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Renal artery thrombosis with deterioration of kidney function.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-263115
Selena Gajić
{"title":"Renal artery thrombosis with deterioration of kidney function.","authors":"Selena Gajić","doi":"10.1136/bcr-2024-263115","DOIUrl":"https://doi.org/10.1136/bcr-2024-263115","url":null,"abstract":"<p><p>Renal artery thrombosis is an uncommon but serious cause of acute kidney injury that can result in permanent loss of function. It is frequently misdiagnosed due to its non-specific appearance, which can mimic renal colic and other more common causes of abdominal pain. There is no agreement on the first-line treatment and no prospective studies comparing thrombolysis, anticoagulation and embolectomy. We present a case of a patient with right renal artery thrombosis and acute kidney injury, in whom renal function was recovered with anticoagulation therapy.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852666","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
Bleb-related endophthalmitis during an epidemic of viral keratoconjunctivitis.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2023-258874
Nitika Beri, Saurabh Verma, Namrata Sharma, Tanuj Dada
{"title":"Bleb-related endophthalmitis during an epidemic of viral keratoconjunctivitis.","authors":"Nitika Beri, Saurabh Verma, Namrata Sharma, Tanuj Dada","doi":"10.1136/bcr-2023-258874","DOIUrl":"https://doi.org/10.1136/bcr-2023-258874","url":null,"abstract":"<p><p>There is an annual epidemic of viral conjunctivitis at the onset of the monsoon (rainy) season in North India. This affects a large population, with many patients developing ocular symptoms and then getting better without any treatment as there is no specific therapy for adenoviral infections. However, this creates a dangerous situation for patients with operated trabeculectomy with a filtering bleb as conjunctivitis can lead to blebitis and bleb-related endophthalmitis with super-added bacterial/fungal infections. While the viral infection is self-limiting and most patients get well without treatment, urgent medical attention is required if patients with operated trabeculectomy develop this condition. It is important to educate all patients with operated glaucoma about the outbreak of conjunctivitis and explain the danger signs (like redness, sensitivity to light, vision decrease and pain, which require immediate medical attention and initiation of broad-spectrum antibiotics if a delay is anticipated in visiting the hospital.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852637","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
Development of Behçet's disease on maintenance therapy for autoimmune hepatitis.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2023-259199
George Thieroff, Samantha Jane Bartholow, Adam Kilian
{"title":"Development of Behçet's disease on maintenance therapy for autoimmune hepatitis.","authors":"George Thieroff, Samantha Jane Bartholow, Adam Kilian","doi":"10.1136/bcr-2023-259199","DOIUrl":"https://doi.org/10.1136/bcr-2023-259199","url":null,"abstract":"<p><p>Behçet's disease is a clinical diagnosis with variable presentations. Liver involvement is rare in the absence of vascular complications. We describe a patient diagnosed with Hashimoto's thyroiditis and autoimmune hepatitis on azathioprine who developed extensive aphthous ulcers approximately 10 years later. She was initially diagnosed with an overlap autoimmune connective tissue disorder in the setting of a positive anti-Ro antibody. Symptoms did not resolve with prednisone, hydroxychloroquine or mycophenolate mofetil. She subsequently developed pseudofolliculitis, erythema nodosum-like lesions, large cutaneous ulcers and pathergy phenomenon at sites of venipuncture consistent with Behçet's disease. She was successfully treated with infliximab, azathioprine, colchicine and apremilast. This case represents an unusual sequence of autoimmune conditions and a diagnostic challenge.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852641","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
Difficult airway foreign body removal.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-262862
Golla Ramakrishna, Krishna Mohan Gulla, Ketan Kumar, Rashmi Ranjan Das
{"title":"Difficult airway foreign body removal.","authors":"Golla Ramakrishna, Krishna Mohan Gulla, Ketan Kumar, Rashmi Ranjan Das","doi":"10.1136/bcr-2024-262862","DOIUrl":"https://doi.org/10.1136/bcr-2024-262862","url":null,"abstract":"<p><p>Foreign body (FB) aspiration in children is a common emergency. Traditionally, rigid bronchoscopy has been considered to be the mainstay for removal. However, in certain cases, flexible bronchoscopy can prove to be a better option and avoid thoracic surgery and unnecessary morbidity. Here, we describe the case of a child with accidental aspiration of a 4 cm long sewing needle, lodged in the lateral basal segment of the left lower lobe. Rigid bronchoscopy was unsuccessful as it could not access the distally placed needle. Instead, a flexible bronchoscopy performed through the endotracheal tube after sedating and paralysing the patient was effective and the needle could be grasped and removed using a wire basket. We describe our patient management protocol for paediatric airway FBs, which has been quite effective and prevents procedural delay. Expertise of the operator and a concerted team effort are the recipe for success.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852642","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
Multidisciplinary unravelling Cogan's syndrome post-C-section: insights into diagnosis, treatment and a possible identified new trigger.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-261520
Nataliia Mala, Greta Zweigart, Lukas S Fiedler
{"title":"Multidisciplinary unravelling Cogan's syndrome post-C-section: insights into diagnosis, treatment and a possible identified new trigger.","authors":"Nataliia Mala, Greta Zweigart, Lukas S Fiedler","doi":"10.1136/bcr-2024-261520","DOIUrl":"https://doi.org/10.1136/bcr-2024-261520","url":null,"abstract":"<p><p>We present a case series consisting of three female patients in their 30s with presumed autoimmune uveitis resembling Cogan's syndrome following caesarean sections (C-sections) with severe intraoperative bleeding and the use of chitosan-tamponade, exhibiting a combination of varying ocular and auditory symptoms postoperatively. Our patients displayed a range of inflammatory ocular changes, including stromal keratitis, panuveitis, retinal infiltrates, haemorrhages, optic disc swelling, and intraretinal and subretinal fluid, along with otalgia and hearing loss, consistent with typical and atypical Cogan's syndrome. Treatment involved systemic corticosteroids, resulting in variable outcomes. Given the rarity of this disease and its occurrence in similar circumstances, we investigated for a possible common trigger. Vigilance for ocular and auditory symptoms post-C-section, severe blood loss or after the use of chitosan is emphasised, and further research into potential triggers is warranted.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852663","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
Porcelain appendix: a rare mimicker of the acute abdomen.
IF 0.6
BMJ Case Reports Pub Date : 2024-12-18 DOI: 10.1136/bcr-2024-260475
Nilosh Sathiyamoorthi, Loku Singham Kutti Kankanamlage Priyantha Maduranga, Sabu Thomas, Vipul Vyas
{"title":"Porcelain appendix: a rare mimicker of the acute abdomen.","authors":"Nilosh Sathiyamoorthi, Loku Singham Kutti Kankanamlage Priyantha Maduranga, Sabu Thomas, Vipul Vyas","doi":"10.1136/bcr-2024-260475","DOIUrl":"https://doi.org/10.1136/bcr-2024-260475","url":null,"abstract":"<p><p>An appendiceal mucocele is a rare clinical entity often mimicking that of acute appendicitis in a majority of cases leading to incidental intraoperative findings. Nevertheless, appropriate diagnosis is vital prior to surgery to prevent complications such as pseudomyxoma peritonei. This report details a case of a man in his 70s, who was admitted to the emergency department with right iliac fossa pain with imaging showing wall thickening of the caecum and the ascending colon. During surgery, a calcified appendix raised the suspicion of a neoplastic process leading to a right hemicolectomy. The histology revealed a low-grade appendiceal mucinous neoplasm.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852665","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
Identification of a novel MAG gene mutation with 22q11.21 microduplication linked to hereditary spastic paraplegia. 发现与遗传性痉挛性截瘫有关的 22q11.21 微重复的新型 MAG 基因突变。
IF 0.6
BMJ Case Reports Pub Date : 2024-12-16 DOI: 10.1136/bcr-2024-260342
Madhura Kavishwar, Pratima Bisen, Sumeet Baheti, Poonam Wade
{"title":"Identification of a novel MAG gene mutation with 22q11.21 microduplication linked to hereditary spastic paraplegia.","authors":"Madhura Kavishwar, Pratima Bisen, Sumeet Baheti, Poonam Wade","doi":"10.1136/bcr-2024-260342","DOIUrl":"https://doi.org/10.1136/bcr-2024-260342","url":null,"abstract":"<p><p>Diagnosing hereditary spastic paraplegia (HSP) in paediatric patients can be challenging, especially when there is no positive family history. Children are often initially misdiagnosed with cerebral palsy due to the gradual progression of the disease and non-specific neuroimaging findings, despite the absence of perinatal insult. This misdiagnosis can prevent timely prenatal diagnosis, limiting the ability to make informed decisions about the pregnancy and to plan early interventions. Homozygous variants in the MAG gene, encoding myelin-associated glycoprotein (MAG), have been associated with complicated forms of HSP. In this study, we identified a novel mutation suggestive of an apparently homozygous variant of the MAG gene with deletion in exon 5 (c.451del (p.Ala151GlnfsTer22)) that is predicted to result in a frameshift and premature truncation of the protein 22 amino acids downstream to codon 151. This variant was of pathological significance in our patient who presented with cerebellar ataxia, nystagmus and hypotonia, gradually progressing to spastic paraplegia. Therefore, identifying these variants helps in understanding the underlying genetic factors contributing to HSP, aiding in correct diagnosis.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845863","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
Dobutamine induced multifocal myoclonus in a patient with chronic kidney disease. 多巴酚丁胺诱发慢性肾病患者多灶性肌阵挛。
IF 0.6
BMJ Case Reports Pub Date : 2024-12-16 DOI: 10.1136/bcr-2024-262214
Manjappa Mahadevappa, Sakeer Hussain, Shasthara Paneyala, U S Dinesh Kumar
{"title":"Dobutamine induced multifocal myoclonus in a patient with chronic kidney disease.","authors":"Manjappa Mahadevappa, Sakeer Hussain, Shasthara Paneyala, U S Dinesh Kumar","doi":"10.1136/bcr-2024-262214","DOIUrl":"https://doi.org/10.1136/bcr-2024-262214","url":null,"abstract":"<p><p>Adverse drug reactions (ADRs) are common in clinical practice, especially among patients with multiple comorbidities and polypharmacy. The ADRs associated with medications may be minor or life-threatening. Many available ADR assessment scales and pharmacovigilance programmes have streamlined the early diagnosis and management of ADRs. Dobutamine is a commonly used inotropic agent in patients with cardiovascular decompensation which is caused by depressed contractility secondary to organic heart disease, cardiac surgery, cardiac arrest or acute myocardial infarction. Dobutamine-associated adverse effects are mainly due to sympathetic overstimulation causing chest discomfort, palpitations, tremors, headache, shortness of breath, hypertension, nausea, vomiting and eosinophilic myocarditis. Myoclonus is a neurological side effect that may be rarely caused by dobutamine infusion, especially among patients with chronic kidney disease (CKD). We are reporting a rare case of dobutamine-induced multifocal myoclonus in a patient with CKD during the management of decompensated heart failure.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845921","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
Osseous metaplasia of the endometrium presenting as haematometra: a rare presentation. 子宫内膜骨化症表现为血子宫：一种罕见的表现。
IF 0.6
BMJ Case Reports Pub Date : 2024-12-15 DOI: 10.1136/bcr-2024-262503
Mona Mishra, Neetu Singh, Rupita Kulshreshtha
{"title":"Osseous metaplasia of the endometrium presenting as haematometra: a rare presentation.","authors":"Mona Mishra, Neetu Singh, Rupita Kulshreshtha","doi":"10.1136/bcr-2024-262503","DOIUrl":"10.1136/bcr-2024-262503","url":null,"abstract":"<p><p>Osseous metaplasia of the endometrium is a rare condition involving the bone tissue in the endometrial cavity. Its presence along with haematometra is an infrequent condition and is not reported until now. We present a case of a woman in her mid-30s with primary infertility and secondary amenorrhoea. On evaluation, she was diagnosed with osseous metaplasia, intrauterine synechiae and haematometra. Hysteroscopic removal of bone fragments was done along with synechiolysis which led to the return of menses.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827416","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
Embolisation of an acquired uterine arteriovenous malformation. 后天性子宫动静脉畸形栓塞术。
IF 0.6
BMJ Case Reports Pub Date : 2024-12-15 DOI: 10.1136/bcr-2024-261005
Aidan John Coffey, Daniel Galvin, Stephen Power, Deirdre Hayes-Ryan
{"title":"Embolisation of an acquired uterine arteriovenous malformation.","authors":"Aidan John Coffey, Daniel Galvin, Stephen Power, Deirdre Hayes-Ryan","doi":"10.1136/bcr-2024-261005","DOIUrl":"10.1136/bcr-2024-261005","url":null,"abstract":"<p><p>A G5P2+2 woman in her 30s presented to hospital with per vaginum (PV) bleeding, approximately 2 weeks post electric vacuum aspiration (EVA) for retained products of conception. Ultrasound and MRI demonstrated a large vascular myometrial lesion, suggestive of a uterine arteriovenous malformation (UAVM). She underwent digital subtraction angiography (DSA) with interventional radiology and simultaneous uterine artery embolisation (UAE). She represented 2 weeks later with recurrent PV bleeding and anaemia. She underwent repeat DSA, demonstrating persistent UAVM, and a repeat embolisation was performed. Symptoms resolved following the second embolisation, and a repeat MRI performed 12 weeks later demonstrated complete resolution of the UAVM.Although UAVMs are rare lesions, they can cause significant haemorrhage and morbidity. The presence of UAVM should particularly be considered after uterine intervention such as EVA or caesarean section.UAE is a safe and effective therapy, which preserves fertility.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"17 12","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827363","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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