Archive of clinical cases最新文献_第4页

Mirror syndrome associated with fetal cardiomyopathy. 与胎儿心肌病相关的镜像综合征。

Archive of clinical cases Pub Date : 2023-12-14 eCollection Date: 2023-01-01 DOI: 10.22551/2023.41.1004.10273

Petra Glad Štritof, Lucija Zanze, Paulo Zekan, Gordana Horvat, Vladimir Blagaic

引用次数: 0

Eosinophilic enteritis: the great mimic. 嗜酸性粒细胞肠炎：伟大的模仿者。

Archive of clinical cases Pub Date : 2023-12-14 eCollection Date: 2023-01-01 DOI: 10.22551/2023.41.1004.10271

Raluca-Ioana Avram, Anca Victoriţa Trifan, Irina Girleanu, Simona Ştefania Juncu, Cristina Maria Muzica, Ana-Maria Sîngeap, Laura Huiban

{"title":"Eosinophilic enteritis: the great mimic.","authors":"Raluca-Ioana Avram, Anca Victoriţa Trifan, Irina Girleanu, Simona Ştefania Juncu, Cristina Maria Muzica, Ana-Maria Sîngeap, Laura Huiban","doi":"10.22551/2023.41.1004.10271","DOIUrl":"https://doi.org/10.22551/2023.41.1004.10271","url":null,"abstract":"Eosinophilic enteritis (EoN), a subtype of eosinophilic gastrointestinal disease, is a rare and complicated inflammatory condition affecting the small intestine. This case report discusses a 42-year-old patient who presented with acute gastrointestinal symptoms including diarrhea, nausea, and vomiting. Initial laboratory investigations revealed leukocytosis, peripheral eosinophilia, and distinctive imaging findings, prompting further evaluation. Endoscopic evaluation revealed extensive mucosal lesions in the small intestine, with subsequent biopsies confirming eosinophilic infiltration, ultimately leading to the diagnosis of chronic enteritis, probably of an eosinophilic nature. The case highlights the complex differential diagnostic process involved in identifying EoN, which requires a comprehensive understanding of all the clinical and histopathological features of the disease. The efficacy of budesonide therapy is also discussed in the management of EoN and it was evidenced by our patient's positive response to treatment. This case report contributes significant insights into the understanding and management of EoN, providing essential information for the medical community to facilitate accurate diagnosis and tailored therapeutic interventions for individuals experiencing this complex disorder.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"183-186"},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800332","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

Retroperitoneal liposarcoma: unveiling diagnostic delays and multimodal treatment dilemmas. 腹膜后脂肪肉瘤：揭示诊断延误和多模式治疗困境。

Archive of clinical cases Pub Date : 2023-12-14 eCollection Date: 2023-01-01 DOI: 10.22551/2023.41.1004.10272

Vlad Ionuţ Vlăsceanu, Radu Petru Soroceanu, Daniel Vasile Timofte, Andi Gabriel Iordache, Cristina Ciobanu Strobescu, Sergiu Timofeiov

{"title":"Retroperitoneal liposarcoma: unveiling diagnostic delays and multimodal treatment dilemmas.","authors":"Vlad Ionuţ Vlăsceanu, Radu Petru Soroceanu, Daniel Vasile Timofte, Andi Gabriel Iordache, Cristina Ciobanu Strobescu, Sergiu Timofeiov","doi":"10.22551/2023.41.1004.10272","DOIUrl":"10.22551/2023.41.1004.10272","url":null,"abstract":"Liposarcomas are a prevalent subtype of soft tissue sarcomas, constituting less than 1% of all malignancies. Originating in the adipose tissue, they can manifest in various locations and are categorized by the World Health Organization into several subtypes: well-differentiated liposarcomas, dedifferentiated liposarcomas, myxoid liposarcomas, pleomorphic liposarcomas and mixed-type liposarcomas. These tumors typically affect middle-aged and older individuals, and their incidence has been progressively increasing over the years. As liposarcomas advance they tend to encase blood vessels and major organs, particularly in the retroperitoneal area. Often asymptomatic initially, symptoms arise as the tumor reaches a considerable size, exerting pressure on adjacent tissues and organs. This report features a 54-year-old patient incidentally diagnosed with a substantial retroperitoneal tumor extending to the antero-lateral abdominal wall and inner thigh via the right inguinal ligament. The patient, with a previous three-year history of a right inguinal mass, sought acute care for a perianal abscess The histological examination revealed morphological aspects consistent with a low-grade myxoid liposarcoma. While surgery remains the primary treatment for retroperitoneal liposarcomas, controversies exist regarding the role of radiotherapy and chemotherapy in improving survival rates. This case highlights the challenges in managing retroperitoneal tumors and underscores the importance of a personalized, multidisciplinary approach to optimize patient outcomes.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"187-190"},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800649","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

Small fiber neuropathy with normal intra-epidermal nerve fiber density but reduced sweat gland density after third BNT162b2 shot. 小纤维神经病，表皮内神经纤维密度正常，但第三次注射BNT162b2后汗腺密度降低。

Archive of clinical cases Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI: 10.22551/2023.41.1004.10264

Josef Finsterer

引用次数: 0

Unilateral complicated pleural empyema in a patient with bronchial asthma due to clindamycin-resistant Prevotella buccae. 支气管哮喘患者单侧并发胸膜脓胸1例，原因为耐克林霉素结核菌普氏菌。

Archive of clinical cases Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI: 10.22551/2023.41.1004.10263

Sakshi Patel, Hamza Hanfe, Alkesh Kumar Khurana, Arati Bhadade, Shashwati Nema

{"title":"Unilateral complicated pleural empyema in a patient with bronchial asthma due to clindamycin-resistant Prevotella buccae.","authors":"Sakshi Patel, Hamza Hanfe, Alkesh Kumar Khurana, Arati Bhadade, Shashwati Nema","doi":"10.22551/2023.41.1004.10263","DOIUrl":"https://doi.org/10.22551/2023.41.1004.10263","url":null,"abstract":"Prevotella buccae (P. buccae) is a gram-negative obligate anaerobe mainly associated with infections of odontogenic origin. Non-oral monomicrobial infection by these obligate anaerobic bacteria is rare. Only a few cases of monomicrobial non-oral infections by P. buccae have been reported in the literature. We are reporting a case of unilateral complicated pleural empyema in a patient with bronchial asthma infected by P. buccae. Pleural fluid aerobic culture and blood culture reports were sterile. No acid-fast bacilli were detected by Acid Fast Bacilli (AFB) staining, and cartridge-based nucleic acid assay test (CBNAAT) reports were negative for Mycobacterium tuberculosis. The isolate, P. buccae was found susceptible to Metronidazole (MIC = 3 μg/ml) and resistant to Clindamycin (MIC = 256 μg/ml). In view of rising trends of antimicrobial resistance among anaerobes, it is recommended to perform anaerobic culture and sensitivity testing in clinically suspected cases of pleuropulmonary infection for appropriate diagnosis and optimal patient management. Clindamycin should be used with caution for empiric treatment.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"150-152"},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464733","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

From spotlight to shadow: ALK inhibitor-induced acute liver failure in a patient with non-small cell lung cancer. 从聚光灯到阴影:ALK抑制剂诱导的非小细胞肺癌患者急性肝衰竭。

Archive of clinical cases Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI: 10.22551/2023.41.1004.10266

Simona Ştefania Juncu, Anca Victorita Trifan, Horia Minea, Raluca-Ioana Avram, Camelia Cojocariu, Ana-Maria Sîngeap

{"title":"From spotlight to shadow: ALK inhibitor-induced acute liver failure in a patient with non-small cell lung cancer.","authors":"Simona Ştefania Juncu, Anca Victorita Trifan, Horia Minea, Raluca-Ioana Avram, Camelia Cojocariu, Ana-Maria Sîngeap","doi":"10.22551/2023.41.1004.10266","DOIUrl":"https://doi.org/10.22551/2023.41.1004.10266","url":null,"abstract":"Novel oncological therapies substantially improved the prognosis of cancer patients. Immunotherapies (immune checkpoint inhibitors) and targeted therapies (tyrosine kinase inhibitors) represent innovative strategies, which have revolutionized cancer patient's approaches. However, the new treatments may bring additional adverse effects, therefore right selection, close monitoring, and appropriate clinical decisions in the event of a complication are of upmost importance in these patients' management. We present an elderly male patient undergoing treatment with alectinib - anaplastic lymphoma kinase (ALK) inhibitor for metastatic non-small cell lung cancer, who was diagnosed with acute liver failure by drug-induced liver injury, five months after the start of the therapy. After the other possible causes of hepatocellular injury were excluded, the drug was discontinued. Using corticotherapy and supportive measures, the evolution of the patient was favorable. Up to this moment, data showed that alectinib was less associated with liver function abnormalities compared to other ALK inhibitors, however most commonly of mild or moderate grade of severity, especially in the first two months of treatment. The case we report presented acute onset liver failure, with a relatively late occurrence during alectinib therapy. Timely recognition may improve patients' prognosis, and monitoring must be carried out rigorously. Awareness and effective interdisciplinary communication among medical specialties play a pivotal role in the comprehensive care of cancer patients.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"160-163"},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464712","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

An uncommon culprit of neutropenic fever: a case of Sweet syndrome following induction therapy for acute myeloid leukemia. 中性粒细胞减少热的罕见病因:急性髓性白血病诱导治疗后出现Sweet综合征1例。

Archive of clinical cases Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI: 10.22551/2023.41.1004.10262

Ahmed Alderazi, Alec B Rezigh

{"title":"An uncommon culprit of neutropenic fever: a case of Sweet syndrome following induction therapy for acute myeloid leukemia.","authors":"Ahmed Alderazi, Alec B Rezigh","doi":"10.22551/2023.41.1004.10262","DOIUrl":"https://doi.org/10.22551/2023.41.1004.10262","url":null,"abstract":"Sweet syndrome (SS) is a rare inflammatory disorder characterized by the rapid onset of a characteristically tender rash, fever, and other systemic symptoms. These manifestations are often mistaken for an infection that is not responding to antimicrobials, especially in immunocompromised hosts. We present the case of a 44-year-old woman who developed SS following induction chemotherapy for newly diagnosed acute myeloid leukemia (AML). She exhibited a painful rash on the anterior chest, which spread centrifugally, along with neutropenic fever unresponsive to broad-spectrum antimicrobials. Biopsy of the rash revealed a dense neutrophilic infiltrate within the dermis, confirming the diagnosis of SS. The patient was subsequently treated with systemic steroids with prompt resolution of fevers and improvement of her rash. This case highlights that SS can manifest with a robust neutrophilic infiltrate, even in the context of neutropenia stemming from chemotherapy. SS serves as a crucial consideration in hematologic malignancies, particularly AML, when patients present with fever and cutaneous eruptions. Prompt recognition followed by systemic steroid therapy often leads to symptom resolution.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 4","pages":"146-149"},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464711","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

Sodium valproate: cacosmia and dysgeusia as uncommon side effects. 丙戊酸钠:不常见的不良反应。

Archive of clinical cases Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI: 10.22551/2023.41.1004.10265

Clara Montalbano, Accursio Raia, Valerio Caruso, Lavinia Migli

引用次数: 0

Xanthogranulomatous epithelial tumor: a novel entity of uncertain biologic potential. 黄粒细胞性上皮肿瘤：一种生物学潜力不确定的新实体。

Archive of clinical cases Pub Date : 2023-10-05 eCollection Date: 2023-01-01 DOI: 10.22551/2023.40.1003.10261

Teodor Svantesson, Kim van Oudenaarde, Bruno Fuchs, Beata Bode, Alexander Vogetseder

引用次数: 0

A challenging case of bradykinin-mediated angioedema with airway obstruction: management and therapeutic strategies. 缓激肽介导的血管性水肿伴气道阻塞的一个具有挑战性的病例：管理和治疗策略。

Archive of clinical cases Pub Date : 2023-10-03 eCollection Date: 2023-01-01 DOI: 10.22551/2023.40.1003.10260

Lisete Rolo Nunes, Mónica Palma Anselmo, Tiago Salvador Brito

{"title":"A challenging case of bradykinin-mediated angioedema with airway obstruction: management and therapeutic strategies.","authors":"Lisete Rolo Nunes, Mónica Palma Anselmo, Tiago Salvador Brito","doi":"10.22551/2023.40.1003.10260","DOIUrl":"https://doi.org/10.22551/2023.40.1003.10260","url":null,"abstract":"Angioedema is a potentially life-threatening condition that can have an allergic origin, usually mediated by histamine or a non-allergic origin, mediated by bradykinin. The distinction between these origins may present a clinical challenge at first approach, especially in cases that appear as an emergency and the outcome is time dependent. The authors describe a rare case of bradykinin angioedema associated with airway obstruction and discuss the right approach and therapeutic options. A 46-year-old patient under ACE inhibitor, renin-angiotensin-aldosterone blocker and beta blocker presented with difficulty swallowing, shortness of breath and angioedema, associated with inspiratory stridor, incapacity of talking, plantar pruritus and vomits minutes after ingestion of shrimp. The symptoms did not respond to epinephrine, anti-histamines or steroids. The airway quickly became an emergency and the authors discuss the importance of airway obstruction management and having a multidisciplinary well-defined plan of approach with backup plans. Exuberant angioedema persisted leading to the suspicion of drug induced angioedema. Treatment with tranexamic acid 1g 6/6h and icatibant 30 mg 6/6h (3 doses) was started with resolution. In these cases, the rapid institution of the right pharmacological line will relate significantly to a better outcome. It is particularly important because, as their underlying physiopathologic mechanism differ, bradykinin mediated angioedema does not respond to drugs that histamine mediated angioedema does, like corticosteroids and antihistaminic. In severe and life-threatening cases icatibant and tranexamic acid have proven to be an effective therapy.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 3","pages":"138-141"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/75/acc-10-03-10260.PMC10546096.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168633","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