad Jaber Amin","doi":"10.1093/omcr/omaf088","DOIUrl":"10.1093/omcr/omaf088","url":null,"abstract":"<p><p>Left ventricular pseudoaneurysms (LVPA) are rare complications of myocardial infarction (MI), occurring in less than 1% of cases. Diagnosis is challenging due to nonspecific symptoms, particularly in large aneurysms. Imaging modalities like echocardiography, CTA, and CMR are vital for identifying LVPA, especially in atypical presentations involving massive aneurysms. We report a 75-year-old male with chest pain, diagnosed with inferior wall MI due to left circumflex artery occlusion and treated with PCI. Four weeks later, echocardiography detected an aneurysmal outpouching, confirmed by CTA and CMR, which revealed an unusually large aneurysm with a 30-mm neck, thrombus formation, and extensive myocardial damage. Conservative management was chosen after the patient declined surgery. This case is significant due to the aneurysm's extraordinary size, emphasizing the role of multimodal imaging, particularly CMR, in diagnosis and management. Further research is needed to refine treatment guidelines for such complex cases.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 7","pages":"omaf088"},"PeriodicalIF":0.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643802","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":"First reported case of axillary Angiolymphoid hyperplasia with eosinophilia: a rare localization and literature review.","authors":"Dyala Sayed Ahmed, Zeinab Mustafa Asmar, Moatasem Hussein Al-Janabi, Fouz Hassan","doi":"10.1093/omcr/omaf089","DOIUrl":"10.1093/omcr/omaf089","url":null,"abstract":"<p><p>Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign vasoproliferative disorder that commonly affects the scalp and periauricular region. It presents as solitary or multiple erythematous papules or nodules, typically in young to middle-aged adults. The etiology remains unclear, with trauma, infections, and hormonal influences considered possible triggers. Here, we report a rare case of ALHE in a 72-year-old male with multiple scalp nodules and a solitary lesion in the axilla, an unusual anatomical site. Histopathological examination confirmed ALHE. Surgical excision was performed, with no recurrence at six months. To our knowledge, this is the first documented case of axillary ALHE, expanding the spectrum of its clinical presentation.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 6","pages":"omaf089"},"PeriodicalIF":0.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530274","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}
Stanley Kim, John Schaerth, Kevin Chen, William Stull, Gian Yakoub
{"title":"Adenocarcinoma of Müllerian origin developed 22 years after Salpingo-oophorectomy in a woman with BRCA1 mutation: a thought about modification of chemotherapy dose and peritoneal resection.","authors":"Stanley Kim, John Schaerth, Kevin Chen, William Stull, Gian Yakoub","doi":"10.1093/omcr/omaf075","DOIUrl":"10.1093/omcr/omaf075","url":null,"abstract":"<p><p>Late recurrence of ovarian cancer is exceedingly rare. We report a case of adenocarcinoma of Müllerian origin that developed 22 years after hysterectomy and bilateral salpingo-oophorectomy (BSO) for ovarian cancer in an 81-year-old woman with a pathogenic BRCA1 mutation. The patient underwent six cycles of reduced-dose carboplatin and paclitaxel, achieving remission with a dramatic decline in CA-125 levels. Women with BRCA mutations have a significantly increased risk of ovarian/tube/peritoneal cancer. Although risk-reducing BSO effectively decreases the risk of ovarian and fallopian tube cancers, the risk of peritoneal cancer remains substantial. This case not only illustrates the persistent lifetime risk of ovarian/tube/peritoneal cancer despite BSO but also underscores the need for reevaluation of prophylactic surgical strategies, particularly regarding the extent of peritoneal resection, in BRCA mutation carriers. Additionally, this case report demonstrated the efficacy of dose-modified chemotherapy for BRCA-associated cancers. Further research is warranted to refine surgical and therapeutic strategies for patients with BRCA mutation.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 6","pages":"omaf075"},"PeriodicalIF":0.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530262","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}
Daniel Peñaherrera-Vásquez, Diego Peñaherrera, Luis Fuenmayor-González
{"title":"Bilateral acquired Perirenal Lymphangiectasia: case report.","authors":"Daniel Peñaherrera-Vásquez, Diego Peñaherrera, Luis Fuenmayor-González","doi":"10.1093/omcr/omaf086","DOIUrl":"10.1093/omcr/omaf086","url":null,"abstract":"<p><p>Bilateral perirenal lymphangiectasia is a rare condition characterized by the dilation of lymphatic ducts and the formation of fluid-filled cavities. Renal lymphangiectasia is rarely observed, affecting approximately 1% of cases, with only 34 bilateral cases reported in adults by 2025. This case report discusses a 55-year-old male with a history of recurrent pyelonephritis who was eventually diagnosed with bilateral acquired perirenal lymphangiectasia based on CT, MRI, and cytochemical analysis of perirenal fluid. The patient exhibited mild left flank pain without further complications, and given the disease's benign nature, an expectant management approach was adopted. Follow-up assessments confirmed an asymptomatic status. This report highlights the importance of considering lymphangiectasia in differential diagnoses for renal cystic lesions to avoid unnecessary procedures. Our case is the 35th documented instance of bilateral renal lymphangiectasia in the literature, underscoring the need for medical awareness of this condition to improve diagnosis and patient care.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 6","pages":"omaf086"},"PeriodicalIF":0.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530264","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}
Qusai Alqudah, Omar Obeidat, Moh'd Daise, Abdallah Rayyan, Aseed Mestarihi, Andrew L Smock
{"title":"Carbon monoxide-induced atrial fibrillation: unveiling the cardiovascular Spectrum through a case report and systematic review of reported cases.","authors":"Qusai Alqudah, Omar Obeidat, Moh'd Daise, Abdallah Rayyan, Aseed Mestarihi, Andrew L Smock","doi":"10.1093/omcr/omaf087","DOIUrl":"10.1093/omcr/omaf087","url":null,"abstract":"<p><strong>Background: </strong>Carbon monoxide (CO) poisoning is a public health concern with cardiovascular consequences like arrhythmias. Atrial fibrillation (AF) has been sporadically linked to CO exposure.</p><p><strong>Case report: </strong>A 72-year-old woman presented with gait imbalance, dizziness, and headache. ECG showed new-onset AF, while echocardiography and brain imaging were unremarkable. Her husband exhibited similar symptoms, raising suspicion of CO poisoning. Carboxyhemoglobin was 2.9%. She spontaneously reverted to sinus rhythm with normobaric oxygen therapy. Systematic Review: 7 cases of CO-induced AF (ages 21-82) were reviewed. Most patients were male 4 (57%) and did not have a history of cardiovascular diseases 6 (86%). The most common symptoms were headache and nausea, each occurring in 4 (57%) cases. Rapid ventricular response was observed in 6 (86%) cases, with most reverting to sinus rhythm.</p><p><strong>Conclusion: </strong>CO poisoning increases dysrhythmia risk through hypoxia-induced myocardial changes and voltage-gated channel alterations. Greater awareness is needed regarding its cardiovascular implications.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 6","pages":"omaf087"},"PeriodicalIF":0.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530265","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}
Katrina J Villegas, Laura Guerrero, Hala Moussa, Islam Rajab, Abraam Rezkalla, Dhruv Patel, Mohammed A Qarqash
{"title":"Euglycemic diabetic ketoacidosis of unknown Etiology in a type 2 diabetic patient.","authors":"Katrina J Villegas, Laura Guerrero, Hala Moussa, Islam Rajab, Abraam Rezkalla, Dhruv Patel, Mohammed A Qarqash","doi":"10.1093/omcr/omaf057","DOIUrl":"10.1093/omcr/omaf057","url":null,"abstract":"<p><p>Euglycemic diabetic ketoacidosis is a rare form of DKA characterized by severe ketosis and metabolic acidosis without marked hyperglycemia. We report a 45-year-old female with insulin-dependent diabetes and chronic kidney disease, initially presenting with acute heart failure, who later developed euglycemic DKA. Despite near-normal glucose levels, high anion gap metabolic acidosis with significant ketones highlighted this crisis. Treatment included fluids, insulin with dextrose, and intensive monitoring. This case underscores the need for early recognition of euglycemic DKA, especially in complex patients, to improve outcomes.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 6","pages":"omaf057"},"PeriodicalIF":0.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530273","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}