Case Reports in Medicine最新文献

{"title":"Metachronous Bilateral Nephrectomy, Supratrigonal Cystectomy, and Living Donor Renal Transplantation in a Patient With Chronic Kidney Disease due to Interstitial Cystitis and Total Urethral Stricture.","authors":"Rashad Sholan, Rufat Aliyev, Anar Almazkhanli, Jalal Gasimov, Nargiz Bakhshaliyeva, Malahat Sultan","doi":"10.1155/carm/3103124","DOIUrl":"10.1155/carm/3103124","url":null,"abstract":"<p><p><b>Introduction:</b> Interstitial cystitis (IC) is a chronic pelvic pain syndrome characterized by urinary urgency, frequency, and pain. Although the exact cause of IC is unclear, severe cases may lead to chronic kidney disease (CKD), requiring complex surgical interventions. <b>Case Presentation:</b> This case report presents a 46-year-old male with IC complicated by CKD secondary to total urethral stricture. Following recurrent surgeries for urinary tract infections and strictures, the patient underwent a staged surgical approach involving bilateral nephrectomy, supratrigonal cystectomy, and renal transplantation with Bricker ileal conduit diversion. Postoperatively, renal function was fully restored, and IC-related symptoms resolved. <b>Conclusion:</b> This case underscores the efficacy of major surgical interventions for refractory IC, highlighting the need for individualized, multidisciplinary management in complex cases.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"3103124"},"PeriodicalIF":0.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991331","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}

{"title":"Hypokalemic Paralysis Is Not Always Periodic: A Case Series.","authors":"Mohak Jain, Gaurav Mehta, Ajay Parmar, Minal Shastri, Sahaj Patel, Vidhi Gandhi, Shifa Karatela, Apurva Patel","doi":"10.1155/carm/9925534","DOIUrl":"10.1155/carm/9925534","url":null,"abstract":"<p><p>Potassium is vital for cellular function, particularly in excitable tissues like nerves and muscles, which rely on potassium gradients to function normally. Hypokalemia can lead to severe issues such as muscle weakness and irregular heart rhythms. This case series presents four instances of hypokalemic paralysis, a neuromuscular condition that can be either periodic or isolated. The cases vary in presentation and treatment approach, highlighting the need to differentiate between primary and secondary causes of hypokalemia for optimal management. Fast and accurate diagnosis through laboratory tests and history taking is critical, and while acute management is standard, preventive strategies depend on the underlying cause. Further research is needed to establish definitive guidelines for the prevention of hypokalemic paralysis.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"9925534"},"PeriodicalIF":0.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991327","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}

{"title":"Presumed Cerebral Vasculitis Following Pneumococcal Meningitis: A Rare but Life-Threatening Complication.","authors":"Daniel Matassa, Pooja Patel, Lisa Dever","doi":"10.1155/carm/9029598","DOIUrl":"10.1155/carm/9029598","url":null,"abstract":"<p><p>A 65-year-old woman presented with pneumococcal sepsis and meningitis. Despite appropriate antimicrobial therapy and intravenous (IV) dexamethasone, her mental status did not improve. Findings of brain imaging were suggestive of cerebral vasculitis. Her condition improved rapidly with the initiation of high-dose IV methylprednisolone therapy. One week after completion of a 3-week oral prednisone taper, the patient's neurocognitive deficits recurred. A more extensive diagnostic evaluation, including conventional angiography, was again consistent with a presumptive diagnosis of cerebral vasculitis. High-dose IV methylprednisolone and a more prolonged taper of oral prednisone led to remission of her disease, with marked improvement in mental status and left-sided hemiparesis. Cerebral vasculitis is a rare but potentially lethal complication of pneumococcal meningitis that may be difficult to recognize and treat. The role of brain biopsy in diagnosis is unclear, and due to its rarity, management of this condition lacks conclusive evidence-based data.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"9029598"},"PeriodicalIF":0.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944099","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}

{"title":"A Rare Case of Quadrivalvular Infective Endocarditis.","authors":"Mahidhar Jeedigunta, Padmakumar R, Krishnananda, Mukhyaprana Prabhu, Ashwini M V","doi":"10.1155/carm/6648360","DOIUrl":"10.1155/carm/6648360","url":null,"abstract":"<p><p>Infective endocarditis is a devastating disease with high morbidity and mortality. Infective endocarditis affecting all four valves is rarely encountered. Even rarer is the involvement of all four valves by nutritionally variant streptococci, <i>Granulicatella</i>. The case describes a female in her 40s, known case of small perimembranous ventricular septal defect, who presented with symptoms of fever and congestive cardiac failure, with severe anemia, glomerulonephritis, and pain abdomen, who was found to have vegetations on pulmonary, tricuspid, mitral, and aortic valves, with pulmonary regurgitation, tricuspid regurgitation, mitral, and aortic regurgitations. Blood culture grew <i>Granulicatella adiacens</i> species. She improved clinically after intravenous antibiotics, decongestive measures, and blood transfusion. Causation of quadrivalvular infective endocarditis is rare and previously has not been documented in <i>Granulicatella</i> infection, a fastidious species. Interestingly, the patient remained quite stable despite involvement of all four heart valves, likely due to the predominant involvement of the pulmonary valve. This case report discusses the factors predisposing to infective endocarditis in a known case of congenital heart disease and the importance of timely diagnosis and treatment.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"6648360"},"PeriodicalIF":0.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944150","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}

{"title":"Dynamic Changes in Fourth Heart Sound in Type 2 Diabetes: Insights From Visualized Phonocardiography and SGLT2 Inhibitor Adjustment.","authors":"Kunimasa Yagi, Daisuke Chujo, Shimpei Ogawa, Shumpei Saito, Makoto Iwazawa, Taketsugu Tsuchiya, Shuichi Mizuta, Naohito Yamasaki, Takashi Muro","doi":"10.1155/carm/2871380","DOIUrl":"10.1155/carm/2871380","url":null,"abstract":"<p><p>The fourth heart sound (S4) is an auscultatory marker of left ventricular diastolic dysfunction (LVDD). Additionally, S4 correlates with atrial function, which is typically impaired in patients with Type 2 diabetes (T2D) but can improve with sodium-glucose co-transporter-2 inhibitor (SGLT2i) therapy. This case report highlights the dynamic changes in S4 associated with modification of SGLT2i therapy. An 83-year-old male with T2D and LVDD, confirmed via echocardiography, was treated with SGLT2i therapy for 4 years for glycemic control. The therapy was discontinued in December 2023 because of increased nocturnal urination. Two months after discontinuation, the patient developed pronounced S4, accompanied by mild chest discomfort and worsening of evening leg edema. Resumption of SGLT2i therapy led to a marked reduction in S4 along with a remarkable improvement in chest discomfort and edema within 1 month. These findings were confirmed by visual phonocardiography. This case underscores the potential utility of dynamic S4 changes as a noninvasive indicator of SGLT2i therapy adjustment. These findings highlight the novel clinical application of S4 monitoring in mitigating heart failure progression in patients with T2D.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"2871380"},"PeriodicalIF":0.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882276","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}

{"title":"A Patient With Granuloma Annulare and Lichen Planus Treated With Apremilast: A Case Report.","authors":"Emre Sarıkaya, Meltem Türkmen, Selcen Kundak, Sümeyye Ekmekci","doi":"10.1155/carm/6883705","DOIUrl":"10.1155/carm/6883705","url":null,"abstract":"<p><p>Granuloma annulare (GA) is an inflammatory and granulomatous dermatosis characterized by annular erythematous papules/plaques frequently localized in acral regions. Proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ), which are released by T helper 1 (Th1) lymphocytes inducing macrophages, are thought to play a role in its pathogenesis. Lichen planus (LP) is an inflammatory dermatosis characterized by pruritic scaly purple papules, often on the wrists and ankles, and can also affect mucosa, hair, and nails. T-cell-mediated proinflammatory cytokines such as IFN-γ and TNF-α, which are released by macrophages upon Th1 stimulation, have been implicated in the pathogenesis of LP, as in GA. A new treatment option is needed in the treatment of these diseases due to suboptimal results and adverse side-effect profiles with conventional treatments. Apremilast is a phosphodiesterase-4 (PDE4) inhibitor and inhibits the production of various inflammatory mediators such as IFN-γ, TNF-α, IL-2, IL-5, IL-8, IL-12, and leukotriene B4. This molecule has three Food and Drug Administration (FDA) approved indications: moderate to severe plaque psoriasis, psoriatic arthritis, and oral ulcers associated with Behcet's disease. Apremilast exhibits a favorable side-effect profile compared to conventional treatments and is a good treatment option with its ability to reduce cytokines implicated in the pathogenesis of GA and LP. Here, we report the case of a 55-year-old woman in whom apremilast treatment led to an almost complete resolution of her GA and LP.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"6883705"},"PeriodicalIF":0.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844529","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}

{"title":"Pleomorphic Adenoma of the Soft Palate: Case Report.","authors":"Yuliya Menchisheva, Saule Mussabekova, Dana Menzhanova, Shynggys Duisenbay, Magomed Khairoyev, Kamil Zubanov","doi":"10.1155/carm/8048933","DOIUrl":"10.1155/carm/8048933","url":null,"abstract":"<p><p><b>Background:</b> Pleomorphic adenoma is the most prevalent benign tumor of the salivary glands. While it primarily affects the parotid gland, it can also arise from minor salivary glands in the soft palate. <b>Presentation:</b> A case of a 28-year-old female who presented with a painless, slowly enlarging mass on the soft palate was reported. CT revealed a well-circumscribed lesion measuring 2.5 × 2.0 cm. Complete surgical excision was performed, and histopathological analysis confirmed the diagnosis of pleomorphic adenoma. <b>Conclusion:</b> Pleomorphic adenoma of the palate is an important entity to consider in the differential diagnosis of salivary gland neoplasms. Early recognition and complete surgical removal are key to preventing recurrence and malignant transformation.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"8048933"},"PeriodicalIF":0.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844530","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}

{"title":"Thoracic Duct Injury in a Patient Undergoing Axillary Lymphadenectomy: A Case Report.","authors":"Michelle Albano Ferreira, Juliana Oliveira Costa, Juliana Lopes de Aguiar Araújo, Kleyton Santos de Medeiros, Larissa Dos Santos Lourenço Ferreira, Ubiratan Wagner de Sousa, Macerly Layse de Menezes Dantas, Diana Taissa Sampaio Marinho Navarro","doi":"10.1155/carm/9720159","DOIUrl":"10.1155/carm/9720159","url":null,"abstract":"<p><p>A 56-year-old female patient, with no significant comorbidities, presented with abnormal breast exam findings. Imaging revealed a 5.4-cm irregular nodule in the left breast, diagnosed as invasive breast carcinoma (NST, Grade 2). Neoadjuvant chemotherapy was initiated, leading to a reduction in lesion size. Surgical intervention included quadrantectomy, sentinel lymph node biopsy, and axillary lymphadenectomy, which revealed residual carcinoma and positive lymph nodes. Postoperatively, chylous drainage through a Portovac drain was observed, prompting reoperation, during which the injured lymphatic duct was identified. Conservative management with medium-chain triglycerides resulted in a progressive reduction of drainage. The patient was discharged on the 13th postoperative day, subsequently underwent adjuvant radiotherapy, and is currently receiving regular outpatient follow-up.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"9720159"},"PeriodicalIF":0.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820674","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}

{"title":"Recurrent Tachycardia, Abdominal, and Chest Pain as a Presentation of Stiff Person Syndrome.","authors":"Neeki Torabi, Padi Reddy, Amir Torabi","doi":"10.1155/carm/4821987","DOIUrl":"10.1155/carm/4821987","url":null,"abstract":"<p><p><b>Introduction:</b> Stiff person syndrome (SPS) is a rare neurological disorder marked by muscle stiffness, spasms, specific electromyographic findings, and elevated levels of glutamate acid decarboxylase. Patients' symptoms and signs can be challenging for general practitioners and specialists. <b>Case report:</b> We present a case of a 56-year-old man with a history of type 1 diabetes with episodes of severe chest, abdominal, and low back pain; severe tachycardia; and difficulty with walking who was seen by different physicians over a period of 10 months without any significant improvement. He had significant weight loss during this period due to abdominal pain. Multiple studies, including computerized tomography and magnetic resonance imaging of the abdomen and entire spine, upper and lower gastrointestinal (GI) endoscopies, and cardiac catheterization, were unremarkable. The patient presented at our facility with severe abdominal and chest pain, diffuse abdominal muscle rigidity, and periods of severe tachycardia. He also had elevated creatine kinase and lactate levels. Extensive workup for infectious, cardiac, and GI processes was negative. The patient was diagnosed with SPS based on history, clinical examination, and an exceedingly high titer of glutamic acid decarboxylase. He responded well to oral diazepam, baclofen, and gabapentin, and he received a 5-day course of intravenous immunoglobulin therapy. <b>Conclusion:</b> In patients presenting with recurrent tachycardia, abdominal pain, and chest pain, SPS should be considered in the differential diagnosis. It is essential for non-neurologists to be familiar with this disorder.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"4821987"},"PeriodicalIF":0.7,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815818","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}

{"title":"Effects of a Combined Nutritional and Physical Training Program Approach in a Case of Facioscapulohumeral Dystrophy: A One-Year Follow-Up.","authors":"Venere Quintiero, Oscar Crisafulli, Jessica Lacetera, Giorgio Bottoni, Massimo Negro, Rossella Tupler, Emanuela Lavaselli, Giuseppe D'Antona","doi":"10.1155/carm/7873892","DOIUrl":"10.1155/carm/7873892","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Facioscapulohumeral dystrophy (FSHD) patients experience a progressive loss of fat free mass (FFM) and increase of fat mass (FM). Such an occurrence may lead to an impaired physical efficiency. A personalized diet, combined with a physical exercise program, may improve body composition, and potentially reduce functional limitations. Here, we present the case of a nineteen-years-old male clinically and genetically characterized FSHD patient who underwent a one-year nutritional and training intervention aimed at contrasting the disease-induced body composition modifications and associated negative sequelae. <b>Methods:</b> Baseline assessments included dietary intake (nutritional anamnesis), body composition (bioimpedance analysis), biochemical parameters (blood tests), resting metabolic rate (RMR; measured by indirect calorimetry), physical efficiency, and quality of life (Checklist Individual Strength Fatigue and Functional Assessment Chronic Illness Therapy Fatigue). Based on the initial findings (insufficient daily caloric intake, inadequate leucine distribution, and nonphysiological glycemia), a personalized nutritional (50% carbohydrates, 30% fats and proteins at 1.5 g/kg of body weight/day, with leucine intake of 1-3 g per meal) and supplementation (11 g/day of essential amino acids) plan was prescribed, alongside a physical training program composed by two resistance and one aerobic exercise sessions per week. <b>Results:</b> After one year, improvements in body composition (FFM +6.9 kg, body cell mass +3.3 kg, FM -2.1 kg), RMR (+309 kcal/day), fasting glycemia (-1.6 mmol/L), perceived physical efficiency (diminished perceived fatigue), and quality of life were reported. <b>Conclusions:</b> Our results suggest that a tailored dietary intervention, when combined with an appropriate training program, could represent a promising long-term strategy for contrasting disease-related physical deconditioning in FSHD. These findings encourage further research on this approach in a larger cohort of patients.</p>","PeriodicalId":9627,"journal":{"name":"Case Reports in Medicine","volume":"2025 ","pages":"7873892"},"PeriodicalIF":0.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074480","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}