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Total 25 results found since Jan 2013.
Corneal perforation in ocular cicatricial pemphigoid: A CARE-compliant case report
We describe the first case of OCP with minimal immunosuppressant and initial ocular surface reconstruction procedure using double layer AMT.
Patient concerns:
A 66-year-old female patient presented to our outpatient department with right eye pain for several days.
Diagnosis:
Slit lamp examination revealed the right eye cornea perforation with iris incarceration and total collapse of anterior chamber. Symblepharon formation and severe fornix shortening was also noted. While bulbi phthisis with ankyloblepharon and ocular surface keratinization was observed in the left eye. The final diagnosis was right eye stag...
Source: Medicine - December 23, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Effectiveness of perampanel in managing chronic pain caused by the complex regional pain syndrome: A case report
This report describes a patient with complex regional pain syndrome (CRPS) type I in the right lower leg and foot who responded well to perampanel, an AMPA receptor antagonist, for managing the chronic pain.
Patient concern:
A 61-year-old woman complained of pain in her right lower leg and foot over a period of 7 year (numeric rating scale: 8) due to CRPS type I.
Diagnosis:
CRPS type 1.
Interventions:
Despite the combination of 300 mg pregabalin, 225 mg/1950 mg tramadol/acetaminophen, and 10 mg nortriptyline per day, her right lower leg and foot were nearly disabled due to the severity of the p...
Source: Medicine - December 3, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
IgA vasculitis mimicking drug-induced skin reaction and infectious colitis in an elderly patient: A case report
This study reports a case of IgAV mimicking drug-induced skin reaction in an elderly patient.
Patient concerns:
A 74-year-old female without any underlying disease presented to our emergency department as she was suffering from lower abdominal pain and diarrhea for 3 weeks. The patient was diagnosed with infectious colitis, and antibiotic treatment was administered at a local clinic. At presentation, the patient had rashes on both lower legs that developed after the antibiotic treatment, which was assumed as a drug eruption. Although antibiotic treatment was continued, the patient had persistent abdominal pain, di...
Source: Medicine - November 5, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
A case report about eosinophilic enteritis presenting as abdominal pain
Rationale:
Eosinophilic enteritis (EE) is an immune-mediated antigen-driven disease that may lead to clinical symptoms and organ dysfunction and characterized by the presence of extensive eosinophilic infiltrates on histopathological examination of the intestinal mucosa.
Patient concerns:
A 29-year-old man presented with a half-month duration of paroxysmal upper abdominal pain that gradually evolved into continuous pain accompanied by the urge to defecate.
Diagnoses:
Pathological findings of enteroscopy showed acute and chronic inflammation accompanied by eosinophilic infiltration (>20/ high-power field)....
Source: Medicine - October 1, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Acute acalculous cholecystitis as the initial manifestation of systemic lupus erythematous: A case report
Rationale:
Acute acalculous cholecystitis (AAC) is an extremely rare manifestation of systemic lupus erythematous (SLE). In previous reports, most of the patients were already diagnosed cases of SLE upon confirmation of AAC.
Patient concerns:
A 24-year-old female who initially presented with fever and acute right upper quadrant abdominal pain. She had no medical history.
Diagnoses:
Abdominal ultrasonography and computed tomography (CT) showed gallbladder thickening with pericholecystic edema without gallstones or sludge, demonstrating acalculous cholecystitis. She revealed discoid rash on the both shin. L...
Source: Medicine - June 4, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis in a COVID-19 patient: A case report
We report a case of acute optic neuritis (ON) associated with myelin oligodendrocyte glycoprotein (MOG) antibody possibly induced by COVID-19.
Patient concerns:
A 47-year-old man presented to our clinic with left eye pain and vision loss. Magnetic resonance imaging of the orbit revealed the bilateral high intensity of the optic nerve sheaths. He tested positive for COVID-19 by polymerase chain reaction (PCR) testing on the day of admission but he had no signs of respiratory illness. Laboratory testing revealed that MOG immunoglobulin G (MOG IgG) was positive, but other antibodies including aquaporin-4 were negative....
Source: Medicine - May 14, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Henoch-Schönlein purpura in a patient with oesophageal cancer: A case report
We report a rare case of oesophageal squamous cell carcinoma initially presented as HSP. This case suggests the importance of evaluating adult patients with HSP for an underlying malignancy.
Source: Medicine - December 4, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Vocal cord involvement and hoarseness in a patient with Behcets disease: A rare case report
Rationale:
Behcets disease (BD) is a type of chronic systemic vasculitis that typically manifests as a mucocutaneous disease with orogenital ulcers, skin damage, and uveitis. The clinical diagnosis is often difficult because of the diversity of organs that may be involved and lack of specific pathological diagnosis.
Patient concerns:
A 26-year-old woman presented as a nearly 2-week history of hoarseness with throat pain.
Diagnoses:
In the present case, Fiber laryngoscopy showed multiple ulcers involving the epiglottic tubercle, bilateral false vocal cord, middle area of the left vocal cord, and full length of the r...
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Concurrent treatment with rituximab and plasma exchange for severe refractory granulomatosis with polyangiitis: A case report
Rationale:
Rituximab is recommended to induce remission of severe granulomatosis with polyangiitis (GPA). Plasma exchange (PE) may be considered in the setting of rapidly progressive glomerulonephritis (RPGN) with a serum creatinine increase of more than 5.6 mg/dl or diffuse alveolar hemorrhage (DAH). However, there are no sufficient studies on combination therapy with rituximab and PE in GPA.
Patient concerns:
A 23-year-old woman was admitted with fever, abdominal pain, and diarrhea on suspicion of infectious colitis. Colonoscopy showed hemorrhagic colitis and antibiotic treatment was ineffective. Physical examinat...
Source: Medicine - December 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Non-traumatic perforation of the jejunum in a human immunodeficiency virus-infected patient receiving combination antiretroviral therapy: A case report
Rationale:
Non-traumatic bowel perforation caused by cytomegalovirus (CMV) and Mycobacterium avium complex (MAC) infections has become rare among patients with acquired immunodeficiency syndrome (AIDS) in the era of combination antiretroviral therapy (cART); however, CMV-associated and MAC-related immune reconstitution inflammatory syndrome (IRIS) has subsequently emerged owing to the wide use of integrase inhibitor-based regimens. Here we report a case of spontaneous perforation of the jejunum in a patient with human immunodeficiency virus (HIV) infection with good compliance to cART.
Patient concerns:
A 32-year-old ...
Source: Medicine - December 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
An unusual case of Behcet disease with posterior scleritis: A case report
Rationale:
Posterior scleritis is an ocular inflammatory disorder that can be associated with both infectious and non-infectious immune reactions. Behcet disease is a chronic, relapsing, multisystemic inflammatory disorder with uveitis. There are no reported cases of posterior scleritis with Bechet disease.
Patient concerns:
A 50-year-old man previously diagnosed with systemic Behcet disease presented with ocular pain and decreased vision in the left eye.
Diagnosis:
Posterior scleritis associated with Behcet disease was diagnosed based on optical coherence tomography showing choroidal folds, as well as contrast com...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Utility of power Doppler ultrasonography for detecting forefoot bursae in early rheumatoid arthritis: A case report
We report the case of an RA patient who developed reduced foot mobility and had detectable intermetatarsal bursitis with remarkable power Doppler (PD) signals in MSUS at the onset of RA.
Patient concerns:
A 40-year-old Japanese woman diagnosed with palindromic rheumatism visited our department due to sustained forefoot pain and difficulty walking. The levels of both rheumatoid factor (RF) and anticitrullinated protein antibody (ACPA) were high. She had opening toes with swelling in metatarsophalangeal (MTP) joints. PDUS showed intermetatarsal bursitis with mild MTP synovitis.
Diagnoses:
We diagnosed RA by comprehensi...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Adult Langerhans’ cell histiocytosis with multisystem involvement: A case report
Rationale:
Langerhans’ cell histiocytosis (LCH), also called histiocytosis X, is an uncommon disorder manifesting in a variety of ways. Although LCH can involve various organs including bone, skin, and lymph nodes, multisystem involvement of LCH is rare in adults.
Patient concerns:
A 31-year-old woman first presented to our hospital with left leg pain. She had a history of a 20-kg weight gain over three months.
Diagnoses:
X-ray, magnetic resonance imaging (MRI), computed tomography (CT), and bone scan images revealed enhancing lesions in the left femur and right temporal bone, multiple cystic lesions in the lung,...
Source: Medicine - November 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Immune checkpoint inhibitors of CTLA4 and PD-1 for malignant melanoma arising in ovarian cystic teratoma: A case report
Rationale:
Malignant melanoma (MM) arising in ovarian cystic teratoma (OCT) is a rare disease with poor prognosis. Recently, immune checkpoint inhibitors of cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) and programmed death 1 (PD-1) have shown promising results in MM. Herein we report a case of MM arising in OCT.
Patient concerns:
A 63-year-old Japanese primigravida had lower abdominal pain. Magnetic resonance imaging revealed the presence of an 85-mm mass at the right ovary.
Diagnoses:
The patient underwent right salpingo-oophorectomy for right ovarian tumor, and histopathological examinations revealed MM ar...
Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Diagnostic value of ultrasonography in synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome: A case report
We report a 44-year-old male with a 20-year history of pustulosis who presented with pain in the lower extremities. Plain radiography demonstrated hyperostosis with subperiosteal erosions in the right tibia. Magnetic resonance imaging and computed tomography showed inflammatory accumulation, whereas musculoskeletal ultrasonography clearly depicted a periosteal reaction, osteitis, and enthesitis with abnormal blood flow in the surface of the right tibia.
Diagnoses:
A diagnosis of SAPHO syndrome was made.
Interventions:
The patient was treated with combination therapy comprising prednisolone, methotrexate, and inflixim...
Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
