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Sertraline-induced renal phospholipidosis. 舍曲林诱导的肾脏磷脂沉积症。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-20 DOI: 10.1136/bcr-2026-274410
Filipa Fonte Rodrigues, Diogo Borges, Rita Manso, Sara Barreto
{"title":"Sertraline-induced renal phospholipidosis.","authors":"Filipa Fonte Rodrigues, Diogo Borges, Rita Manso, Sara Barreto","doi":"10.1136/bcr-2026-274410","DOIUrl":"https://doi.org/10.1136/bcr-2026-274410","url":null,"abstract":"<p><p>Zebra bodies-electron-dense lamellar lysosomal inclusions-are the renal hallmark of Fabry disease, caused by deficient α-galactosidase A (GLA) activity. However, several pharmacological agents with cationic amphiphilic properties produce morphologically indistinguishable deposits, resulting in drug-induced phospholipidosis. We describe a woman in her 50s referred to nephrology with non-nephrotic proteinuria and non-visible haematuria following an ischaemic stroke treated with prednisolone and methotrexate for concomitant medium-vessel vasculitis. Aetiological workup-including autoimmunity, anti-phospholipase A2 receptor and GLA gene sequencing-was negative. Renal biopsy revealed lamellated myelin bodies in podocyte cytoplasm on electron microscopy, alongside thin basement membrane disease. Given negative Fabry testing and chronic sertraline exposure-a selective serotonin reuptake inhibitor with known cationic amphiphilic properties-the drug was discontinued. Proteinuria fell from 2.8 g/24 hours to 0.13 g/24 hours at 6 months, with complete resolution of non-visible haematuria. This case underscores the importance of pharmacological review in Zebra body nephropathy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788070","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
Radiolucency of aluminium causing a diagnostic challenge in a paediatric airway foreign body. 铝的放射性引起儿科气道异物的诊断挑战。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2025-270585
Iva Jovanovic, Danielle McElhone, Keith Trimble
{"title":"Radiolucency of aluminium causing a diagnostic challenge in a paediatric airway foreign body.","authors":"Iva Jovanovic, Danielle McElhone, Keith Trimble","doi":"10.1136/bcr-2025-270585","DOIUrl":"https://doi.org/10.1136/bcr-2025-270585","url":null,"abstract":"","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788107","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
Intraoperative asystole during bilateral sagittal split osteotomy: An insight into the trigeminocardiac reflex. 双侧矢状面劈开截骨术中心脏骤停：三叉心反射的观察。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2025-270796
Somakshi Pise, Gayatri Kulkarni, Archit Dhawan, Nikhil Kothari, Ankita Chugh
{"title":"Intraoperative asystole during bilateral sagittal split osteotomy: An insight into the trigeminocardiac reflex.","authors":"Somakshi Pise, Gayatri Kulkarni, Archit Dhawan, Nikhil Kothari, Ankita Chugh","doi":"10.1136/bcr-2025-270796","DOIUrl":"10.1136/bcr-2025-270796","url":null,"abstract":"<p><p>The trigeminocardiac reflex (TCR) occurs when branches of the trigeminal nerve are stimulated by physical and/or chemical triggers, leading to cardiac changes. It is commonly associated with midface manipulation, especially in the orbital region and similar incidents with mandibular procedures are not frequently reported. A girl in her late teens with no significant medical history or concurrent medications developed asystole during a bilateral sagittal split osteotomy (BSSO) under general anaesthesia. Prompt cardiopulmonary resuscitation led to the return of spontaneous circulation. The surgery was successfully completed post resuscitation.Although uncommon, similar episodes associated with manipulation of the mandibular division of the trigeminal nerve have been reported previously. This case describes a clinical presentation consistent with TCR during BSSO. Awareness of this potential association, prompt recognition, effective communication between the surgical and anaesthesiology teams, and timely management are essential for favourable outcomes.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788132","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
Four-year evolution of the retinal microvasculature in an APOE ε4/ε4 cognitively normal individual. APOE ε4/ε4认知正常个体视网膜微血管的四年演化
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2026-274211
Hemal Patel, Elyse Corpuz, Andy J Liu, Heather Whitson, Dilraj Grewal, Sharon Fekrat
{"title":"Four-year evolution of the retinal microvasculature in an APOE ε4/ε4 cognitively normal individual.","authors":"Hemal Patel, Elyse Corpuz, Andy J Liu, Heather Whitson, Dilraj Grewal, Sharon Fekrat","doi":"10.1136/bcr-2026-274211","DOIUrl":"https://doi.org/10.1136/bcr-2026-274211","url":null,"abstract":"<p><p>Alzheimer's disease is a neurodegenerative disorder with a prolonged preclinical phase during which pathological changes begin 15-20 years before clinical presentation. We present longitudinal optical coherence tomography angiography (OCTA) images from a cognitively normal female with APOE ε4/ε4. Over a 4-year period, she demonstrated an accelerated rate of retinal microvasculature loss compared with that expected due to normal ageing, despite no significant changes in medical history and no development of cognitive symptoms. Four years after initial presentation, brain amyloid was detected on positron emission tomography while she remained cognitively normal. This accelerated retinal microvasculature loss may mirror the pathogenesis of cerebral amyloid angiopathy and may represent a hypothesis-generating observation supporting further study of OCTA-derived retinal microvascular metrics in genetically predisposed individuals.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788094","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
Complete tumour regression of in-transit melanoma following discontinuation of talimogene laherparepvec. 停用利莫gene laherparepvec后运输中的黑色素瘤完全消退。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2025-269006
Allan Samuel Chen, Alan D Proia, Lisa Ho, Paul Mosca
{"title":"Complete tumour regression of in-transit melanoma following discontinuation of talimogene laherparepvec.","authors":"Allan Samuel Chen, Alan D Proia, Lisa Ho, Paul Mosca","doi":"10.1136/bcr-2025-269006","DOIUrl":"10.1136/bcr-2025-269006","url":null,"abstract":"<p><p>We report a case of complete tumour regression in a man in his 80s with in-transit melanoma following discontinuation of talimogene laherparepvec (T-VEC). The patient underwent a standard course of 1.0 mL of 1×10⁸ pfu/mL T-VEC every 2 weeks. After 10 T-VEC injections over approximately 5 months, the lesion still displayed fluorine-18 fluorodeoxyglucose activity on positron emission tomography/CT and biopsy-confirmed viable tumour. Due to side effects, including fatigue, headache and concern for a localised herpes simplex virus rash, the decision was made to discontinue T-VEC and perform surgical resection of the lesion. However, surgery was delayed by 8 weeks due to a minor stroke. After excision, the final pathology showed no residual melanoma, indicating a delayed, complete pathological response to T-VEC. This case may reflect the potential for continued or delayed anti-tumour immune activity after cessation of T-VEC and support further investigation into T-VEC's immune effects and timing of treatment in neoadjuvant settings.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787926","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
Atypical presentation of necrotising pancreatitis in early adolescence. 青少年早期坏死性胰腺炎的不典型表现。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2025-271837
Declan Thomas Vardy, Abdunasr Alaber, Anne MacCafferty, Nicola Heddy, Ashley Uttley, Robyn Smith
{"title":"Atypical presentation of necrotising pancreatitis in early adolescence.","authors":"Declan Thomas Vardy, Abdunasr Alaber, Anne MacCafferty, Nicola Heddy, Ashley Uttley, Robyn Smith","doi":"10.1136/bcr-2025-271837","DOIUrl":"https://doi.org/10.1136/bcr-2025-271837","url":null,"abstract":"<p><p>Necrotising pancreatitis (NP) is a severe form of acute pancreatitis (AP), occurring in <1% of cases and associated with significant morbidity.An early adolescent presented with a 48-hour history of abdominal pain and vomiting. On arrival, he was tachycardic and pale with distractible abdominal tenderness but normotensive and afebrile. Initial blood glucose was 41.6 mmol/L, ketones 0.5 mmol/L, pH 7.36 and lactate 7.7 mmol/L. Laboratory investigations showed elevated haemoglobin (Hb), white cell count (WCC) and neutrophils, acute kidney injury (AKI), with a normal glycated haemoglobin (HbA1c) and amylase.He was initially treated with intravenous (IV) fluids and sliding scale insulin. Imaging revealed radiological features consistent with severe NP. He was commenced on Creon and insulin for pancreatic failure. He has subsequently developed acute recurrent pancreatitis.No underlying cause for his presentation has been identified, and he is being considered for total pancreatectomy.This case highlights the importance of maintaining a broad differential diagnosis in the assessment of abdominal pain in paediatric patients. Prompt diagnosis and timely interventions are essential to reduce the risk of potentially significant consequences in NP.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787760","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
Dasatinib-induced cervicofacial oedema in chronic myeloid leukaemia blast crisis. 达沙替尼诱导的慢性髓性白血病细胞危象颈面水肿。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2026-275506
Maris May P Ledesma, Rene A Amadore, April Joy K Ong, Anne Kristine H Quero-Taggaoa
{"title":"Dasatinib-induced cervicofacial oedema in chronic myeloid leukaemia blast crisis.","authors":"Maris May P Ledesma, Rene A Amadore, April Joy K Ong, Anne Kristine H Quero-Taggaoa","doi":"10.1136/bcr-2026-275506","DOIUrl":"10.1136/bcr-2026-275506","url":null,"abstract":"<p><p>Dasatinib-induced cervicofacial oedema is an exceedingly rare adverse event of second-generation tyrosine kinase inhibitor (TKI) therapy. We report a man in his 40s diagnosed with chronic myeloid leukaemia in myeloid blast crisis (<i>BCR::ABL1</i> 88% international scale) who developed progressive facial and neck swelling on day 13 of induction chemotherapy with cytarabine, doxorubicin and dasatinib. In the setting of febrile neutropenia (absolute neutrophil count 200/μL), the differential diagnosis included deep space infection and drug reaction. CT imaging demonstrated diffuse cervicofacial oedema without abscess. Vancomycin, initially added for suspected facial cellulitis, was discontinued; piperacillin-tazobactam was continued for febrile neutropenia prophylaxis. Intravenous hydrocortisone 100 mg every 8 hours produced marked improvement by day 2. The patient completed induction, achieved remission and later tolerated dasatinib rechallenge at 100 mg daily during consolidation. This case highlights the diagnostic challenge of TKI-associated oedema in neutropenic patients, the effectiveness of corticosteroids and the feasibility of cautious rechallenge.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787938","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
Infliximab-associated sarcoid-like reaction and haemophagocytic lymphohistiocytosis in multisystem sarcoidosis. 多系统结节病中英夫利昔单抗相关的结节样反应和噬血细胞淋巴组织细胞增多症。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2026-274044
Indira Acharya, Onyekachi C Ibe-Ejiogu, Ashik Pokharel, Palapun Waitayangkoon, Kevin D Kerin, Scott A Pompa, Christopher M Burns
{"title":"Infliximab-associated sarcoid-like reaction and haemophagocytic lymphohistiocytosis in multisystem sarcoidosis.","authors":"Indira Acharya, Onyekachi C Ibe-Ejiogu, Ashik Pokharel, Palapun Waitayangkoon, Kevin D Kerin, Scott A Pompa, Christopher M Burns","doi":"10.1136/bcr-2026-274044","DOIUrl":"10.1136/bcr-2026-274044","url":null,"abstract":"<p><p>Drug-associated sarcoidosis-like reactions and drug-associated haemophagocytic lymphohistiocytosis (HLH) are rare immune-mediated complications, each associated with significant diagnostic and therapeutic challenges. We report a man with multisystem sarcoidosis who developed concurrent drug-associated sarcoid-like reaction and secondary HLH following initiation of infliximab therapy. The diagnosis was supported by characteristic imaging findings, laboratory evidence of hyperinflammation and a clear temporal relationship to infliximab exposure, with clinical improvement after drug discontinuation and immunosuppressive therapy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788118","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
PHACE syndrome in an infant: the importance of multidisciplinary screening in extensive facial infantile haemangiomas. 婴儿PHACE综合征：广泛面部血管瘤多学科筛查的重要性。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2026-273029
Yuri Igor Lopez Carrera, Alondra Valdez Maya, Montserrat Ortiz Farris
{"title":"PHACE syndrome in an infant: the importance of multidisciplinary screening in extensive facial infantile haemangiomas.","authors":"Yuri Igor Lopez Carrera, Alondra Valdez Maya, Montserrat Ortiz Farris","doi":"10.1136/bcr-2026-273029","DOIUrl":"10.1136/bcr-2026-273029","url":null,"abstract":"<p><p>PHACE syndrome is a rare congenital condition characterised by the association of facial haemangiomas with structural anomalies. We report the case of an infant presenting with a mixed segmental facial haemangioma and progressive deformity. Diagnostic evaluation revealed hypoplasia of the vertebral arteries and the left posterior communicating artery, as well as an ocular coloboma, confirmed by ophthalmology. Given that early diagnosis is essential to prevent serious complications, this report emphasises that infants with extensive facial haemangiomas should undergo multidisciplinary screening, including neurology, ophthalmology and cardiology, and vascular imaging to ensure comprehensive management.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788092","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
Menstruation-triggered paroxysmal hemicrania. 经期引发的阵发性偏头痛。
IF 0.4
BMJ Case Reports Pub Date : 2026-08-19 DOI: 10.1136/bcr-2026-274651
Sujal Patel, Heeya Shah, Sanjay Prakash
{"title":"Menstruation-triggered paroxysmal hemicrania.","authors":"Sujal Patel, Heeya Shah, Sanjay Prakash","doi":"10.1136/bcr-2026-274651","DOIUrl":"10.1136/bcr-2026-274651","url":null,"abstract":"<p><p>A woman in her late 30s presented with a 7-year history of recurrent strictly left-sided headaches occurring exclusively during menstruation. Attacks began from 2 days before menstruation to the first day of bleeding and recurred for 7-10 days each cycle. Pain was severe, orbital-temporal, lasted 5-20 min and occurred five to eight times daily. Associated features included restlessness, agitation and conjunctival injection, lacrimation and rhinorrhoea. She had no nausea, photophobia, phonophobia, aura or interictal pain. Laboratory investigations and neuroimaging were normal. Multiple preventive and symptomatic treatments had been ineffective. The clinical phenotype suggested paroxysmal hemicrania (PH), and an indomethacin trial was given. Indomethacin 25 mg three times per day resulted in complete remission within 24 hours, with repeated benefit in subsequent cycles. This case highlights that not all menstruation-associated headaches are migraine and that PH should be considered in women with short-lasting unilateral cyclical headaches.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"19 8","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788104","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
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