Shashi Rajnarinesingh, Maria Georgiou, Nita Prasannan, Priya Sriskandarajah
{"title":"Pure red cell aplasia in a patient with rheumatoid arthritis after JAK inhibitor exposure-diagnostic challenges.","authors":"Shashi Rajnarinesingh, Maria Georgiou, Nita Prasannan, Priya Sriskandarajah","doi":"10.1093/omcr/omag125","DOIUrl":"10.1093/omcr/omag125","url":null,"abstract":"<p><p>We describe a patient with long-standing rheumatoid arthritis (RA) who developed severe refractory transfusion-dependent anaemia lasting several months following treatment with a JAK1 inhibitor (Filgotinib). The patient proceeded with extensive investigations, including bone marrow assessment, and was initially diagnosed with Filgotinib-associated anaemia. However, despite stopping this agent, the anaemia persisted with fluctuating reticulocyte count resulting in multiple hospital admissions. Although the anaemia was initially attributed to Filgotinib, its persistence alongside delayed reticulocytopenia, ultimately led to a diagnosis of acquired Pure Red Cell Aplasia more than 12 months later. Complete remission was achieved with prednisolone + ciclosporin A. This case underscores the need to consider PRCA in RA patients on JAK inhibitors even with initially normal reticulocyte counts, as these agents may transiently mask underlying aplasia.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag125"},"PeriodicalIF":0.6,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431357","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":"Serpiginous erythema multiforme.","authors":"Jamie D P Wen, Dimitrios Karponis","doi":"10.1093/omcr/omag122","DOIUrl":"10.1093/omcr/omag122","url":null,"abstract":"","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag122"},"PeriodicalIF":0.6,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431371","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 Usman Fareed, Abdur Rehman, Abdullah Shehryar, Shivam Singla, Bhavna Singla, Shabbir Mazari
{"title":"Roberts syndrome presenting with bilateral Cryptophthalmos: a case report.","authors":"Muhammad Usman Fareed, Abdur Rehman, Abdullah Shehryar, Shivam Singla, Bhavna Singla, Shabbir Mazari","doi":"10.1093/omcr/omag128","DOIUrl":"10.1093/omcr/omag128","url":null,"abstract":"<p><p>Roberts syndrome (RBS) is a rare autosomal recessive cohesinopathy caused by pathogenic ESCO2 variants and characterized by severe growth restriction, limb reduction defects, and craniofacial anomalies. Cryptophthalmos is classically associated with Fraser syndrome and is not well described in RBS. We report a 7-day-old male neonate born to consanguineous parents who presented with respiratory distress, poor feeding, severe growth restriction, symmetrical limb reduction defects, ambiguous genitalia, and bilateral cryptophthalmos. Prenatal ultrasonography identified limb and genitourinary anomalies. Postnatal evaluation demonstrated multisystem involvement, including horseshoe kidney with hydronephrosis. Molecular testing identified a homozygous pathogenic ESCO2 variant, confirming Roberts syndrome. Although cryptophthalmos initially raised concern for Fraser syndrome, the overall phenotype and genetic findings supported RBS. This case expands the recognized phenotypic spectrum of Roberts syndrome and highlights the importance of molecular testing in complex congenital presentations.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag128"},"PeriodicalIF":0.6,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431395","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":"Benign <i>struma ovarii</i> mimicking ovarian cancer in an afghan woman: an unusual case report and literature review.","authors":"Maryam Yousefi, Elham Sadat Banimostafavi, Mahdiieh Ghoddoosi","doi":"10.1093/omcr/omag124","DOIUrl":"10.1093/omcr/omag124","url":null,"abstract":"<p><strong>Introduction: </strong><i>Struma ovarii</i> is a rare monodermal teratoma composed predominantly of thyroid tissue. While typically benign, its clinical and radiological presentation can be highly deceptive, often mimicking a malignant ovarian tumor.</p><p><strong>Case presentation: </strong>A 52-year-old postmenopausal Afghan woman presented with progressive abdominal distension, pelvic pain, severe ascites, and a complex, highly vascular right adnexal mass. Imaging (ORADS 5) and markedly elevated CA-125 suggested advanced ovarian carcinoma. Despite receiving seven cycles of carboplatin/paclitaxel chemotherapy for presumed primary peritoneal carcinoma, the mass and ascites persisted. Following laparotomy and left salpingo-oophorectomy, histopathology confirmed benign <i>struma ovarii</i> without peritoneal carcinomatosis. Postoperatively, ascites resolved and CA-125 normalized. The patient remained well with no recurrence at 14-month follow-up.</p><p><strong>Conclusion: </strong>This case underscores the critical importance of considering struma ovarii in the differential diagnosis of a complex ovarian mass, even when clinical features and tumor markers strongly suggest malignancy.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag124"},"PeriodicalIF":0.6,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431376","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":"Pure Sertoli cell tumor of the right ovary managed with fertility-sparing surgery: a case report.","authors":"Yohannis Derbew Molla, Suleiman Ayalew Belay, Abebaw Muhabaw Zegeye, Samuel Addisu Abera, Endeshaw Asaye Kindie, Getachew Shiferaw Yigezaw","doi":"10.1093/omcr/omag131","DOIUrl":"10.1093/omcr/omag131","url":null,"abstract":"<p><p>Sertoli cell tumors (SCTs) of the ovary are rare sex cord-stromal neoplasms. We describe a 37-year-old Ethiopian woman (G2P2) with six months of progressive lower abdominal pain but no virilization. Ultrasound revealed a solid 11 cm right adnexal mass. Hormonal profile was normal. An open fertility-sparing right salpingo-oophorectomy was performed. Histopathology confirmed a FIGO Stage IA well-differentiated pure SCT. Postoperative surveillance was conducted via clinical pelvic examinations and abdominal/pelvic ultrasounds every three months. At 12-month follow-up, there was no recurrence. This case highlights that SCTs may be hormonally inactive; histopathologic evaluation remains decisive, and fertility-preserving surgery is a safe option in early-stage lesions.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag131"},"PeriodicalIF":0.6,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431400","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":"An exceptional localization of esophageal cancer: metastasis to the internal auditory canal.","authors":"Thomas Renders, Younes Steffens, Anne Doyen","doi":"10.1093/omcr/omag103","DOIUrl":"10.1093/omcr/omag103","url":null,"abstract":"<p><p>Metastasis to the internal auditory canal (IAC) is rare, representing less than 1% of lesions in this region. We report the case of a 76-year-old man with a history of esophageal adenocarcinoma treated with chemoradiotherapy, who presented with progressive dizziness and unilateral hearing loss. Days later, he developed acute left peripheral facial paralysis. Magnetic resonance imaging revealed an enhancing IAC lesion associated with two cerebellar nodules. Vestibular testing confirmed a complete unilateral deficit. Positron emission tomography (PET) imaging showed hypermetabolic activity in all lesions, and a stereotactic biopsy of the largest cerebellar nodule confirmed the diagnosis of metastatic adenocarcinoma consistent with the esophageal primary. Despite supportive care, the patient died within one month. This case highlights the need to consider metastatic disease in atypical audiovestibular presentations in patients with a cancer history.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag103"},"PeriodicalIF":0.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413410","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}
R E Agnew, F Garcia, C Barton, S Kearney, J P M Kane
{"title":"Late-life decompensation in longstanding obsessive compulsive disorder: a psychiatric prodrome of dementia with Lewy bodies? A case report.","authors":"R E Agnew, F Garcia, C Barton, S Kearney, J P M Kane","doi":"10.1093/omcr/omag115","DOIUrl":"10.1093/omcr/omag115","url":null,"abstract":"<p><p>Psychiatric-onset dementia with Lewy bodies (poDLB) is a recognised but poorly characterised prodromal phenotype. The existing literature focuses almost entirely on <i>de novo</i> psychiatric presentations; decompensation of pre-existing primary psychiatric illness as a manifestation of poDLB has not previously been described. We present a case of a patient with a near-lifelong history of severe obsessive compulsive disorder (OCD), decompensation of which in her early 70s was later recognised as a harbinger of dementia with Lewy bodies (DLB). Escalating OCD symptoms, emergent parkinsonism, and cognitive fluctuations culminated in a probable DLB diagnosis within one year of psychiatric presentation, supported by significantly abnormal dopamine transporter imaging. Recognising decompensation of longstanding primary psychiatric illness as a potential manifestation of poDLB has important implications for timely diagnosis, safe prescribing (particularly neuroleptics) and early biomarker-driven referral.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag115"},"PeriodicalIF":0.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413222","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}
Idan Grossmann, Aubin Attila, Anid Hassan, Anasuya Brahmamdam, Jaimin Dudhia, William Sebastian, Stuart Campbell, Aroob Farooqi, Kamil Ahmad Kamil, Mohammad Amir Hossain, Lee Peng
{"title":"Bronchoperitoneal fistula in a patient with pneumatosis Cystoides intestinalis: a diagnostic challenge.","authors":"Idan Grossmann, Aubin Attila, Anid Hassan, Anasuya Brahmamdam, Jaimin Dudhia, William Sebastian, Stuart Campbell, Aroob Farooqi, Kamil Ahmad Kamil, Mohammad Amir Hossain, Lee Peng","doi":"10.1093/omcr/omag116","DOIUrl":"10.1093/omcr/omag116","url":null,"abstract":"<p><strong>Background: </strong>Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of multiple gas-filled cysts within the wall of the gastrointestinal tract, leading to variable clinical presentations and diagnostic challenges. A bronchoperitoneal fistula is an exceedingly rare complication, typically resulting from downward gas tracking secondary to thoracic pathology.</p><p><strong>Case presentation: </strong>We report the case of a 76-year-old female with a remote history of hiatal hernia repair who developed chronic gastrointestinal symptoms associated with pneumoperitoneum and PCI, complicated by a bronchoperitoneal fistula. While the most bronchoperitoneal fistulas reported are due to thoracic pathology, we suggest that in this case, the fistula may be associated with PCI-related pneumoperitoneum.</p><p><strong>Conclusions: </strong>The case demonstrates unique clinical and diagnostic features and raises the possibility of an atypical pathophysiologic association for broncho-peritoneal fistula formation.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag116"},"PeriodicalIF":0.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413373","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}
Shivangi Tetarbe, Dhruv Gandhi, Lakshmi Shobhavat, Ira Shah
{"title":"Pediatric acute liver failure in a child with arsenic toxicity and underlying rotor syndrome.","authors":"Shivangi Tetarbe, Dhruv Gandhi, Lakshmi Shobhavat, Ira Shah","doi":"10.1093/omcr/omag111","DOIUrl":"10.1093/omcr/omag111","url":null,"abstract":"<p><p>Pediatric acute liver failure can result from infections, metabolic disorders, autoimmune diseases, toxins, or malignancies. It is crucial to consider herbal medicines as an etiological factor in such cases. We report a 7-year-old boy presenting with PALF from arsenic toxicity after consuming herbal medicine. He presented with jaundice, fever, vomiting, and lethargy, with hepatomegaly and signs of raised intracranial tension on examination. He had taken herbal medicine for the jaundice. His toxicology screen revealed high levels of arsenic and lead in serum and urine. Whole exome sequencing incidentally identified pathogenic mutations of the SLCO1B1 and SLCO1B3 genes, suggestive of Rotor syndrome (RS). Despite intensive care, including continuous renal replacement therapy and plasmapheresis, he died from multiorgan dysfunction and sepsis. This case shows the risks of unregulated herbal formulations containing toxins and explores the potential interaction between RS and arsenic toxicity.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag111"},"PeriodicalIF":0.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413180","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}
Barkha Dhanjani, Shivangi Tetarbe, Dhruv Gandhi, Ira Shah
{"title":"Intestinal failure-associated liver disease in a child with short bowel syndrome: management issues.","authors":"Barkha Dhanjani, Shivangi Tetarbe, Dhruv Gandhi, Ira Shah","doi":"10.1093/omcr/omag117","DOIUrl":"10.1093/omcr/omag117","url":null,"abstract":"<p><p>Intestinal failure (IF) refers to a state where the absorptive surface of the small intestine is inadequate to maintain water and electrolyte balance and to meet nutritional demands for optimal growth in children. We describe a 2-month-old infant with short bowel syndrome (SBS) and intestinal failure-associated liver disease (IFALD) following surgical resection for intestinal malrotation and midgut volvulus. He required prolonged total parenteral nutrition (TPN), which resulted in cholestasis and progressive liver dysfunction. Management included ursodeoxycholic acid, amino acid-based continuous feeds, antibiotics, percutaneous transhepatic biliary drainage, and supportive therapies. The illness course was complicated by recurrent diarrhea, hypoglycemia, suspected small intestinal bacterial overgrowth, and Candida sepsis. Gradual clinical improvement was observed, with the resolution of IFALD and appropriate weight gain. On follow-up at 1.5 years, the child was tolerating full oral feeds and had normal liver function. This case highlights the management challenges of SBS with IFALD associated with TPN.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2026 7","pages":"omag117"},"PeriodicalIF":0.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413239","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}