AACE Clinical Case Reports最新文献

{"title":"Hematospermia in a Transgender Woman with Evidence for Endometrial Tissue in the Prostate","authors":"Janet Coleman-Belin BS ,&nbsp;Uchechukwu O. Amakiri BS ,&nbsp;Fang-Ming Deng MD, PhD ,&nbsp;Deepthi Hoskoppal MD ,&nbsp;Joshua D. Safer MD ,&nbsp;Tamar Reisman MD","doi":"10.1016/j.aace.2024.01.006","DOIUrl":"10.1016/j.aace.2024.01.006","url":null,"abstract":"<div><h3>Background/Objective</h3><p>The frequency of hematospermia in transgender women is unknown. This report aimed to describe the development of hematospermia in a transgender woman.</p></div><div><h3>Case Report</h3><p>A 35-year-old transgender woman treated with estradiol valerate and leuprolide presented with painless rust-tinged ejaculate, urethral bleeding after ejaculation, and intermittent hematuria. Her medical history included gastroesophageal reflux disease, internal hemorrhoids, and attention deficit hyperactivity disorder with negative tobacco smoking and urologic history. Additional medications included emtricitabine-tenofovir disoproxil fumarate and fexofenadine. Physical examination did not reveal constitutional or genitourinary abnormalities. Urinalysis and culture disclosed rare white blood cells with gram-variable bacilli. The chlamydia, gonorrhea, and human immunodeficiency virus test results were negative. Abdominal computed tomography did not reveal bladder or prostate cancer, calcifications, inflammation, or cysts. She continued to have symptoms after this initial workup. One year after the initial symptom onset, transrectal ultrasound disclosed a 1.7-cm midline posterior prostatic cyst with hemorrhagic products, later revealed by magnetic resonance imaging as communicating with the left seminal vesicle. Two ultrasound-guided transperineal biopsy samples revealed benign prostatic tissue with a small focus of Müllerian or endometrial-type tissue, evidenced by immunopositivity for paired-box gene 8 and estrogen receptor in epithelium and cluster of differentiation 10 immunopositivity in stroma. After medical consultation, the patient underwent prostatic cyst aspiration, resection of the transurethral ejaculatory ducts, and orchiectomy. She did not experience any complications after these procedures.</p></div><div><h3>Discussion</h3><p>The etiology of hematospermia may be idiopathic, iatrogenic, anatomic, or pathologic.</p></div><div><h3>Conclusion</h3><p>Occult endometriosis or ectopic Müllerian epithelial tissue growth may occur in transgender women taking feminizing gender-affirming hormone therapy.</p></div>","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 80-83"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000063/pdfft?md5=1510b499a9d8c244524a70a4a9503be8&pid=1-s2.0-S2376060524000063-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139635092","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":"Cushing Syndrome Due to a Corticotropin-Releasing Hormone– and Adrenocorticotropic Hormone–Secreting Silent Pheochromocytoma","authors":"Sananda Moctezuma MD ,&nbsp;Jonathan L. Perez BS ,&nbsp;Ezra Baraban MD ,&nbsp;Patrizio Caturegli MD, MPH ,&nbsp;Lilah Morris-Wiseman MD ,&nbsp;Roberto Salvatori MD","doi":"10.1016/j.aace.2024.01.007","DOIUrl":"10.1016/j.aace.2024.01.007","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Ectopic cosecretion of corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) in silent (ie, non–catecholamine-secreting) pheochromocytoma is a rare cause of Cushing syndrome.</p></div><div><h3>Case Report</h3><p>A 57-year-old woman rapidly developed hypercortisolism, clinically manifesting as fatigue, muscle weakness, weight gain, and worsening hypertension and biochemically characterized by hypokalemia and marked increases in the serum cortisol and plasma ACTH levels. This acute presentation suggested a diagnosis of ectopic ACTH syndrome (EAS). Imaging studies revealed a right adrenal mass that enhanced after administration of the radioisotope gallium-68-DOTATATE. Plasma metanephrines were normal in 2 separate measurements. The possibility of a silent pheochromocytoma was considered. After controlling her hypercortisolism with metyrapone and surgical preparation with alpha blockade, the patient underwent elective right adrenalectomy. Pathology revealed a pheochromocytoma that stained focally for ACTH and CRH. Postoperatively, the cortisol levels normalized, the hypothalamic-pituitary-adrenal axis was not suppressed, and clinical symptoms from hypercortisolism abated.</p></div><div><h3>Discussion</h3><p>Patients who exhibit a rapid progression of ACTH-dependent hypercortisolism should be screened for EAS. The use of functional imaging radioisotopes (eg, gallium DOTA-peptides) improves the detection of ACTH-secreting tumors. Preoperative treatment with steroidogenesis inhibitors helps control clinical and metabolic derangements associated with severe hypercortisolemia, whereas alpha blockade prevents the onset of an adrenergic crisis.</p></div><div><h3>Conclusion</h3><p>We present a rare case of EAS due to a silent pheochromocytoma that cosecreted ACTH and CRH. Pheochromocytoma should be considered in patients with EAS who have an adrenal mass even in the absence of excessive catecholamine secretion.</p></div>","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 84-88"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000075/pdfft?md5=5dd4c1da1751e233132665d59d41fec2&pid=1-s2.0-S2376060524000075-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139875101","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":"Severe Hyponatremia Triggered by Immune Checkpoint Inhibitor Therapy in a Patient With Mulvihill-Smith Syndrome","authors":"Tammy Tavdy DO ,&nbsp;Janaki Manasa Samavedam MD ,&nbsp;Priyanka Mathias MD ,&nbsp;Hanna J. Lee MD","doi":"10.1016/j.aace.2024.03.002","DOIUrl":"10.1016/j.aace.2024.03.002","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Immune checkpoint inhibitors (ICI), including Programmed Cell Death 1, Programmed Cell Death Ligand 1, and Cytotoxic T-lymphocyte Associated Antigen 4 inhibitors, upregulate T-cell responses against tumor cells and are becoming a cornerstone in the treatment of various advanced solid and hematological cancers. Mulvihill-Smith Syndrome (MSS) is a rare genetic syndrome that has been associated with metabolic abnormalities and early-onset tumors, including malignancies. We report the first known case of ICI-induced hyponatremia attributable to syndrome of inappropriate antidiuretic hormone ADH release (SIADH) in a patient with MSS.</p></div><div><h3>Case Report</h3><p>A 23-year-old female patient with MSS and hepatocellular carcinoma presented with recurrent hyponatremia. Assessment of fluid status and electrolytes revealed a euvolemic, hypotonic process consistent with SIADH shortly after initiating adjuvant therapy with atezolizumab, a Programmed Cell Death Ligand 1 inhibitor.</p></div><div><h3>Discussion</h3><p>Endocrine etiologies for euvolemic hypotonic hyponatremia, including adrenal insufficiency and hypothyroidism, were excluded. The diagnosis of SIADH was confirmed based on electrolyte and osmolality studies. Sodium levels normalized with fluid restriction. Given the onset of hyponatremia 30 days after atezolizumab initiation, we posit that atezolizumab triggered severe hyponatremia due to SIADH.</p></div><div><h3>Conclusion</h3><p>With the expanding utilization of ICIs, including in patients predisposed to malignancies such as MSS, vigilant monitoring for ICI-mediated electrolyte imbalances is crucial. Monitoring for hyponatremia and SIADH in the setting of ICI therapy is recommended.</p></div>","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 105-108"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000269/pdfft?md5=8a3ccb382030e347a3bac6287c85fa83&pid=1-s2.0-S2376060524000269-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277515","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":"Recurrent Pheochromocytoma With Bone Metastasis Eight Years After Bilateral Adrenalectomies in a Patient With Neurofibromatosis Type 1","authors":"Elvina Yunasan MD ,&nbsp;Xinyuan Ning MD ,&nbsp;Mohammed Rifat Shaik MBBS ,&nbsp;Marjorie Pennant MD","doi":"10.1016/j.aace.2024.02.006","DOIUrl":"10.1016/j.aace.2024.02.006","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Pheochromocytoma can recur years after curative surgical resection. Rarely, it may reoccur as metastasis. Here, we present a case of metastatic pheochromocytoma to the bones in a patient with neurofibromatosis type 1 (NF1), 8 years after initial resection of primary bilateral adrenal pheochromocytomas without metastases.</p></div><div><h3>Case Report</h3><p>A 44-year-old woman presented with diffuse body pain and palpitations. Her past medical history included NF1 and hypertension. Eight years prior to her current presentation, she had undergone a bilateral adrenalectomy for the management of bilateral adrenal pheochromocytomas. Her plasma metanephrines normalized after surgery and remained normal at her 1-year postoperative visit. She was subsequently lost to follow-up until her current presentation. Our evaluation revealed significantly elevated urine and plasma metanephrines as well as innumerable DOTATATE avid lesions along the axial and perpendicular spine compatible with a metastatic neuroendocrine tumor. She was started on doxazosin and metoprolol and discharged home with a plan to be seen by Oncology to discuss systemic therapy.</p></div><div><h3>Discussion</h3><p>Predicting malignant disease in patients with primary tumors without metastases is challenging. There is no single factor that can reliably predict tumor behavior. It is unknown if individuals with NF1, who have a genetic predisposition for developing pheochromocytomas, are at an increased risk of malignant disease.</p></div><div><h3>Conclusion</h3><p>Due to a lack of accurate predictors, annual biochemical testing is recommended after primary tumor resection and in patients with a genetic predisposition. Strict lifelong follow-up should be strongly considered due to a possible higher risk of malignant disease.</p></div>","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 93-96"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000117/pdfft?md5=4d6c6846d0ea2e11fb36e606495c7407&pid=1-s2.0-S2376060524000117-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140465469","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":"Hypoglycemia Unawareness and Recurrent Severe Hypoglycemia in an Individual With Type 1 Diabetes Mellitus on Insulin","authors":"Carlos Escudero MD, MSc ,&nbsp;Alaa Husain MD, FRCPC ,&nbsp;Amel Arnaout MD, FRCPC","doi":"10.1016/j.aace.2024.03.001","DOIUrl":"10.1016/j.aace.2024.03.001","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Hypoglycemia unawareness is a complication of recurrent hypoglycemia that can complicate diabetes management and impact quality of life. We present the case of an individual with type 1 diabetes with hypoglycemia unawareness and recurrent severe hypoglycemia requiring emergency intervention.</p></div><div><h3>Case Report</h3><p>A 55-year-old man with type 1 diabetes was referred for hypoglycemia unawareness and recurrent hypoglycemia with seizures. Over the prior 4 years he had &gt;400 paramedic responses with 56 hospitalizations. Blood glucose levels ranged between 0.7 and 2.4 mmol/L during these episodes and presenting Hemoglobin A1c (HbA1c) was 4.6% (28 mmol/mol). He was taking insulin glargine daily and aspart with meals via insulin pens with no alternative etiology for his hypoglycemia was identified. The patient expressed difficulty with self-management, social instability, and limited appointment attendance. He was provided a continuous glucose monitor, educational support, and glycemic targets were broadened. After 6 months, HbA1c was 4.6% (28 mmol/mol) and he had 65 paramedic responses. A multidisciplinary team was organized for biweekly follow-up, community outreach, remote technological support, and psychological counseling. After 2 years, the patient had 2 emergency responses and HbA1c was 7.2% (55.2 mmol/mol).</p></div><div><h3>Discussion</h3><p>Permissive hyperglycemia, educational interventions, and continuous glucose monitoring are validated strategies for prevention of hypoglycemia. Limiting hypoglycemia is crucial to restore hypoglycemia awareness, and in severe cases may require high intensity follow-up, community outreach, and psychosocial support.</p></div><div><h3>Conclusion</h3><p>Hypoglycemia unawareness can complicate hypoglycemia prevention. Severe refractory cases are often multifaceted and may warrant a multidisciplinary approach to identify and target patient-specific needs.</p></div>","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 101-104"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000257/pdfft?md5=13e71642e90591ddc4fc43ddea0c7cf2&pid=1-s2.0-S2376060524000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140085708","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":"Hypercalcemia Associated With Severe Dysphagia in a Patient With Parathyroid Adenoma and Significant Cervical Spondylophytes","authors":"Duje Čulina MD ,&nbsp;Mirta Peček MD ,&nbsp;Tomislav Gregurić MD, PhD ,&nbsp;Ivana Aras MD, PhD ,&nbsp;Andro Košec MD, PhD, FEBORL-HNS ,&nbsp;Siniša Stevanović MD, PhD","doi":"10.1016/j.aace.2024.02.004","DOIUrl":"10.1016/j.aace.2024.02.004","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Severe dysphagia is a rare presenting symptom of primary hyperparathyroidism, whereas the most common hypercalcemia-related causes include gastrointestinal symptoms, such as anorexia, constipation, and pancreatitis. This case presentation aimed to describe swallowing difficulty as a leading symptom of hypercalcemia.</p></div><div><h3>Case Report</h3><p>A 62-year-old man experienced vomiting, dysphagia bordering with aphagia, and 20-kg weight loss in a 2-month period. The parathyroid hormone and serum calcium levels were 102 pmol/L (reference range, 1.8-7.9 pmol/L) and 4.12 mmol/L (reference range, 2.14-2.53 mmol/L), respectively. Ultrasound-guided exploration of the neck revealed a large, rounded hypoechoic mass inferior to the left thyroid lobe, which contained parathyroid tissue on fine-needle aspiration cytology examination. Contrast-enhanced neck computed tomography revealed a mass measuring 3.6 × 2.6 × 2.5 cm behind the left thyroid lobe, alongside massive ventral spondylophytes of the cervical spine at the level of the postcricoid segment of the hypopharynx. Magnetic resonance imaging confirmed ventral tissue displacement due to spondylophyte size and location. Surgical exploration of the left side of the neck was performed, and the left lower parathyroid gland weighing 9.07 g was excised. Pathohistologic findings verified a parathyroid gland adenoma. The postoperative values showed parathyroid hormone and serum calcium levels at 4.54 pmol/L and 2.25 mmol/L, respectively.</p></div><div><h3>Discussion</h3><p>The pathophysiology of dysphagia in hypercalcemia is not fully elucidated. In this case, the patient’s improvement after surgery implies a plausible connection between hypercalcemia and dysphagia, suggesting a causal relationship.</p></div><div><h3>Conclusion</h3><p>Although aphagia is not a typical presenting symptom of parathyroid adenoma, it should be noted in the differential diagnosis.</p></div>","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 89-92"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000129/pdfft?md5=b50b772c9917ba7595bfe3dec5f4fb67&pid=1-s2.0-S2376060524000129-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140470073","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":"Dopamine-Secreting Carotid Body Paraganglioma in a Patient With SDHB Mutation","authors":"Katherine Mustafa MD ,&nbsp;Sara Zadeh MD ,&nbsp;Silas A. Culver MD","doi":"10.1016/j.aace.2024.03.003","DOIUrl":"10.1016/j.aace.2024.03.003","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Exclusively dopamine-secreting paragangliomas (PGLs) are rare, and the majority of head and neck PGLs are nonsecretory. Here, we describe a patient with succinate dehydrogenase subunit B (SDHB) mutation and a dopamine-secreting carotid body PGL to highlight the potential importance of screening for dopamine excess in patients with suspected PGL.</p></div><div><h3>Case Report</h3><p>We report a 34-year-old patient who presented with cranial nerve palsy and was found to have a cerebellopontine PGL. Biochemical testing demonstrated increased circulating dopamine levels with normal levels of other catecholamines. Dopamine excess improved with resection of the PGL, and subsequent genetic testing revealed an SDHB mutation.</p></div><div><h3>Discussion</h3><p>Secretory head and neck PGLs and exclusively dopamine-secreting PGLs are both uncommon and rarely present together, although PGLs in patients with SDHB mutations often do produce dopamine. Although current guidelines do not recommend routine evaluation of the dopamine levels in patients at risk for PGL, dopamine-secreting PGLs are frequently locally invasive or metastatic.</p></div><div><h3>Conclusion</h3><p>Screening for dopamine excess in patients with a predisposition to PGL or with suspected PGL may aid in diagnosis and as a marker of successful treatment.</p></div>","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 109-112"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000270/pdfft?md5=cfaaca4bcb9bea1d793cfe23f1829fcd&pid=1-s2.0-S2376060524000270-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140283624","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":"Malignant Insulinoma","authors":"Sindhu Kishore MD ,&nbsp;Michael Eerhart MD ,&nbsp;Mohammad Hijazi MD ,&nbsp;Gehna Kishore MD ,&nbsp;Shahla Mallick MD ,&nbsp;Elie Klam MD","doi":"10.1016/j.aace.2024.01.004","DOIUrl":"10.1016/j.aace.2024.01.004","url":null,"abstract":"","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 119-120"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S237606052400004X/pdfft?md5=35168511ccd9a409dc68e078745aa566&pid=1-s2.0-S237606052400004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139640106","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":"Malignant Pheochromocytoma Presenting as a Large Adrenal Mass With Cavoatrial Tumor Thrombus","authors":"Run Yu MD, PhD ,&nbsp;Martin S. Allen-Auerbach MD ,&nbsp;Michael W. Yeh MD","doi":"10.1016/j.aace.2024.02.001","DOIUrl":"10.1016/j.aace.2024.02.001","url":null,"abstract":"","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 117-118"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000087/pdfft?md5=9a951e01a1ac90bb775e12e62b1a72a7&pid=1-s2.0-S2376060524000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139825943","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 Vertebral Fracture Unmasking Systemic Mastocytosis in a 29-Year-Old Man","authors":"Christopher N. Nguyen DO ,&nbsp;Nathan A. Boggs MD ,&nbsp;Devin B. Maxwell DO ,&nbsp;David T. Danielson MD ,&nbsp;Thanh D. Hoang DO","doi":"10.1016/j.aace.2024.02.003","DOIUrl":"10.1016/j.aace.2024.02.003","url":null,"abstract":"","PeriodicalId":7051,"journal":{"name":"AACE Clinical Case Reports","volume":"10 3","pages":"Pages 113-114"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2376060524000105/pdfft?md5=31f1bb7137b68f0b430bc7ecf3a21019&pid=1-s2.0-S2376060524000105-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466687","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}