Granulomatosis with polyangiitis (GPA) is a rare and potentially life-threatening systemic vasculitis characterized by necrotizing granulomatous inflammation of small- to medium-sized vessels. This case reports a unique case of a 38-year-old woman who presents with strawberry gingivitis as the first sign of GPA. The patient was seen in different departments and was finally diagnosed with GPA after a delay of 3 months from the first sign of gingival lesions. The patient did not suffer from any serious complications of this delay besides from tinnitus, reduced hearing and sensitivity to sound. The present case highlights the importance of early recognition of the oral manifestations of GPA in order to start the comprehensive treatment timely for successful outcome.
{"title":"Oral manifestations as the first sign of Granulomatosis with polyangiitis – A case report","authors":"Yousra Akhlef , Ulrik Ørsø Andersen , Preben Homøe","doi":"10.1016/j.hmedic.2024.100129","DOIUrl":"10.1016/j.hmedic.2024.100129","url":null,"abstract":"<div><div>Granulomatosis with polyangiitis (GPA) is a rare and potentially life-threatening systemic vasculitis characterized by necrotizing granulomatous inflammation of small- to medium-sized vessels. This case reports a unique case of a 38-year-old woman who presents with strawberry gingivitis as the first sign of GPA. The patient was seen in different departments and was finally diagnosed with GPA after a delay of 3 months from the first sign of gingival lesions. The patient did not suffer from any serious complications of this delay besides from tinnitus, reduced hearing and sensitivity to sound. The present case highlights the importance of early recognition of the oral manifestations of GPA in order to start the comprehensive treatment timely for successful outcome.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100129"},"PeriodicalIF":0.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656390","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}
Pub Date : 2024-11-03DOI: 10.1016/j.hmedic.2024.100130
Karam Karam , Houssein Chebbo , Sarah Saleh , Elias Fiani
Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the atrophy of gastric oxyntic mucosa mediated by anti-parietal cells antibodies. AAG is a pre-neoplastic condition that is conducive to gastric neuroendocrine tumor type I and gastric adenocarcinoma. The diagnosis of AAG is made by a combined serological and histological profile. AAG-induced iron deficiency can lead to iron-deficiency anemia, whereas vitamin B12 deficiency can lead to pernicious anemia. Management of AAG is by replenishment of iron and vitamin B12 deficiencies and endoscopic surveillance. Crohn’s disease is an inflammatory bowel disease that can target any portion of the gastrointestinal tract, with a predilection for the ileo-colonic area. Crohn’s disease is characterized by skipped lesions and transmural involvement. We herein present two cases of AAG occurring in conjunction with Crohn’s disease, unveiling a potential causality between the two entities.
{"title":"Deciphering a potential causality between autoimmune atrophic gastritis and Crohn’s disease: A report of two cases","authors":"Karam Karam , Houssein Chebbo , Sarah Saleh , Elias Fiani","doi":"10.1016/j.hmedic.2024.100130","DOIUrl":"10.1016/j.hmedic.2024.100130","url":null,"abstract":"<div><div>Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the atrophy of gastric oxyntic mucosa mediated by anti-parietal cells antibodies. AAG is a pre-neoplastic condition that is conducive to gastric neuroendocrine tumor type I and gastric adenocarcinoma. The diagnosis of AAG is made by a combined serological and histological profile. AAG-induced iron deficiency can lead to iron-deficiency anemia, whereas vitamin B12 deficiency can lead to pernicious anemia. Management of AAG is by replenishment of iron and vitamin B12 deficiencies and endoscopic surveillance. Crohn’s disease is an inflammatory bowel disease that can target any portion of the gastrointestinal tract, with a predilection for the ileo-colonic area. Crohn’s disease is characterized by skipped lesions and transmural involvement. We herein present two cases of AAG occurring in conjunction with Crohn’s disease, unveiling a potential causality between the two entities.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100130"},"PeriodicalIF":0.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587223","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}
Pub Date : 2024-10-30DOI: 10.1016/j.hmedic.2024.100127
Farzana Hoque
{"title":"US medical education landscape: Now and beyond","authors":"Farzana Hoque","doi":"10.1016/j.hmedic.2024.100127","DOIUrl":"10.1016/j.hmedic.2024.100127","url":null,"abstract":"","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100127"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561014","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}
Pub Date : 2024-10-28DOI: 10.1016/j.hmedic.2024.100126
S. El Gazzane , G. Jaabouti , S. Aminou , N. El Hafidi , A. Masrar , H. Andour , L. Chat , C. Mahraoui , S. Benchekroun
Background
Because of the Factor V Leiden Mutation, activated protein C resistance is the most common hereditary condition predisposing individuals to venous thrombosis in infancy and childhood. The prevalence of this mutation varies among ethnic groups and geographical regions. Laboratory tests for thrombophilic markers, including Activated Protein C Resistance (APCR) and Factor V Leiden, are essential for diagnosis. While genetic tests are essential for confirming the diagnosis, determining homozygous or heterozygous status, and assessing recurrence risk, coagulation methods often use APCR detection as the primary screening approach.
Case presentation
We describe a 10-year-old North African male patient with recurrent thrombosis of the right internal jugular vein who was found to have protein C resistance. Further genetic testing revealed that the patient is heterozygous for the Factor V Leiden mutation.
Conclusions
This case highlights the importance of considering the Factor V Leiden mutation in pediatric patients presenting with recurrent venous thrombosis. Early detection and accurate diagnosis are critical for effective management and prevention of future thrombotic events.
背景由于因子 V Leiden 突变，活化蛋白 C 抗性是婴幼儿时期最常见的易患静脉血栓的遗传性疾病。这种突变的发生率因种族群体和地理区域而异。嗜血栓标记物的实验室检测，包括活化蛋白 C 抵抗（APCR）和因子 V 莱登（Factor V Leiden），对诊断至关重要。虽然基因检测对于确诊、确定同卵或异卵状态以及评估复发风险至关重要，但凝血方法通常将 APCR 检测作为主要筛查方法。病例介绍我们描述了一名右颈内静脉反复血栓形成的 10 岁北非男性患者，他被发现患有蛋白 C 抗性。进一步的基因检测发现，该患者是因子 V Leiden 突变的杂合子。结论本病例强调了考虑因子 V Leiden 突变对反复出现静脉血栓的儿童患者的重要性。早期发现和准确诊断对于有效治疗和预防未来的血栓事件至关重要。
{"title":"Recurrent cerebral venous thrombosis in a child due to Factor V Leiden mutation leading to activated protein C resistance: A case report","authors":"S. El Gazzane , G. Jaabouti , S. Aminou , N. El Hafidi , A. Masrar , H. Andour , L. Chat , C. Mahraoui , S. Benchekroun","doi":"10.1016/j.hmedic.2024.100126","DOIUrl":"10.1016/j.hmedic.2024.100126","url":null,"abstract":"<div><h3>Background</h3><div>Because of the Factor V Leiden Mutation, activated protein C resistance is the most common hereditary condition predisposing individuals to venous thrombosis in infancy and childhood. The prevalence of this mutation varies among ethnic groups and geographical regions. Laboratory tests for thrombophilic markers, including Activated Protein C Resistance (APCR) and Factor V Leiden, are essential for diagnosis. While genetic tests are essential for confirming the diagnosis, determining homozygous or heterozygous status, and assessing recurrence risk, coagulation methods often use APCR detection as the primary screening approach.</div></div><div><h3>Case presentation</h3><div>We describe a 10-year-old North African male patient with recurrent thrombosis of the right internal jugular vein who was found to have protein C resistance. Further genetic testing revealed that the patient is heterozygous for the Factor V Leiden mutation.</div></div><div><h3>Conclusions</h3><div>This case highlights the importance of considering the Factor V Leiden mutation in pediatric patients presenting with recurrent venous thrombosis. Early detection and accurate diagnosis are critical for effective management and prevention of future thrombotic events.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100126"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561013","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}
Pub Date : 2024-10-28DOI: 10.1016/j.hmedic.2024.100125
Jasmin Martin , Narayanan Venkatasubramani , Nancy McGreal
Intestinal lymphangiectasia (IL) is a rare and unusual condition characterized by the abnormal dilation of lymphatic vessels within the intestines. IL can arise from an intrinsic defect in lymphatic development or as a secondary consequence of factors that obstruct the lymphatic system. In this case study, a 2-year-old child presenting with chronic diarrhea, vomiting, and inadequate weight gain was ultimately diagnosed with IL secondary to chronic volvulus, confirmed by CT abdomen/pelvis and MRI abdomen, with persistent manifestations of protein losing enteropathy requiring two exploratory laparotomies. The condition in this patient was attributed to lymphatic obstruction resulting from recurrent episodes of midgut volvulus, which led to impaired lymphatic drainage and subsequent development of IL. The main takeaway from this case reports is the importance of IL to the differential diagnosis because early abdominal imaging and surgical interventions are lifesaving.
{"title":"Intestinal lymphangiectasia secondary to chronic midgut volvulus: A rare childhood presentation case report","authors":"Jasmin Martin , Narayanan Venkatasubramani , Nancy McGreal","doi":"10.1016/j.hmedic.2024.100125","DOIUrl":"10.1016/j.hmedic.2024.100125","url":null,"abstract":"<div><div>Intestinal lymphangiectasia (IL) is a rare and unusual condition characterized by the abnormal dilation of lymphatic vessels within the intestines. IL can arise from an intrinsic defect in lymphatic development or as a secondary consequence of factors that obstruct the lymphatic system. In this case study, a 2-year-old child presenting with chronic diarrhea, vomiting, and inadequate weight gain was ultimately diagnosed with IL secondary to chronic volvulus, confirmed by CT abdomen/pelvis and MRI abdomen, with persistent manifestations of protein losing enteropathy requiring two exploratory laparotomies. The condition in this patient was attributed to lymphatic obstruction resulting from recurrent episodes of midgut volvulus, which led to impaired lymphatic drainage and subsequent development of IL. The main takeaway from this case reports is the importance of IL to the differential diagnosis because early abdominal imaging and surgical interventions are lifesaving.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100125"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553097","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}
Rapid progression to fatal expanded dengue syndrome is unusual, presenting a challenge for clinical management. We present a case of a 32-year-old female with atypical dengue manifestations who underwent extensive evaluation at a Kathmandu infectious disease hospital, including vital signs assessment, clinical scoring, and routine and advanced laboratory analyses. Severe abdominal pain, disorientation, and abnormal hemodynamics with multi-organ involvement were noted with a secondary dengue virus (DENV) infection. Co-infection of DENV-1 and DENV-3, exhibiting high viral loads, was observed, marking the first fatal case of its kind in Nepal. Despite intensive care management, the patient’s condition rapidly deteriorated, leading to fatal expanded dengue syndrome within four days of a hospital visit. This poses a serious challenge to clinicians. Heightened vigilance from the onset of DENV infection is imperative, regardless of serotypes or viral load levels. Predictive markers for early detection and management strategies are urgently needed to achieve the WHO's goal of zero dengue-related deaths by 2030.
{"title":"A challenge to clinical management: A case of expanded dengue syndrome co-infection with dengue 1 and dengue 3 serotypes in Nepal","authors":"Sabin Shrestha , Milan Bajracharya , Sandesh Rimal , Rajshree Bhujel , Bimal Chalise , Yuba Nidhi Basaula , Prasanna Amatya , Shrijana Pandey , Pratik Joshi , Nabaraj Adhikari , Mya Myat Ngwe Tun , Kouichi Morita , Shyam Prakash Dumre , Basu Dev Pandey","doi":"10.1016/j.hmedic.2024.100123","DOIUrl":"10.1016/j.hmedic.2024.100123","url":null,"abstract":"<div><div>Rapid progression to fatal expanded dengue syndrome is unusual, presenting a challenge for clinical management. We present a case of a 32-year-old female with atypical dengue manifestations who underwent extensive evaluation at a Kathmandu infectious disease hospital, including vital signs assessment, clinical scoring, and routine and advanced laboratory analyses. Severe abdominal pain, disorientation, and abnormal hemodynamics with multi-organ involvement were noted with a secondary dengue virus (DENV) infection. Co-infection of DENV-1 and DENV-3, exhibiting high viral loads, was observed, marking the first fatal case of its kind in Nepal. Despite intensive care management, the patient’s condition rapidly deteriorated, leading to fatal expanded dengue syndrome within four days of a hospital visit. This poses a serious challenge to clinicians. Heightened vigilance from the onset of DENV infection is imperative, regardless of serotypes or viral load levels. Predictive markers for early detection and management strategies are urgently needed to achieve the WHO's goal of zero dengue-related deaths by 2030.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100123"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538297","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}
Pub Date : 2024-10-23DOI: 10.1016/j.hmedic.2024.100122
Muhammad Usama Bin Shabbir , Muhammad Bilal , Sikandar Ajmal Abbasi , Afaq Ahmad , Ahmad Abubakr
Introduction and importance
Male breast cancer is a rare condition, representing less than one per cent of all breast cancer cases. It is characterized by late presentation and a higher incidence of metastatic disease due to diagnostic delays. In Pakistan, male breast cancer tends to appear at a younger age than in Western countries. Risk factors include advancing age, hormonal imbalances, and family history. Despite the proven effectiveness of neoadjuvant chemotherapy, its adoption in clinical practice is limited.
Case presentation
This case involves a fifty-six-year-old Pakistani man presenting with a lump in his right breast. The physical examination showed a lump with axillary lymphadenopathy and skin changes. Laboratory tests were within normal ranges, and imaging revealed a highly suspicious lesion in the right breast. After a modified radical mastectomy, the biopsy confirmed grade two invasive ductal carcinoma with lymph node metastasis.
Clinical discussion
The case highlights the need to consider male breast cancer in diagnoses. Male breast cancer differs from female breast cancer in its pathology, with a higher expression of the estrogen receptor-beta. The patient, who tested negative for BRCA1 and BRCA2 mutations, received chemotherapy followed by surgery, underscoring the importance of personalized treatment.
Conclusion
Male breast cancer is among the rarest cancers globally, requiring more research and awareness to improve management and outcomes. Dispelling the myth that breast cancer is a female-only disease is vital for early detection and treatment, which could enhance survival rates.
{"title":"Invasive ductal carcinoma in a male patient: A case report","authors":"Muhammad Usama Bin Shabbir , Muhammad Bilal , Sikandar Ajmal Abbasi , Afaq Ahmad , Ahmad Abubakr","doi":"10.1016/j.hmedic.2024.100122","DOIUrl":"10.1016/j.hmedic.2024.100122","url":null,"abstract":"<div><h3>Introduction and importance</h3><div><em>Male breast cancer</em> is a rare condition, representing less than one per cent of all breast cancer cases. It is characterized by late presentation and a higher incidence of metastatic disease due to diagnostic delays. In Pakistan, male breast cancer tends to appear at a younger age than in Western countries. Risk factors include advancing age, hormonal imbalances, and family history. Despite the proven effectiveness of neoadjuvant chemotherapy, its adoption in clinical practice is limited.</div></div><div><h3>Case presentation</h3><div>This case involves a fifty-six-year-old Pakistani man presenting with a lump in his right breast. The physical examination showed a lump with axillary lymphadenopathy and skin changes. Laboratory tests were within normal ranges, and imaging revealed a highly suspicious lesion in the right breast. After a modified radical mastectomy, the biopsy confirmed grade two invasive ductal carcinoma with lymph node metastasis.</div></div><div><h3>Clinical discussion</h3><div>The case highlights the need to consider male breast cancer in diagnoses. Male breast cancer differs from female breast cancer in its pathology, with a higher expression of the estrogen receptor-beta. The patient, who tested negative for BRCA1 and BRCA2 mutations, received chemotherapy followed by surgery, underscoring the importance of personalized treatment.</div></div><div><h3>Conclusion</h3><div>Male breast cancer is among the rarest cancers globally, requiring more research and awareness to improve management and outcomes. Dispelling the myth that breast cancer is a female-only disease is vital for early detection and treatment, which could enhance survival rates.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100122"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538408","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}
Intestinal type sinonasal adenocarcinoma (ITAC) is a locally aggressive, rare malignancy occurring mostly in elderly males. It is the second most common sinonasal adenocarcinoma, with characteristic microscopic features in their marked resemblance to intestinal mucosa. It also has a well-documented association with prolonged occupational exposure to wood dust. Here we report a case of papillary variant of ITAC originating in the ethmoid sinus with metastasis to the mandibular condyle. A 53 year old male, bookseller by profession reported to outpatient department with difficulty in mouth opening since five months. On examination, he had swelling with pain and tenderness on the right side of face and the right temporomandibular joint (TMJ) area. The radiographs revealed a destructive mass in the right ethmoid sinus, encroaching into the maxillary antrum, orbit and nasal cavity along with beak like erosion of anteromedial aspect of the right condyle. The hematoxylin and eosin stained sections showed presence of glandular structures, recapitulating intestinal mucosal morphology and papillary arrangement of stratified tall columnar cells with dysplastic features. Immunohistochemical stain with CK20, CD-X2, CK7 and villin was positive. The patient was referred to oncology department for further treatment. This case reiterates the importance of proper clinical evaluation of the patient to consider profession related lesions. Metastases from Sinonasal adenocarcinomas can be considered for differential diagnosis for inability to open mouth.
{"title":"Intestinal type of sinonasal adenocarcinoma with condylar metastases: A case report","authors":"Karpagaselvi Sanjai , Sumana Bukanakere Sangappa , Divya Shivalingaiah , Anjum Baker , Roopa Rao","doi":"10.1016/j.hmedic.2024.100124","DOIUrl":"10.1016/j.hmedic.2024.100124","url":null,"abstract":"<div><div>Intestinal type sinonasal adenocarcinoma (ITAC) is a locally aggressive, rare malignancy occurring mostly in elderly males. It is the second most common sinonasal adenocarcinoma, with characteristic microscopic features in their marked resemblance to intestinal mucosa. It also has a well-documented association with prolonged occupational exposure to wood dust. Here we report a case of papillary variant of ITAC originating in the ethmoid sinus with metastasis to the mandibular condyle. A 53 year old male, bookseller by profession reported to outpatient department with difficulty in mouth opening since five months. On examination, he had swelling with pain and tenderness on the right side of face and the right temporomandibular joint (TMJ) area. The radiographs revealed a destructive mass in the right ethmoid sinus, encroaching into the maxillary antrum, orbit and nasal cavity along with beak like erosion of anteromedial aspect of the right condyle. The hematoxylin and eosin stained sections showed presence of glandular structures, recapitulating intestinal mucosal morphology and papillary arrangement of stratified tall columnar cells with dysplastic features. Immunohistochemical stain with CK20, CD-X2, CK7 and villin was positive. The patient was referred to oncology department for further treatment. This case reiterates the importance of proper clinical evaluation of the patient to consider profession related lesions. Metastases from Sinonasal adenocarcinomas can be considered for differential diagnosis for inability to open mouth.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100124"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538298","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}
Pub Date : 2024-10-17DOI: 10.1016/j.hmedic.2024.100121
Faryal Afridi , Tooba Fida , Muhammad Usama Bin Shabbir , Hasban Ahmad Halim , Ishwa Ghouri , Muhammad Fawad Ashraf
Evans syndrome is a rare autoimmune-mediated cytopenic disorder. We described the case of a male 27-year-old who had a 15-day history of fever, cough, and myalgia. Although the clinical examination other than a fever is unremarkable, blood workup and cytochemistry showed an autoimmune hemolytic reaction and peripheral destruction of platelets consistent with Evans syndrome. The patient was given multiple transfusions of RBC and platelets in addition to oral corticosteroids, parenteral folic acid, and vitamin B12. This case highlights the importance of considering Evans Syndrome in the differential diagnosis and timely management for a better patient outcome. The following prescriptions were given to the patient upon discharge: injectable deltacortil, tab folic acid, and Cap Opt-D. The patient was instructed to come see the outpatient department at the hospital. This case report highlights the uncharted region of Evans Syndrome in Pakistan.
埃文斯综合征是一种罕见的自身免疫介导的细胞减少性疾病。我们描述了一例 27 岁男性患者的病例，他有 15 天的发热、咳嗽和肌痛病史。虽然除发热外，其他临床检查均无异常，但血液检查和细胞化学检查显示，其自身免疫性溶血反应和外周血小板破坏与埃文斯综合征一致。除了口服皮质类固醇、肠外叶酸和维生素 B12 外，患者还多次输注红细胞和血小板。本病例强调了在鉴别诊断中考虑埃文斯综合征的重要性，及时治疗可使患者获得更好的预后。患者出院时获得了以下处方：注射用溴氢可的松、叶酸片和 Cap Opt-D。并嘱咐患者到医院门诊部就诊。本病例报告突显了埃文斯综合征在巴基斯坦的未知领域。
{"title":"Evans syndrome: An uncommon hematological conundrum in a young adult: A case report","authors":"Faryal Afridi , Tooba Fida , Muhammad Usama Bin Shabbir , Hasban Ahmad Halim , Ishwa Ghouri , Muhammad Fawad Ashraf","doi":"10.1016/j.hmedic.2024.100121","DOIUrl":"10.1016/j.hmedic.2024.100121","url":null,"abstract":"<div><div>Evans syndrome is a rare autoimmune-mediated cytopenic disorder. We described the case of a male 27-year-old who had a 15-day history of fever, cough, and myalgia. Although the clinical examination other than a fever is unremarkable, blood workup and cytochemistry showed an autoimmune hemolytic reaction and peripheral destruction of platelets consistent with Evans syndrome. The patient was given multiple transfusions of RBC and platelets in addition to oral corticosteroids, parenteral folic acid, and vitamin B12. This case highlights the importance of considering Evans Syndrome in the differential diagnosis and timely management for a better patient outcome. The following prescriptions were given to the patient upon discharge: injectable deltacortil, tab folic acid, and Cap Opt-D. The patient was instructed to come see the outpatient department at the hospital. This case report highlights the uncharted region of Evans Syndrome in Pakistan.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100121"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534405","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}
Pub Date : 2024-10-15DOI: 10.1016/j.hmedic.2024.100119
Anthony El Dada , Yara El Ratel , Mandy El Khoury , Karam Karam , Mahmoud Othman
Background
Intussusception is exceedingly rare in adults and is often unthought off as a differential diagnosis for abdominal pain. Here, we describe the case of intussusception in a young female unveiling colon adenocarcinoma.
Case presentation
A 36-year-old female, previously healthy, presented for abdominal pain and bloody diarrhea of 2 days duration. The patient was initially treated for Amebiasis. She sought medical care the next day with tenesmus and lancinating abdominal pain, leading to hospitalization for further work-up. Computed tomography (CT) scan revealed an obstruction of the large bowel with dilation of the transverse colon reaching 6 cm. The obstruction was caused by a collapsed, intussuscepted descending colon, with mesenteric fat and vessels telescoped into its lumen along with a 3.7 cm wall thickening. She was scheduled for surgical repair.
Conclusion
A well-timed CT scan is necessary for favorable patient outcomes. Due to their rare occurrence in young adults, intussusception and colon cancer, could potentially go undiagnosed.
{"title":"Colon cancer disguised as intussusception in a young adult: A case report","authors":"Anthony El Dada , Yara El Ratel , Mandy El Khoury , Karam Karam , Mahmoud Othman","doi":"10.1016/j.hmedic.2024.100119","DOIUrl":"10.1016/j.hmedic.2024.100119","url":null,"abstract":"<div><h3>Background</h3><div>Intussusception is exceedingly rare in adults and is often unthought off as a differential diagnosis for abdominal pain. Here, we describe the case of intussusception in a young female unveiling colon adenocarcinoma.</div></div><div><h3>Case presentation</h3><div>A 36-year-old female, previously healthy, presented for abdominal pain and bloody diarrhea of 2 days duration. The patient was initially treated for Amebiasis. She sought medical care the next day with tenesmus and lancinating abdominal pain, leading to hospitalization for further work-up. Computed tomography (CT) scan revealed an obstruction of the large bowel with dilation of the transverse colon reaching 6 cm. The obstruction was caused by a collapsed, intussuscepted descending colon, with mesenteric fat and vessels telescoped into its lumen along with a 3.7 cm wall thickening. She was scheduled for surgical repair.</div></div><div><h3>Conclusion</h3><div>A well-timed CT scan is necessary for favorable patient outcomes. Due to their rare occurrence in young adults, intussusception and colon cancer, could potentially go undiagnosed.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"8 ","pages":"Article 100119"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442288","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}
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