Archive of clinical cases最新文献_第8页

Clinical features and treatment outcomes of progressive uveal melanoma. 进行性葡萄膜黑色素瘤的临床特点及治疗效果。

Archive of clinical cases Pub Date : 2023-01-01 DOI: 10.22551/2023.39.1002.10251

Milda Rancelyte, Justinas Pamedys, Ruta Grigiene, Birute Brasiuniene

{"title":"Clinical features and treatment outcomes of progressive uveal melanoma.","authors":"Milda Rancelyte, Justinas Pamedys, Ruta Grigiene, Birute Brasiuniene","doi":"10.22551/2023.39.1002.10251","DOIUrl":"https://doi.org/10.22551/2023.39.1002.10251","url":null,"abstract":"Uveal melanoma (UM) is a rare malignant tumor that differs from cutaneous melanoma in terms of pathogenesis, clinical behavior, and treatment response. Despite treatment for the primary tumor, 50% of UM patients develop metastatic disease, with the liver being the most affected organ. Furthermore, UM responds poorly to chemotherapy and immune checkpoint inhibitors. We present a clinical case of a 58-year-old female patient who was diagnosed with right eye choroidal melanoma cT2aN0M0. For the treatment of the initial tumor, the patient received stereotactic radiotherapy. However, 11 months after the initial diagnosis, the disease had progressed to the liver. The patient underwent radiofrequency ablation of liver metastases, then as the UM progressed - anti-PD-1 immunotherapy with nivolumab and ipilimumab were prescribed for the first-line palliative systemic treatment, later chemotherapy with dacarbazine (5 cycles) as the second-line systemic treatment. Based on the Foundation-One®CDx findings and an overview of clinical trials data, the MEK inhibitor trametinib was prescribed as a third-line palliative treatment. The patient died due to cancerous intoxication, with overall survival (OS) of 28 months (∼2.33 years) and a progression-free survival (PFS) of 11 months (∼0.92 years) since the initial diagnosis. Treatment-related adverse events could have an impact on the general health condition of the patient.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"10 2","pages":"102-106"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/eb/acc-10-10251.PMC10289051.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9705171","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

Challenging management of coralliform kidney and ureteral stones.

IF 0.8

Archive of clinical cases Pub Date : 2022-12-20 eCollection Date: 2024-01-01 DOI: 10.22551/2024.45.1104.10303

Catrinel-Ana Codău, Flavia Coman, Bogdan Novac

引用次数: 0

Marijuana-induced myocarditis in a 24-year-old man. 一名 24 岁男子因吸食大麻引发心肌炎。

IF 0.8

Archive of clinical cases Pub Date : 2022-07-07 eCollection Date: 2022-01-01 DOI: 10.22551/2022.35.0902.10206

Toktam Alirezaei, Mohammad Kalateh Agha Mohammadi, Rana Irilouzadian, Hamidreza Zarinparsa

引用次数: 0

Successful outcome using Tocilizumab in COVID-19 pneumonia with respiratory failure on a ward level Tocilizumab治疗病房级别的新冠肺炎肺炎伴呼吸衰竭的成功结果

Archive of clinical cases Pub Date : 2022-01-10 DOI: 10.22551/2022.34.0901.10200

B. Morărașu, Aida Basirat, M. Kooblall, S. Lane

引用次数: 0

Diagnostic dilemma in a patient presenting with thrombotic microangiopathy in the setting of pregnancy 一例妊娠期血栓性微血管病患者的诊断困境

Archive of clinical cases Pub Date : 2022-01-10 DOI: 10.22551/2022.34.0901.10199

M. Jiffry, M. Ahmed-khan, Felipe Carmona Pires, Nkechi A Okam, Mahnoor Hanif

{"title":"Diagnostic dilemma in a patient presenting with thrombotic microangiopathy in the setting of pregnancy","authors":"M. Jiffry, M. Ahmed-khan, Felipe Carmona Pires, Nkechi A Okam, Mahnoor Hanif","doi":"10.22551/2022.34.0901.10199","DOIUrl":"https://doi.org/10.22551/2022.34.0901.10199","url":null,"abstract":"Abstract We report a case of thrombotic microangiopathy in a postpartum female for which considerable diagnostic uncertainty existed initially regarding the etiology. This case highlights the limitations surrounding PLASMIC scoring criteria for the diagnosis of thrombotic thrombocytopenic purpura (TTP). A 32-year-old woman presented to maternofetal medicine in her third trimester of pregnancy at 32 weeks for a routine follow up and was subsequently found to have elevated blood pressures with proteinuria, and was diagnosed with pre-eclampsia. Worsening anemia and thrombocytopenia prompted a blood smear which showed schistocytes, concerning for a thrombotic microangiopathy. Creatinine was also elevated with normal liver enzymes being noted. A PLASMIC score of 4 placed her in the low-risk category for severe ADAMTS13 deficiency whilst she fulfilled criteria for partial HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome per Tennessee classification. Despite delivery, her symptoms persisted with subsequent ADAMTS13 assay confirming acquired TTP, subsequently requiring repeated plasmapheresis and rituximab to achieve disease control. Thrombotic microangiopathy remains a diagnostic challenge especially in the peripartum population, and scoring systems such as PLASMIC score and Tennessee classification may be of limited utility.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"9 1","pages":"24 - 28"},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44999544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vitamin D deficiency in thyroid autoimmune diseases 甲状腺自身免疫性疾病的维生素D缺乏

Archive of clinical cases Pub Date : 2022-01-10 DOI: 10.22551/2022.34.0901.10201

Ioana-Codruța Lebădă, R. Ristea, M. Metiu, M. Stanciu

{"title":"Vitamin D deficiency in thyroid autoimmune diseases","authors":"Ioana-Codruța Lebădă, R. Ristea, M. Metiu, M. Stanciu","doi":"10.22551/2022.34.0901.10201","DOIUrl":"https://doi.org/10.22551/2022.34.0901.10201","url":null,"abstract":"Abstract The role of vitamin D in the human body is a complex one, proven by the many studies performed related to this aspect. Data from the literature on the correlation between vitamin D deficiency and thyroid autoimmune pathology, although present and increasing in the last 10 years, have failed to establish exactly whether or not there is a link between them. The aim of the study was to assess the status of vitamin D in patients with autoimmune thyroid disease; and to determine if there is a correlation between parameters such as: thyroid stimulating hormone (TSH), free thyroxine (FT4), ATPO; and vitamin D levels. Therefore, we performed a retrospective study in which we included 60 patients, 32 with autoimmune thyroid pathology and 28 patients with negative antithyroid antibodies. The average age of those in the case group was 58 years old and 52 years old for the control group. Female sex was predominant in both groups of patients, 97% in the study group and 71% in the control group. Vitamin D values in patients with thyroid autoimmune pathology in our study were on average higher than those obtained in the control group (patients with negative thyroid antibodies), without finding a statistically significant difference between the values of the two groups of patients (p = 0.197). The study shows a high prevalence of vitamin D deficiency in both groups of patients (with or without autoimmune thyroid disease), the highest rate being observed among patients without autoimmune pathology, but without a statistically significant difference between values.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"9 1","pages":"34 - 40"},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44394876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leptomeningeal carcinomatosis in gastric cancer: a case report of a rare yet aggressive entity 癌症中的瘦素样癌：一例罕见但侵袭性实体的病例报告

Archive of clinical cases Pub Date : 2022-01-10 DOI: 10.22551/2022.34.0901.10196

M. Baleiras, J. Graça, Leonor Fernandes

引用次数: 0

New onset severe ulcerative colitis following Ixekizumab therapy. 伊谢珠单抗治疗后新发严重溃疡性结肠炎。

Archive of clinical cases Pub Date : 2022-01-01 DOI: 10.22551/2022.37.0904.10227

Alina Mihaela Morosanu, Ioana Ruxandra Mihai, Ioana Irina Rezus, Otilia Gavrilescu, Mihaela Dranga, Cristina Cijevschi Prelipcean, Catalina Mihai

引用次数: 4

Lower limb arterial thrombosis followed by sub-massive pulmonary thromboembolism after Sinopharm BBIBP-CorV COVID-19 vaccination. 国药BBIBP-CorV - COVID-19疫苗接种后下肢动脉血栓形成继发亚块状肺血栓栓塞。

Archive of clinical cases Pub Date : 2022-01-01 DOI: 10.22551/2022.37.0904.10222

Hamidreza Zaheri, Arda Kiani, Siamak Afaghi, Fatemehsadat Rahimi, Mohammadhossein Banitorfi, Amirmohammad Kazemzadeh Norozi, Samaneh Hashemi, Atefeh Abedini

{"title":"Lower limb arterial thrombosis followed by sub-massive pulmonary thromboembolism after Sinopharm BBIBP-CorV COVID-19 vaccination.","authors":"Hamidreza Zaheri, Arda Kiani, Siamak Afaghi, Fatemehsadat Rahimi, Mohammadhossein Banitorfi, Amirmohammad Kazemzadeh Norozi, Samaneh Hashemi, Atefeh Abedini","doi":"10.22551/2022.37.0904.10222","DOIUrl":"https://doi.org/10.22551/2022.37.0904.10222","url":null,"abstract":"The global COVID-19 vaccination had an undeniable influence on the pandemic management, despite of having reported rare but life-threatening side-effects of vaccines. Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare autoimmune complication determined by thrombocytopenia and thrombosis propensity in the circulatory system. The activation of antibodies against platelet factor-4 (PF-4) which mimics the heparin-induced thrombocytopenia (HIT) characteristic is the main known pathogenicity of the disease. Herein, we reported a case of VITT in a middle-aged woman with no previous history of thrombophilia or other medical conditions who presented with thrombosis of the left superficial femoral artery 3-days after receiving the second dose of inactivated BBIBP-CorV (Sinopharm) vaccine. The patient underwent bypass vascular surgery and received none-heparin anticoagulation consistent with high-dose intravenous immunoglobin. Eight days after the discharge, she was subsequently referred to our center with the presentation of sub-massive pulmonary thromboembolism in spite of receiving the prophylactic anticoagulants during follow-up period. Details on side-effects of COVID-19 vaccines, specifically the inactivated ones are yet to be fully ascertained. Clinicians should consider the history of COVID-19 vaccines in thromboembolism patients who do not have well-acknowledged risk factors. Further studies about the necessity of prophylactic anticoagulants and clinical judgment for receiving other vaccines in such patients are required.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"9 4","pages":"150-153"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/f4/acc-09-04-150.PMC9769072.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10511193","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: 1

Hypoxic ischemic brain injury with status myoclonus in a case with post-operative massive pulmonary thromboembolism: A diagnostic and therapeutic challenge. 缺氧缺血性脑损伤伴肌阵挛1例术后大块肺血栓栓塞:诊断和治疗的挑战。

Archive of clinical cases Pub Date : 2022-01-01 DOI: 10.22551/2022.37.0904.10225

Ritwick Mondal, Somesh Saha, Shramana Deb, Rahul Jain, Arindam Maitra, Manoj Mahata

{"title":"Hypoxic ischemic brain injury with status myoclonus in a case with post-operative massive pulmonary thromboembolism: A diagnostic and therapeutic challenge.","authors":"Ritwick Mondal, Somesh Saha, Shramana Deb, Rahul Jain, Arindam Maitra, Manoj Mahata","doi":"10.22551/2022.37.0904.10225","DOIUrl":"https://doi.org/10.22551/2022.37.0904.10225","url":null,"abstract":"Thromboembolic event is an important and widely regarded risk factor, influencing the outcome and overall survival in post-operative cases with second highest association with gynaecological surgeries. Here we report a 52 years old female who underwent total laparoscopic hysterectomy with bilateral salpingo-oophorectomy (TLH+BSO) presented to our emergency in unconscious and intubated state on her post-operative day-1 with cardiorespiratory failure. Based on the immediate investigations after successful resuscitation, an initial diagnosis of massive pulmonary thromboembolism was made following supportive and conservative management. Interestingly on subsequent days she started to display episodic non-rhythmic symmetric myoclonic jerks persisting for seconds to minutes; resembling 'post-hypoxic' or 'post-anoxic' status myoclonus due to hypoxic ischemic brain injury. Further neuro-electrophysiological examination revealed rhythmic well-formed delta activity on both sides symmetrically with a transformation into theta activity with forward displacement on subsequent days, bilaterally over the same areas. Later on, magnetic resonance imaging with magnetic resonance-spectroscopic findings also corroborated to hypoxic ischemic brain injury related changes over bilateral basal ganglia mostly in caudate nucleus. Post operative venous thromboembolism is a major clinical challenge and a subject of constant intensive care yet the neurological sequalae of such event is given less priority despite of its major contribution on overall prognostic and survival index.","PeriodicalId":72274,"journal":{"name":"Archive of clinical cases","volume":"9 4","pages":"161-169"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/22/acc-09-04-161.PMC9769078.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10870320","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