20,975 results match your criteria BMJ case reports[Journal]


Tophaceous gout in uncorrected cyanotic congenital heart disease.

BMJ Case Rep 2020 07 9;13(7). Epub 2020 Jul 9.

Cardiology, All India Institute of Medical Sciences, New Delhi, India.

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http://dx.doi.org/10.1136/bcr-2020-236775DOI Listing

Septic arthritis of the temporomandibular joint in an unvaccinated adolescent.

BMJ Case Rep 2020 Jul 9;13(7). Epub 2020 Jul 9.

Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

Septic arthritis of the temporomandibular joint (TMJ) is a rare condition, particularly in the paediatric population. Our case involves a 15-year-old unvaccinated Amish man with acute pain and trismus of the TMJ. The diagnosis was reached after history, clinical examination, radiographic and laboratory examinations were performed. Read More

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http://dx.doi.org/10.1136/bcr-2020-235597DOI Listing

Dural arteriovenous fistula presenting with dementia and bulbar symptoms.

BMJ Case Rep 2020 Jul 9;13(7). Epub 2020 Jul 9.

Neurology, University Hospitals of Leicester NHS Trust, Leicester, UK

Dural arteriovenous fistulas are relatively rare. Some cases are difficult to diagnose, leading to unnecessary investigations, treatments and delays, particularly if the presentation is atypical. We report a case of a man who presented with progressive dementia and bulbar symptoms, both under-recognised non-haemorrhagic neurological deficits, caused by cortical venous hypertension. Read More

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http://dx.doi.org/10.1136/bcr-2020-234907DOI Listing

Rapidly recurring ovarian fibrosarcoma after optimal debulking surgery in a 46-year-old woman.

BMJ Case Rep 2020 Jul 9;13(7). Epub 2020 Jul 9.

Department of Obstetrics and Gynaecology, Dr Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia.

Ovarian fibrosarcoma is an extremely rare tumour with no universally accepted guidelines for treatment. We present a 46-year-old nulliparous woman with ovarian fibrosarcoma who mainly presented with a painful abdominal enlargement. Optimal debulking surgery was performed, and a specimen of the tumour was examined. Read More

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http://dx.doi.org/10.1136/bcr-2020-234757DOI Listing

Deferasirox-induced liver injury and Fanconi syndrome in a beta-thalassemia major male.

BMJ Case Rep 2020 Jul 9;13(7). Epub 2020 Jul 9.

Gastroenterology and Hepatology Department, Northern Health, Epping, Victoria, Australia.

A 33-year-old male presenting with subacute abdominal pain was found to have hyperbilirubinaemia, hypokalaemia and hyponatraemia. This was in the setting of transitioning between deferasirox iron chelator formulations, from dispersible tablets to film-coated tablets for ongoing treatment of chronic iron overload secondary to transfusion requirement for beta-thalassemia major. A liver biopsy demonstrated acute cholestasis with patchy confluent hepatocellular necrosis and mild to moderate microvesicular steatosis. Read More

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http://dx.doi.org/10.1136/bcr-2020-234542DOI Listing

Post-traumatic preauricular pulsatile swelling in a patient on oral anticoagulation therapy.

BMJ Case Rep 2020 Jul 9;13(7). Epub 2020 Jul 9.

Department of Vascular Surgery, Christian Medical College Vellore, Vellore, India.

The differential diagnoses for preauricular swellings include dermoid cyst, lymph nodes, lipoma, nerve sheath tumours, parotid swelling, mastoiditis, vascular malformations and arterio-venous fistulas aneurysms/pseudoaneurysms. Superficial temporal artery pseudoaneurysm(s) (STAPA) are rare (1% of all aneurysms) vascular complications, which occur following a blunt injury of the head or iatrogenic causes. The use of anticoagulation therapy increases the risk of pseudoaneurysm formation. Read More

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http://dx.doi.org/10.1136/bcr-2020-234497DOI Listing

Acute ophthalmoplegia in a patient with anti-GQ1b antibody and chronic facial diplegia.

BMJ Case Rep 2020 Jul 9;13(7). Epub 2020 Jul 9.

Department of Neurosciences, University of California San Diego Health System, San Diego, California, USA.

A 56-year-old man with a remote history of bilateral recurrent facial palsies presented with a week of ophthalmoplegia with intact deep tendon reflexes and lack of ataxia, cerebrospinal fluid with albuminocytologic dissociation and elevated serum anti-ganglioside Q1b (GQ1b) IgG antibody. We diagnosed the patient with acute ophthalmoplegia without ataxia, a condition under the spectrum of anti-GQ1b antibody syndromes which also includes Miller Fisher syndrome. Given the rarity of recurrent facial palsies and anti-GQ1b antibody syndromes as well as reports associating facial palsies and this syndrome, we suggest that our case may be an unusual presentation of an anti-GQ1b antibody syndrome beginning with recurrent facial palsies several years prior to ophthalmoplegia. Read More

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http://dx.doi.org/10.1136/bcr-2020-234319DOI Listing

Intra-articular horizontal dislocation of the patella: a rare injury and review of the literature.

BMJ Case Rep 2020 Jul 9;13(7). Epub 2020 Jul 9.

Department of Orthopaedic Surgery and Traumatology, Hôpital du Valais, Martigny, Switzerland

Acute traumatic intra-articular dislocation of the patella is not a common presentation in orthopaedic practice; less frequently observed than extra-articular dislocation of the patella. In some of these cases, closed reduction is not possible and an open reduction in the operating theatre must be performed. In this case report, we present an elderly patient with an intra-articular horizontal dislocation of the patella without any other bony or ligamentous lesions seen in a postreduction MRI. Read More

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http://dx.doi.org/10.1136/bcr-2019-232249DOI Listing

Urticaria and angioedema as a prodromal cutaneous manifestation of SARS-CoV-2 (COVID-19) infection.

Authors:
Khalid Hassan

BMJ Case Rep 2020 Jul 7;13(7). Epub 2020 Jul 7.

Loch Lomond Surgery, 75 Bank Street, Alexandria, Scotland

This is a case of a patient who presented with an urticarial rash 48 hours before developing symptoms of fever and a continuous cough. She subsequently developed angioedema of her lips and hands before testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Urticarial rashes occurring 48 hours before other symptoms of COVID-19 infection have been documented. Read More

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http://dx.doi.org/10.1136/bcr-2020-236981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342472PMC

Acute immune thrombocytopaenic purpura in a patient with COVID-19 and decompensated cirrhosis.

BMJ Case Rep 2020 Jul 7;13(7). Epub 2020 Jul 7.

Service and Central Laboratory of Hematology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

We report on a patient with coronavirus disease 2019 (COVID-19) and decompensated cirrhosis who experienced a favourable outcome of severe immune thrombocytopaenic purpura (ITP) after administration of intravenous immunoglobulin and high-dose dexamethasone. The present case suggests that it is reasonable to evoke ITP in case of profound thrombocytopaenia in a patient with COVID-19. Read More

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http://dx.doi.org/10.1136/bcr-2020-236815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342180PMC

Surgical downsizing of a prosthetic ring in congenital mitral valve regurgitation.

BMJ Case Rep 2020 07 7;13(7). Epub 2020 Jul 7.

Cardiac Surgery, Centro Hospitalar de Lisboa Ocidental EPE, Lisbon, Portugal.

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http://dx.doi.org/10.1136/bcr-2020-235788DOI Listing

Choroidal metastases as a presenting manifestation of neuroblastoma.

BMJ Case Rep 2020 07 7;13(7). Epub 2020 Jul 7.

Department of Retina-Vitreous services, Aravind Eye Hospital, Madurai, India.

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http://dx.doi.org/10.1136/bcr-2020-235730DOI Listing

46, XY complete gonadal dysgenesis with pubertal virilisation due to dysgerminoma/gonadoblastoma.

BMJ Case Rep 2020 Jul 7;13(7). Epub 2020 Jul 7.

Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Complete gonadal dysgenesis (CGD) or Swyer syndrome is characterised by sexual infantilism in a phenotypic female with 46, XY karyotype. Patients with gonadal dysgenesis and Y-chromosome material are at a high risk of developing gonadoblastoma and dysgerminoma. A 16-year-old girl presented with progressive virilisation, poor breast development and primary amenorrhea. Read More

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http://dx.doi.org/10.1136/bcr-2020-235501DOI Listing

Acute lupus pneumonitis as the initial presentation of systemic lupus erythematosus.

BMJ Case Rep 2020 Jul 7;13(7). Epub 2020 Jul 7.

Division of Pulmonary Diseases, Geneva University Hospitals, Geneva, Switzerland.

Systemic lupus erythematosus is a multisystem autoimmune disease with wide-ranging pleuropulmonary manifestations. Acute lupus pneumonitis is one of its uncommon complications. We report a 36-year-old woman with acute lupus pneumonitis as the initial presentation of systemic lupus erythematosus. Read More

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http://dx.doi.org/10.1136/bcr-2020-234638DOI Listing

Therapeutic use of intermittent fasting and ketogenic diet as an alternative treatment for type 2 diabetes in a normal weight woman: a 14-month case study.

BMJ Case Rep 2020 Jul 7;13(7). Epub 2020 Jul 7.

Institute of Kidney Life Science Technologies, Scarborough, Ontario, Canada.

This case demonstrates the effective and sustainable use of intermittent fasting (IF) and ketogenic diet (KD) in a normal weight patient with type 2 diabetes, who did not attain glycaemic control with a standard care approach. A 57-year-old woman with type 2 diabetes treated with metformin and strict adherence to a standard diabetic diet presented with a haemoglobin A1c (HbA1c) of 9.3%. Read More

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http://dx.doi.org/10.1136/bcr-2019-234223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342268PMC

Ventriculoperitoneal shunt induced neck mass mimicking sternocleidomastoid tumour: a previously unreported complication.

BMJ Case Rep 2020 Jul 7;13(7). Epub 2020 Jul 7.

Department of Paediatric Surgery, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India.

Ventriculoperitoneal shunt (VPS) for hydrocephalus is associated with various complications. Torticollis due to shunt tract fibrosis is a rare complication of VPS that occurs years later after the initial operation. However, shunt track fibrosis that progressed to large neck mass, mimicking sternocleidomastoid tumour and causing torticollis is a previously unreported complication. Read More

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http://dx.doi.org/10.1136/bcr-2019-233736DOI Listing

Non-typeable and purpura fulminans.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.

typically causes illness and infection in the paediatric population. We report a case of a 53-year-old man who developed invasive non-typeable infection associated with purpura fulminans and multiorgan failure. On review of the literature, this is the first reported case of non-typeable causing purpura fulminans. Read More

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http://dx.doi.org/10.1136/bcr-2020-234880DOI Listing

Case of anisakiasis presenting as an Amyand hernia.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Surgery, WellSpan Good Samaritan Hospital, Lebanon, Pennsylvania, USA.

This is a case of a 31-year-old male patient who presented with signs and symptoms of an incarcerated inguinal hernia. The patient's preoperative imaging showed a tubular structure in the inguinal canal and given the patient's history at presentation, there was a concern for herniation of the appendix, known as an Amyand hernia. On laparoscopy, there was no evidence of appendiceal involvement and a standard open inguinal hernia was completed. Read More

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http://dx.doi.org/10.1136/bcr-2020-234822DOI Listing

Effect of autologous adipose-derived mesenchymal stem cell therapy in the treatment of an osteochondral lesion of the ankle.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Melbourne Stem Cell Centre, Box Hill North, Victoria, Australia.

Osteochondral lesions (OCLs) of the talus are rare but can be associated with significant morbidity and may lead to the development of osteoarthritis. An improved understanding of the action of mesenchymal stem cells (MSCs) has seen renewed interest in their role in cartilage repair, with early preclinical and clinical research showing benefits in symptomatic and structural improvement. A 42-year-old man presented with an unstable OCL of the talus and onset of early osteoarthritis with a history of multiple previous ankle arthroscopies for ankle impingement. Read More

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http://dx.doi.org/10.1136/bcr-2020-234595DOI Listing

Cystic lymphangioma of the stomach with marked reactive changes: a rare cause of gastric outlet obstruction in adult.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

General Surgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India.

Cystic lymphangiomas are benign lymphatic tumours which usually affect the paediatric population and are predominantly located in the head and neck region. Its occurrence during adulthood and an intra-abdominal location are both extremely uncommon. Clinically and radiologically, these lesions often mimic malignancy. Read More

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http://dx.doi.org/10.1136/bcr-2019-233582DOI Listing

Strangulated right-sided diaphragmatic hernia presenting and treated as lung empyema: beware of the differential diagnosis.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Royal Gwent Hospital, Newport, UK.

A 78-year-old man with no surgical history or recent trauma presented to the emergency department with sudden onset right-sided chest pain and dyspnoea. He was admitted under the physicians for investigations and was subsequently diagnosed with empyema of the right thorax. After no improvement with intravenous antibiotics, a chest drain was inserted; no pus was drained. Read More

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http://dx.doi.org/10.1136/bcr-2019-233440DOI Listing

Radical change in osteosarcoma surgical plan due to COVID-19 pandemic.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Orthopedics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.

A 17-year-old man with osteosarcoma of the proximal humerus was planned for possible limb salvage surgery after standard neoadjuvant chemotherapy. However, during the surgical phase of treatment, the COVID-19 or SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) outbreak occurred changing the healthcare landscape due to uncertainty regarding the virus, risk of COVID-19 infection and complications, and implementation of an enhanced community quarantine restricting movement of people within cities. Instead of limb salvage surgery, the patient underwent a forequarter amputation. Read More

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http://dx.doi.org/10.1136/bcr-2020-237197DOI Listing

Mediastinal germ cell tumour during the COVID-19 pandemic.

BMJ Case Rep 2020 07 8;13(7). Epub 2020 Jul 8.

Department of Medical Oncology, Cork University Hospital Group, Cork, Ireland.

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http://dx.doi.org/10.1136/bcr-2020-237003DOI Listing

Erythema nodosum as a cutaneous manifestation of COVID-19 infection.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Internal Medicine, HFR Fribourg Hopital cantonal, Fribourg, Switzerland.

Erythema nodosum (EN) is a common dermatological manifestation with many different aetiologies. Often however, the aetiology remains unidentified. We present here a 42-year-old male patient with an EN that is due to an acute COVID-19 infection. Read More

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http://dx.doi.org/10.1136/bcr-2020-236613DOI Listing

Guillain-Barré syndrome associated with COVID-19 infection: a case from the UK.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Neurology, University Hospitals of Leicester NHS Trust, Leicester, UK.

Originating from Wuhan, China, COVID-19 has rapidly spread worldwide. Neurological manifestations are more commonly associated with severe COVID-19 infection. Guillain-Barré syndrome (GBS) is a rare immune-mediated postinfectious neuropathy. Read More

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http://dx.doi.org/10.1136/bcr-2020-236536DOI Listing

Ureterocele with impacted stone.

BMJ Case Rep 2020 07 8;13(7). Epub 2020 Jul 8.

Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.1136/bcr-2020-236301DOI Listing

Retroperitoneoscopic drainage of cryptogenic psoas abscess.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of General Surgery, IRCCS Policlinico San Donato, University of Milan, Milano, Italy

Psoas abscess is a rare and occasionally life-threatening condition. In the past, the major cause of psoas abscess was a descending infection originating from spine tuberculosis (Pott's disease). Subsequently, secondary infection from spondylodiscitis or Crohn's disease has become the prevalent aetiology. Read More

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http://dx.doi.org/10.1136/bcr-2020-235579DOI Listing

Omeprazole-induced hypomagnesaemia, causing renal tubular acidosis with hypokalaemia, hypocalcaemia, hyperlactacidaemia and hyperammonaemia.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Internal Medicine, Ako City Hospital, Ako, Hyogo, Japan.

A 72-year-old Japanese man treated with omeprazole for 11 years was admitted due to loss of consciousness and muscle weakness. Wolff-Parkinson-White syndrome-induced tachycardia was considered as the cause of syncope. His blood examination revealed rhabdomyolysis, hypokalaemia, hypomagnesaemia, hypocalcaemia, hyperlactacidaemia, hyperammonaemia and high-anion-gap metabolic acidosis. Read More

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http://dx.doi.org/10.1136/bcr-2020-235385DOI Listing

Pazopanib-associated interstitial lung disease in a patient with renal cell carcinoma.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan

Pazopanib is a multi-targeted tyrosine kinase inhibitor, which is indicated for use in patients with advanced renal cell carcinoma or advanced soft-tissue sarcomas. Although rare, interstitial lung disease has been reported as among the adverse sequelae of pazopanib therapy. We report the case of a 75-year-old man who developed interstitial lung disease during treatment with pazopanib for renal cell carcinoma with multiple lung metastases. Read More

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http://dx.doi.org/10.1136/bcr-2020-235177DOI Listing

Late-onset 'sloughing esophagitis' (esophagitis dissecans superficialis) associated with bullous pemphigoid.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Laboratorio de Fisiologia Digestiva y Motilidad, Instituto de Investigaciones Medico Biologicas, Veracruz, Mexico

Pemphigus is a rare autoimmune disease that causes blistering of the skin and oral mucosa. In bullous pemphigoid (BP), skin involvement is predominant, whereas oesophageal involvement is rare, compared with other blistering diseases. We present, herein, the case of a 67-year-old man with a history of successfully treated BP that 2 years later developed progressive dysphagia, unintentional weight loss and iron deficiency anaemia. Read More

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http://dx.doi.org/10.1136/bcr-2020-235135DOI Listing

Favourable outcome in a child with presumed tubercular pancarditis treated with empirical antitubercular therapy.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Pediatrics, Command Hospital Chandigarh, Chandigarh, India.

Cardiac tuberculosis (TB) as an extrapulmonary manifestation of TB is rare. Pericarditis is a common manifestation while myocarditis and endocarditis are less common. Tubercular pancarditis is extremely rare. Read More

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http://dx.doi.org/10.1136/bcr-2020-235125DOI Listing

Oral manifestations of lamellar ichthyosis in association with rickets.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Centre for Dental Education and Research, AIIMS, New Delhi, India

Lamellar ichthyosis (LI) is a rare genetic condition that affects the skin, with an incidence of less than 1:300 000 in different parts of the world. This report describes a case of a 5-year-old girl with LI and rickets presenting with premature loss of 51, 52, 61, 62 and 71, grade II mobility in 72, 73, 81, 82 and 83 along with loss of supporting bone with 53, 63, 72, 73, 82 and 83. This is the first report describing oral manifestations of this combination of LI and rickets. Read More

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http://dx.doi.org/10.1136/bcr-2020-235008DOI Listing

Strictures, stones and cysts: an unusual cause of pancreatitis in a 20-month-old female child.

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA.

Choledochal cysts are dilations of the biliary tree that cause a variety of clinical symptoms and can lead to several types of complications. Choledochal cysts are most commonly diagnosed in childhood and frequently present with abdominal pain, jaundice and, in infants, an abdominal mass. Although the most concerning complication is malignant transformation of the cyst epithelium, other complications such as stone formation, acute pancreatitis and stricture can also occur and lead to patient morbidity. Read More

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http://dx.doi.org/10.1136/bcr-2020-234966DOI Listing

Lung cavitation due to COVID-19 pneumonia.

BMJ Case Rep 2020 07 6;13(7). Epub 2020 Jul 6.

Division of Hospital Medicine, Miriam Hospital, Providence, Rhode Island, USA.

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http://dx.doi.org/10.1136/bcr-2020-237245DOI Listing

Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis.

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Department of Pediatrics, University of Kentucky, Lexington, Kentucky, USA.

Paediatric hyperthyroidism cases are mostly caused by Grave's disease. Thyroid storm is a life-threatening condition seen rarely, in severe thyrotoxicosis, occurring in about 1%-2% of patients with hyperthyroidism. Antithyroid medications and beta-blockers are typically the first-line management of thyroid storm. Read More

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http://dx.doi.org/10.1136/bcr-2020-235536DOI Listing

Giant cervicomediastinal thymic cyst in an elderly: diagnosis by multimodality imaging and fine-needle aspiration cytology with immunocytochemistry.

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Pulmonary Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, Odisha, India.

A 65-year-old woman, a non-smoker, presented to the pulmonary medicine outpatient department with chest pain, mild dyspnoea, right side neck swelling and mild facial puffiness. The cervical swelling was soft, non-tender and fluctuant on palpation. Multimodality imaging revealed a large, thin-walled cervicomediastinal cystic lesion with septations, haemorrhage, septal calcification and without any solid component. Read More

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http://dx.doi.org/10.1136/bcr-2020-235425DOI Listing

Resuscitative hysterotomy for maternal collapse in a triplet pregnancy.

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Department of Obstetrics and Gynecology, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates.

We encountered a 47-year-old woman, at 35 weeks of gestation, carrying triplets, who attended the hospital with severe pre-eclampsia and at admission had eclamptic fit followed by cardiac arrest. Cardiopulmonary resuscitation was started when she did not respond to initial measures; resuscitative hysterotomy was started on the site of collapse immediately, within 4 min postarrest, to deliver the triplets within 5 min postmaternal cardiac arrest. Timely decision of resuscitative hysterotomy done primarily to restore maternal cardiac output due to a grossly gravid uterus saved the mother and the triplets. Read More

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http://dx.doi.org/10.1136/bcr-2020-235328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342181PMC

Purpura-free small intestinal IgA vasculitis complicated by cytomegalovirus reactivation.

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine Hospital, Osaka-Sayama, Osaka, Japan.

IgA vasculitis (Henoch-Schönlein purpura) affects various organs, including the skin, gastrointestinal (GI) tract, joints and kidneys. Its clinical course typically consists of two phases: initial appearance of purpura and delayed onset of arthralgia, GI symptoms and haematuria. We report the case of an adult patient with IgA vasculitis of the small bowel, without skin involvement, complicated by cytomegalovirus (CMV) enteritis following prednisolone administration. Read More

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http://dx.doi.org/10.1136/bcr-2020-235042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342267PMC

Sixth cranial nerve palsy secondary to compression by dolichoectatic vertebrobasilar artery.

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Medical Imaging, University of Toronto, Toronto, Ontario, Canada.

Dolichoectasia refers to distinct elongation, dilatation and tortuosity of an artery. We present a rare well-illustrated case of dolichoectatic vertebrobasilar artery compressing the cisternal portion of the sixth cranial nerve resulting in chronic sixth nerve palsy. High spatial resolution, three-dimensional, heavily T2-weighted MRI sequences are uniquely positioned to assess the cranial nerves especially in their cisternal and canalicular portions and need to be performed for all patients with non-resolving cranial nerve palsies. Read More

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http://dx.doi.org/10.1136/bcr-2020-234949DOI Listing

Progressive familial intrahepatic cholestasis type 4 in an Indian child: presentation, initial course and novel compound heterozygous mutation.

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Pediatric Gasteroenterology, Indraprastha Apollo Hospital, New Delhi, India.

A 15-year-old boy who had a history of on and off pruritus and jaundice since many years found to have a novel mutation in TJP2 gene. On examination, he had clubbing, splenomegaly, grade 3 oesophageal varices and short stature. Investigation revealed direct hyperbirubinemia with elevated liver enzymes with normal gamma-glutamyl transferase (GGT). Read More

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http://dx.doi.org/10.1136/bcr-2019-234193DOI Listing

Laryngeal granular cell tumour: a very rare diagnosis for a child presenting with hoarse voice in the UK.

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Department of Ear, Nose and Throat Surgery, Imperial College Healthcare NHS Trust, London, UK.

We present a rare case of a paediatric laryngeal granular cell tumour (GCT) of the vocal cord. GCTs are rare clinical entities, thought to arise from Schwann cells. There are only a handful of paediatric laryngeal GCTs in the literature, and therefore, little is known regarding their natural history or preferred management strategies. Read More

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http://dx.doi.org/10.1136/bcr-2019-232851DOI Listing

Gastric metastases from primary breast cancers: rare causes of common gastrointestinal disorders.

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada

We report two cases of gastric metastases from primary breast cancers. In case 1, a 31-year-old woman with right-sided ductal breast carcinoma presented with nausea, vomiting and frank haematemesis, 8 months after mastectomy and adjuvant chemotherapy. An esophagogastroduodenoscopy (EGD) revealed multiple ulcerated gastric lesions secondary to metastatic adenocarcinoma from primary breast tumour. Read More

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http://dx.doi.org/10.1136/bcr-2019-231763DOI Listing

Leprosy mimicking rheumatoid vasculitis with scleromalacia perforans.

BMJ Case Rep 2020 07 5;13(7). Epub 2020 Jul 5.

Department of Rheumatology, King George's Medical University, Lucknow, India.

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http://dx.doi.org/10.1136/bcr-2020-236796DOI Listing

Congenital haemifacial hyperplasia.

BMJ Case Rep 2020 07 5;13(7). Epub 2020 Jul 5.

Division of Oral and Maxillofacial Surgery, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, Delhi, India.

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http://dx.doi.org/10.1136/bcr-2020-236504DOI Listing

Lemierre's syndrome in an intravenous drug user.

BMJ Case Rep 2020 Jul 5;13(7). Epub 2020 Jul 5.

Department of Internal Medicine, Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA

A 29-year-old Dominican man with a history of intravenous heroin use and hepatitis C presented with a 5-day history of fever, dyspnoea, haemoptysis, pleuritic chest pain, abdominal pain, haematochezia and haematemesis. Initial physical examination was significant for scleral icterus, generalised abdominal tenderness to palpation, melaena and blood-tinged sputum. Blood cultures grew species. Read More

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http://dx.doi.org/10.1136/bcr-2020-235390DOI Listing

Pancytopenia and TTP-like picture secondary to pernicious anaemia.

BMJ Case Rep 2020 Jul 5;13(7). Epub 2020 Jul 5.

Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, New York, USA.

A 21-year-old man presented to the emergency department with generalised weakness, weight loss and decreased appetite for few weeks. He had evidence of severe pancytopenia and haemolysis. His peripheral smear with many schistocytes was suspicious for thrombotic thrombocytopenic purpura (TTP). Read More

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http://dx.doi.org/10.1136/bcr-2020-235288DOI Listing

Disseminated cryptococcal disease during treatment with idelalisib and corticosteroids for follicular lymphoma.

BMJ Case Rep 2020 Jul 5;13(7). Epub 2020 Jul 5.

Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.

A patient on a regimen of idelalisib and corticosteroids for a relapse of follicular lymphoma presented to our emergency ward with a fever of unknown origin. Despite the initiation of broad-spectrum antibiotics and fluids, the patient's clinical condition deteriorated. Eventually, a diagnosis of disseminated cryptococcosis was established and immunophenotyping revealed complete absence of circulating B and CD4-T lymphocytes, and a markedly diminished CD8-T lymphocyte count. Read More

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http://dx.doi.org/10.1136/bcr-2020-235216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337623PMC

Sinonasal inverted schneiderian papilloma presenting as a large intraoral lesion.

BMJ Case Rep 2020 Jul 5;13(7). Epub 2020 Jul 5.

Department of Prosthodontics, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India.

Sinonasal inverted schneiderian papilloma (ISP) is a rare tumour, which almost exclusively arises from the mucosa lining, the nasal cavity and the paranasal sinuses. The tumour in its early stages presents as an asymptomatic mass, which may be discovered during routine examination. Large lesions usually measure a few millimetres to centimetres in size and show symptoms such as nasal blockade, recurrent sinusitis, postnasal drip, anosmia, epistaxis, facial pain and headache. Read More

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http://dx.doi.org/10.1136/bcr-2020-234985DOI Listing

Hyponatraemia and cerebral oedema due to a modafinil overdose.

BMJ Case Rep 2020 Jul 5;13(7). Epub 2020 Jul 5.

Brain Injury Rehabilitation Unit, North Bristol NHS Trust, Bristol, Avon, UK.

Modafinil is a non-amphetamine stimulant that is prescribed for narcolepsy-associated sleepiness as well as reported off-licence uses among university students looking to improve wakefulness and focus. There is limited information in the medical literature about supratherapeutic modafinil dosage, symptomatology and management of overdose. We report a case of a healthy 32-year-old man who was found unconscious, having vomited, with an empty modafinil blister strip. Read More

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http://dx.doi.org/10.1136/bcr-2020-234530DOI Listing