Journal of clinical case reports最新文献

{"title":"Pericarditis: Uncommon Onset of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Induced by Methimazol","authors":"M. Jemel, H. Sayadi, I. Khochtali","doi":"10.1530/ENDOABS.56.P994","DOIUrl":"https://doi.org/10.1530/ENDOABS.56.P994","url":null,"abstract":"Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a group of small vessel vasculitides characterized by necrotizing inflammation, with few or no immune deposits associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA. It includes microscopic polyangiitis, granulomatosis with polyangiitis (Wegner’s), eosinophilic granulomatosis with polyangiitis (Churg-Strauss) and single-organ AAV (for renal example, renal-limited AAV) [1]. Even the etiology of this vasculitis is still unclear several factors have been reported to be associated with AAV with more consideration of drug-associated ANCAassociated vasculitis [2]. Antithyroid drugs (ATDs) which are generally well tolerated can be associated with minor side effect, but serious and potentially life-threatening complications can occurred in very rare cases with such AAV [3]. To date Propylthiouracil (PTU) is more likely to be associated with AAV than Carbimazole (CBZ) or his active metabolite Methimazole (MMI) [4]. Skin lesions and kidney involvement are the most common clinical features reported in this field. Here we present the first case report of a 25-yr-old woman who developed AAV initially presenting with pericarditis after 1 year of MMI use.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"4 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46939376","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}

{"title":"Klebsiella Meningitis as the Initial Presentation of Macroprolactinoma: A Case Report","authors":"Y. Elamir, W. Grist","doi":"10.4172/2165-7920.10001111","DOIUrl":"https://doi.org/10.4172/2165-7920.10001111","url":null,"abstract":"Introduction: Gram negative bacterial meningitis is a rare initial presentation of a macroprolactinoma. Meningitis in these cases is likely caused by a defect in the sellar floor from surgical manipulation or treatment with a dopamine agonist causing rapid shrinkage of a tumor. Patients generally have headaches as the predominant symptom. Our case is an illustration of where meningitis is caused by a transsphenoidal surgery and where meningitis is the presenting symptom to diagnosing a macroprolactinoma.Case presentation: The patient is a 20-year old African female with history of transsphenoidal surgery over one year ago, who presents with headache associated with subjective fevers, nausea, and vomiting. The patient states that she had similar headaches for the past 2 years but not to this severity. She reports that when she was in her country one year ago she had an unknown surgery through her nose that helped the headaches for a short period of time. She recalls having increasingly irregular periods over the past year and milky discharge from her breasts.Results: Physical exam was significant for nuchal rigidity. CT scan showed large sellar mass and MRI was consistent with likely pituitary adenoma. The patient’s presentation was suspicious for meningitis, so a lumbar puncture was performed, and CSF analysis was consistent with bacterial meningitis. The patient was started on broad spectrum antibiotics until CSF cultures returned showing Klebsiella pneumoniae sensitive to ceftriaxone. Further testing showed very high prolactin levels. Endocrinology was consulted and agreed the tumor was a pituitary macroadenoma, most likely a prolactinoma due to her laboratory findings and symptoms of menstrual irregularity and galactorrhea. The patient was treated with Cabergoline 0.5 mg two times per week.Conclusion: Bacterial meningitis, especially when caused by gram negative organisms is a rare presentation of a pituitary macroprolactinoma. Thorough history taking, and prompt diagnostic evaluation is crucial, especially when medical records cannot be obtained. Treatment of both conditions quickly and simultaneously is important. The case also illustrates that how treating a prolactinoma can result in complications such as meningitis not just immediately after surgery but in any stage of treatment.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43475325","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}

{"title":"Full Term Abdominal Pregnancy with Healthy Newborn: A Case Report","authors":"H. Jalal","doi":"10.4172/2165-7920.10001110","DOIUrl":"https://doi.org/10.4172/2165-7920.10001110","url":null,"abstract":"We report a case of full term abdominal pregnancy with healthy newborn. This is a rare variety of ectopics pregnancies whose evolution to the end remains exceptional. It is unique to developing countries with a high incidence of genital infections and poor pregnancy monitoring. It is associated with significant perinatal mortality because of fetal malformations and maternal morbidity related to hemorrhagic, infectious and occlusive risk. Ultrasound is almost unavoidable for positive diagnosis supplemented by magnetic resonance imaging detecting fetal malformations and allowing a better analysis of placental relations with the abdominal organs; decisive elements to optimize the care of the parturient.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42671268","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}

{"title":"Metastatic Liposarcoma: A Case of Partial Remission with Eribulin in Late Treatment Lines","authors":"V. Grünwald, P. Ivanyi","doi":"10.4172/2165-7920.10001109","DOIUrl":"https://doi.org/10.4172/2165-7920.10001109","url":null,"abstract":"Liposarcoma, a type of soft tissue sarcoma, represents a therapeutic challenge, in particular in the metastatic setting. This case describes a patient with retroperitoneal liposarcoma that was first treated by surgery and, upon manifestation of metastatic disease, with a series of chemotherapy regimens comprising doxorubicin (line 1), doxorubicin plus ifosfamide (line 2), trabectedin (lines 3 and 4) and dacarbazine (line 5). While transient partial remission was achieved in the first three lines, rapid disease progression was observed in subsequent therapies. After failure of the previous chemotherapy regimens, eribulin was administered (line 6), and partial remission was achieved within five months. However, the occurrence of grade 3 polyneuropathy led to temporary discontinuation of therapy. Overall, metastatic liposarcoma was controlled for twelve months with eribulin treatment in a heavily pre-treated patient. This case underscores the efficacy of eribulin in treatment-refractory advanced/metastatic liposarcoma.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45240223","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}

{"title":"Double Duodenal Perforation: A Case Report","authors":"H. Gupta","doi":"10.4172/2165-7920.10001107","DOIUrl":"https://doi.org/10.4172/2165-7920.10001107","url":null,"abstract":"Duodenal perforation is a common cause of acute abdomen which is complication of peptic ulcer disease. The pathogenesis is considered complex and involves imbalance between defensive mechanisms of intestinal mucosa and aggravating factors to which a person is exposed.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"2018 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45851338","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}

{"title":"Drug Induced Aseptic Meningitis due to IV Immunoglobulins","authors":"P. Thaneeru","doi":"10.4172/2165-7920.10001108","DOIUrl":"https://doi.org/10.4172/2165-7920.10001108","url":null,"abstract":"Drug induced aseptic meningitis (DIAM) is an uncommon condition that can mimic infectious process. DIAM constitutes a diagnostic and management challenge. We report a case of a 23-year-old female presenting with aseptic meningitis, two days after commencing a course of intravenous immunoglobulins (IVIG) treatment.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43575397","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}

{"title":"Emergency Lumbar Puncture for Suspected Meningitis after Dabigatran Reversal with Idarucizumab: A Case Report","authors":"S. Agosti, L. Casalino, A. Daffonchio, L. Arena, L. Celli, E. Rota","doi":"10.4172/2165-7920.10001103","DOIUrl":"https://doi.org/10.4172/2165-7920.10001103","url":null,"abstract":"Idarucizumab is a monoclonal antibody which has been shown to be effective for rapid, durable, and safe reversal of the anticoagulant effect of dabigatran. We will describe herein the third case reported so far on the use of idarucizumab in a patient on dabigatran for nonvalvular atrial fibrillation and an indication for emergency lumbar puncture for suspected meningitis.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"8 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42268077","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}

{"title":"Cushing Reflex and Importance during Treatment of Cerebrovascular Diseases via Endovascular Route","authors":"A. Yektaş, Bedih Balkan, Abdülcelil Gezmiş, Tolga Ae, B. Kara, H. H. Selçuk","doi":"10.4172/2165-7920.10001104","DOIUrl":"https://doi.org/10.4172/2165-7920.10001104","url":null,"abstract":"Aim: Assessment of the Cushing reflex developing during mechanical thrombectomy in a case presenting with acute ischemic stroke.Case: A 59-year-old male patient had CT angio tests due to speaking disorder and right lateral weakness developing 5 hours earlier. Acute infarctus was observed in the left MCA irrigation area with M1 segment occlusion observed in the left MCA. The decision was made to treat the patient with mechanical thrombectomy and he was transferred to the interventional neuroradiology unit. Under general anesthesia during navigation of the thromboaspiration catheter to the clot localization as the procedure was technically advancing routinely, with sudden development of bradycardia and hypertension the neuroradiology team was warned, and 1 mg IV atropine was administered for bradycardia.Simultaneously contrast material injection through the guide catheter showed the MCA M1 segment had ruptured and extravasation had developed.Conclusion: The Cushing reflex is a situation characterized by bradycardia and hypertension in cerebrovascular events causing sudden intracranial pressure increases. The most common situations observed during treatment of cerebrovascular diseases via the endovascular route is intracranial hemorrhage linked to arterial rupture. Prevention of the mortality and morbidity linked to hemorrhagic complications developing during endovascular treatment is based on early awareness and rapid treatment. Additionally, as extravasation is commonly not observed radiologically, the anesthesia team should be on the alert for the Cushing reflex and when variations of hemodynamic parameters in accordance with the Cushing response are observed, informing the operation team immediately has vital importance.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"8 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42033009","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}

{"title":"Case Report on Dressler’s Syndrome","authors":"J. Ek, Lisa Koshy, A. Kuriakose","doi":"10.4172/2165-7920.10001106","DOIUrl":"https://doi.org/10.4172/2165-7920.10001106","url":null,"abstract":"Introduction: Dressler’s syndrome (delayed pericarditis) is considered as a secondary form of pericarditis resulting in the inflammation of the sac surrounding heart (pericardium). \u0000Case Presentation: A 56-year-old male was admitted to the cardiology department due to left sided chest pain associated with breathlessness, palpitation and sweating. patient had a past history of CAD-AWMI, moderate left ventricular(LV) dysfunction (diagnosed 2 months back). Percutaneous transluminal coronary angioplasty (PTCA) with stent to CAD done 2 months back. ECHO shows mild to moderate pericardial effusion, mild pulmonary arterial hypertension(PAH), moderate mitral regurgitation (MR), moderate LV dysfunction. \u0000Conclusion: This reveals that the patient is diagnosed with Dressler’s syndrome, a rare disease in the age of reperfusion therapy.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"8 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43894708","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}

{"title":"Isolated Intracranial Rosai-Dorfman Disease: A Case Report of F ollow- Up MRI Showing Dynamic Changes of the Lesion","authors":"Jie-ming Jiang, D. Han, Yuanming Jiang, Zhen-Guang Zhang, Fenglin Xue, B. He","doi":"10.4172/2165-7920.10001099","DOIUrl":"https://doi.org/10.4172/2165-7920.10001099","url":null,"abstract":"Rosai-dorfman disease (RDD) is a histiocytic proliferative disorder and considered to be extremely rare in the CNS. In this paper, we reported a patient confirmed as isolated intracranial RDD in a 58-year-old woman. MRI imaging without contrast enhancement two years ago found nothing at the onset of the symptoms. Follow-up CT and MRI imaging one year later showed dynamic changes of the lesion from scratch. This report suggests that the symptoms of RRD are earlier than imaging findings. Moreover, we made a systematic literature review on the disease to better understand it.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44452227","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}