Medical Reports最新文献

{"title":"Plasma exchange maintains coagulation function to prevent worsening of MODS in a patient with acute severe alcoholic pancreatitis: A case report","authors":"Ping Xiao,&nbsp;Tao Xu ,&nbsp;Ming Zhou ,&nbsp;ZhenYu Lei","doi":"10.1016/j.hmedic.2025.100378","DOIUrl":"10.1016/j.hmedic.2025.100378","url":null,"abstract":"<div><h3>Background</h3><div>Acute severe alcoholic pancreatitis has a high mortality rate without blood purification. Patient and method: We used plasma exchange and continuous venovenous hemofiltration to treat a patient with severe acute pancreatitis complicated by multiple organ dysfunction syndrome.</div></div><div><h3>Results</h3><div>Blood indicators of liver, kidney, coagulation, heart, and inflammation were analyzed during treatment. The blood levels of ALT, TBIL, IB, DB, Cr, WBC, N, HCRP, LDH, CK, and PLT were restored after the patient received treatment with CVVH + PE. PLT, PT, INR, FIB, AT3, and DDI were significantly improved when the coagulation indicators were supplemented by plasma exchange.</div></div><div><h3>Conclusion</h3><div>Plasma exchange may help remove harmful circulating molecules, mitigate the large-scale systemic inflammatory response, facilitate the restoration of normal coagulation mechanisms, and regulate hemodynamic stability, thereby rebalancing coagulation function and alleviating the progression of irreversible deterioration in multiple organ dysfunction syndrome for patients with acute severe alcoholic pancreatitis. Our case first highlights the potential efficacy of both PE and CVVH in treating MODS in SAP. These treatments play a vital role in improving clinical conditions, especially in keeping coagulation stable. CVVH and PE are effective treatments for the SAP patient.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100378"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemophagocytic lymphohistiocytosis in association with acute respiratory distress syndrome in the setting of influenza B infection","authors":"Abdelkader Dib ,&nbsp;Johny Salem ,&nbsp;Mirna Fares","doi":"10.1016/j.hmedic.2025.100379","DOIUrl":"10.1016/j.hmedic.2025.100379","url":null,"abstract":"<div><div>We report the case of a 35-year-old woman who presented with fever, diarrhea, and respiratory symptoms, and was found to have acute respiratory distress syndrome (ARDS) in the setting of influenza B infection. Her stay was complicated with disseminated intravascular coagulation and Hemophagocytic lymphohistiocytosis (HLH) confirmed on bone marrow aspirate. Despite multiple therapies including antiviral, corticosteroids, and etoposide, the patient deteriorated and succumbed on day 10 of hospitalization. This case highlights the potential severity of influenza B and the need for early recognition to try and prevent complications such as ARDS and HLH.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100379"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two case reports of benign vagus nerve tumors: Diagnosis and treatment approaches","authors":"Achraf Amine Sbai ,&nbsp;Oumaima Essadqi ,&nbsp;Adnane Benzirar ,&nbsp;Drissia Benfadil ,&nbsp;Azeddine Lachkar ,&nbsp;Fahd El Ayoubi El Idrissi","doi":"10.1016/j.hmedic.2025.100376","DOIUrl":"10.1016/j.hmedic.2025.100376","url":null,"abstract":"<div><div>Benign tumors of peripheral nerves, particularly schwannomas and neurofibromas, are rare. Involvement of the vagus nerve remains even more uncommon. The cervical para-pharyngeal region is the most common of the extra-cranial locations. Imaging, particularly MRI, plays an essential role in characterizing the mass, assessing its extent, and studying its anatomical relationships, thus allowing for the planning of the surgical procedure. The standard treatment is based on a complete excision of the tumor to prevent recurrences while minimizing the risk of postoperative complications.We report two cases of sporadic benign vagus nerve tumors: one neurofibroma and one schwannoma, both treated by complete excision requiring vagus nerve sacrifice. The postoperative course was favorable without sequelae in the first case, while a Claude-Bernard-Horner syndrome was observed in the second patient. Furthermore, we propose a clinical, radiological, and therapeutic update on this rare condition.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100376"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A diagnostic dilemma: Differentiating hepatic sarcoidosis from DRESS syndrome in a patient with acute liver injury","authors":"Milan Gaihre ,&nbsp;Saket Jha ,&nbsp;Rahul Pathak ,&nbsp;Sujan Ghimire ,&nbsp;Prince Baranawal ,&nbsp;Aashish Poudel ,&nbsp;Ritika Bhatta","doi":"10.1016/j.hmedic.2025.100374","DOIUrl":"10.1016/j.hmedic.2025.100374","url":null,"abstract":"<div><h3>Introduction</h3><div>If unexplained acute liver injury symptoms imply several overlapping etiologies, diagnostic difficulty can ensue. Less frequent diseases like hepatic sarcoidosis and DRESS syndrome need to be included in differential diagnosis, but drug-induced liver injury and viral hepatitis are frequent etiologies.</div></div><div><h3>Presentation of the case</h3><div>A 28-year-old woman patient presented with pruritic rash, jaundice, and right upper quadrant pain for one month. Laboratory tests showed eosinophilia (520 cells/μL), hyperbilirubinemia (6.20 mg/dL), hepatocellular injury (AST 401 U/L, ALT 351 U/L), and highly raised ACE levels (216 U/L). Imaging revealed mediastinal lymphadenopathy. The patient's liver enzymes and symptoms significantly improved with corticosteroid treatment.</div></div><div><h3>Discussion</h3><div>Because DRESS syndrome and hepatic sarcoidosis share clinical and biochemical characteristics, the diagnostic challenge of differentiating between the two conditions is brought about in this case. While temporal drug association and eosinophilia predisposed towards drug hypersensitivity, the raised ACE levels and lymphadenopathy pushed in the direction of granulomatous disease. The shared immune-mediated pathophysiology of the two diseases was emphasized by the steroid response.</div></div><div><h3>Conclusion</h3><div>In the assessment of acute liver injury with systemic manifestations, this case emphasizes the need to rule out both drug hypersensitivity and granulomatous disease. It draws attention towards the need for improved diagnostic markers while also recognizing the utility of serum ACE testing and imaging in these situations. The case highlights the advantage of interdisciplinary management in difficult hepatology patients and the effectiveness of corticosteroids.</div></div><div><h3>Key clinical message</h3><div>This case demonstrates the difficulty of making a distinction between hepatic sarcoidosis and drug-induced liver damage in cases where the two diseases mimic each other. Both etiologies must be considered in cases of unexplained acute liver injury with systemic symptoms. Although corticosteroids can be an effective treatment of immune-mediated disease, prolonged follow-up is indicated. Interdisciplinary collaboration enhances the treatment of such complex cases and the validity of diagnoses.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100374"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the coexistence of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and demyelinating disorders in a pediatric case","authors":"Louise Scridelli Tavares,&nbsp;Felipe Augusto Folha Santos,&nbsp;Marianna Pinheiro Moraes de Moraes,&nbsp;Ricardo Pinho Silva,&nbsp;Marcelo de Melo Aragão,&nbsp;Enedina Maria Lobato de Oliveira","doi":"10.1016/j.hmedic.2025.100377","DOIUrl":"10.1016/j.hmedic.2025.100377","url":null,"abstract":"<div><div>Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an immune-mediated disorder characterized by a complex neuropsychiatric syndrome and the presence of cerebrospinal fluid antibodies targeting the GluN1 subunit of the NMDAR. While well-documented, its association with demyelinating disorders—such as neuromyelitis optica, myelitis, and acute disseminated encephalomyelitis—remains rare, particularly in pediatric cases. Here, we present an unusual case of a 7-year-old female who initially exhibited area postrema syndrome, followed by acute brainstem syndrome and encephalopathy. Within 2 years, she experienced two relapses marked by longitudinally extensive transverse myelitis, seizures, and diencephalic syndrome. Neuroimaging revealed mild contrast-enhancing lesions in both infratentorial and supratentorial regions. Despite repeated testing, both antibodies to myelin-oligodendrocyte glycoprotein and aquaporin-4 remained negative. Subsequently, a comprehensive antibody testing protocol, including indirect immunohistochemistry on rat brain tissue and an extensive panel of both fixed and live cell-based assays was requested, confirming the presence of anti-NMDAR antibodies, along with superimposed reactivity to cerebellar granular cells. This report explores the diagnostic and therapeutic complexities of coexisting anti-NMDAR encephalitis and demyelinating disorders. The rarity of this overlap and its distinct clinical features underscore the need for further research into the immunological mechanisms underlying these conditions.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100377"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A-not-full-blown Weil’s disease: An atypical cause of leptospirosis-induced acute hepatitis","authors":"Amir Omar ,&nbsp;Rayane Salameh ,&nbsp;Tracy Zouein ,&nbsp;Tala Charafeddine ,&nbsp;Karam Karam ,&nbsp;Noha Al Hachem","doi":"10.1016/j.hmedic.2025.100375","DOIUrl":"10.1016/j.hmedic.2025.100375","url":null,"abstract":"<div><div>Leptospirosis is a worldwide zoonotic disease caused by pathogenic Leptospira species. It usually manifests as an acute bacterial febrile septicemia like illness that affects both humans and animals. Human infection may occur via mucosal surfaces, abraded skin, or inhalation of aerosolized contaminated water. Liver involvement is a frequent finding in leptospirosis that ranges from mild dysfunction to severe icteric illness with renal failure. We herein present a case of acute hepatitis and febrile jaundice induced by Leptospirosis. The patient had cardiac involvement but no pulmonary or renal involvement, further adding ambiguity to the diagnosis. The diagnosis of leptospirosis in this case was particularly challenging due to its atypical presentation. The unusual constellation of findings underscores the importance of considering leptospirosis in the differential diagnosis of febrile jaundice, even in the absence of classical risk factors. The initiation of potentially life-saving antibiotic treatment requires a high index of clinical suspicion.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100375"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare case of adnexal torsion in pregnancy: A comprehensive review of recent diagnostic and surgical management approaches","authors":"Marouane Boukroute ,&nbsp;Abdelmajide Regragui ,&nbsp;Soukayna Saidi ,&nbsp;Hafsa Taheri ,&nbsp;Hanane Saadi ,&nbsp;Ahmed Mimouni","doi":"10.1016/j.hmedic.2025.100373","DOIUrl":"10.1016/j.hmedic.2025.100373","url":null,"abstract":"<div><div>Adnexal torsion (AT) during pregnancy is a rare but critical condition that poses significant challenges in diagnosis and management. We present the case of a 22-year-old primigravida at 14 weeks of gestation with no predisposing factors, who presented with acute right-sided pelvic pain. Imaging, including transabdominal ultrasound and MRI, indicated a viable pregnancy with an enlarged, multifollicular right ovary, suggesting AT. The patient underwent an emergency laparoscopy, confirming right-sided adnexal torsion. After successful detorsion, postoperative recovery was uneventful, and follow-up imaging confirmed ongoing pregnancy viability with preserved ovarian function.</div><div>Given the nonspecific clinical presentation, the diagnosis of AT in pregnancy often requires high clinical suspicion supported by imaging modalities. While ultrasound remains the primary diagnostic tool, MRI can offer additional diagnostic clarity when ultrasound findings are inconclusive. The treatment of AT in pregnant women is primarily surgical, with recent guidelines favoring conservative approaches aimed at preserving ovarian function. Laparoscopy is the preferred method for pregnancies under 17 weeks, with emphasis on safety protocols. Conservative management, including detorsion, is recommended for viable ovaries, while oophorectomy is reserved for cases with necrotic tissue. Overall, the prognosis is favorable, with most cases resulting in functional ovarian recovery and continued pregnancy viability.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100373"},"PeriodicalIF":0.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Guillain-Barré syndrome following multiple procedures: A case report","authors":"Palak R. Patel,&nbsp;Craig Carcuffe,&nbsp;Benjamin Abramoff","doi":"10.1016/j.hmedic.2025.100372","DOIUrl":"10.1016/j.hmedic.2025.100372","url":null,"abstract":"<div><div>Postoperative Guillain-Barré syndrome (GBS) is a rare and poorly understood phenomenon. We present the case of a 73-year-old female with cervical myelopathy who developed a GBS variant, acute motor axonal neuropathy (AMAN), following surgical decompression. The patient's initial presentation was consistent with cervical myelopathy, but she experienced a rapid postoperative neurological decline characterized by progressive weakness and areflexia. This unusual timeline, along with the patient having undergone an esophagogastroduodenoscopy just four days prior to her hospital admission, presents a unique clinical puzzle. This case adds to the limited literature on postoperative GBS and suggests that multiple procedures within a short timeframe may increase the risk of developing the syndrome. We emphasize the need for clinicians to consider GBS in the differential diagnosis for postoperative progressive weakness and to utilize advanced diagnostic tools like electrodiagnostic studies for prompt and accurate management.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100372"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated management of facial harmonization complications using ozone therapy: A description of 2 cases","authors":"Vanessa Defelícibus,&nbsp;Leticia Philippi,&nbsp;Victória Maes,&nbsp;Ana Paula Anzolin","doi":"10.1016/j.hmedic.2025.100371","DOIUrl":"10.1016/j.hmedic.2025.100371","url":null,"abstract":"<div><h3>Background</h3><div>Facial harmonization procedures, while popular, can lead to complications such as persistent edema, nodules, and scarring with retraction. Ozone therapy, known for its anti-inflammatory, oxygenating, and regenerative properties, has emerged as a potential adjuvant treatment to improve clinical outcomes in such cases.</div></div><div><h3>Case reports</h3><div>Case 1 involved a 42-year-old female patient who developed persistent facial edema and nodules following an inappropriate hyaluronic acid application. Treatment included ultrasound-guided hyaluronidase injections and subcutaneous medical ozone therapy, resulting in a progressive reduction of inflammation and improved facial symmetry. Case 2 described a 48-year-old female patient with severe scar retraction of the lower eyelids after a \"non-surgical blepharoplasty\" using a plasma jet, leading to ectropion and ocular pain. Management combined subcutaneous ozone therapy, cyclic eyelid traction, and reconstructive surgery, achieving symptom relief, functional recovery, and anatomical stability.</div></div><div><h3>Conclusion</h3><div>Ozone therapy demonstrated a significant adjuvant role in managing complications from facial aesthetic procedures by modulating inflammation, enhancing tissue oxygenation, and promoting local tissue regeneration, ultimately contributing to improved clinical outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100371"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradoxical psoriasis induced by adalimumab in a patient with Crohn’s disease and sacroiliitis: A case report","authors":"Khalid Hamdan,&nbsp;Kaline Maya Khoury,&nbsp;Nicolas Moussallem,&nbsp;Jessy Fadel,&nbsp;Karam Karam,&nbsp;Elias Fiani","doi":"10.1016/j.hmedic.2025.100370","DOIUrl":"10.1016/j.hmedic.2025.100370","url":null,"abstract":"<div><h3>Background</h3><div>Crohn’s disease (CD), a chronic inflammatory bowel disease, has various clinical manifestations that can be treated and controlled with tumor necrosis factor-alpha (TNF-α) inhibitors, like adalimumab, as therapy of choice. Despite the number of patients that have benefited from this treatment and achieved remission of their symptoms, some experience paradoxically induced psoriatic skin lesions, a condition known as paradoxical psoriasis.</div></div><div><h3>Case Presentation</h3><div>We present the case of a 46-year-old Lebanese woman known to have Crohn’s disease, with a history of recurrent flares and episodes of sacroiliitis not controlled on azathioprine. Hence, we switched the patient onto adalimumab, whereby she experienced full remission of her disease associated symptoms for around a duration of five months until she developed widespread erythematous, scaly silver plaques which were determined by dermatologic assessment and biopsy to be psoriasiform dermatitis. The offending agent, adalimumab was discontinued and replaced with ustekinumab, an interleukin-12/23 inhibitor, that led to the complete disappearance of the skin lesions and subsidence of her Crohn’s related gastrointestinal and musculoskeletal symptoms.</div></div><div><h3>Conclusion</h3><div>When starting a patient on a TNF-α inhibitor therapy, physicians should pay close attention and participate in educating patients about possible cutaneous reactions that may occur during treatment. Early detection of these psoriasiform lesions is imperative for prompt treatment adjustments, such as switching to agents with different immunological targets, to prevent widespread of the rash and improve patient outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"14 ","pages":"Article 100370"},"PeriodicalIF":0.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060232","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}