Gastric Pneumatosis: An Atypical Presentation of Desmoid Tumor

Case presentation: A middle-aged woman presented to the emergency department with a chief complaint of abdominal pain, fever, vomiting, and diarrhea. Abdominal computed tomography revealed gastric pneumatosis and air in the portal system. The patient had an unfavorable clinical course with pneumoperitoneum and septic shock due to secondary peritonitis. She underwent emergency laparotomy where neoformation of the mesentery root was found with infiltration of the small intestine and jejunal perforation. The anatomopathological study of the tumor revealed that it was a desmoid tumor. Discussion: To our knowledge this is the first report in the literature of gastric pneumatosis as the initial presentation of a mesenteric desmoid tumor. Although it usually has a benign clinical course, its locally invasive characteristics can lead to critical illness. Physicians shouldn’t overlook these types of complications, as early identification and surgical intervention can modify the prognosis and shorten hospital stay.

Download Full-text

A case of statin-induced liver injury with positive rechallenge with a second statin. Is there a class effect?

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2021-0013 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Giovanna Onfiani ◽

Fabio Nascimbeni ◽

Francesca Carubbi

Keyword(s):

Liver Injury ◽

Clinical Symptoms ◽

High Risk Population ◽

Drug Induced ◽

Case Presentation ◽

Drug Induced Liver Injury ◽

Aged Woman ◽

Cardiovascular Morbidity And Mortality ◽

Middle Aged Woman

Abstract Objectives Statins have proved to reduce cardiovascular morbidity and mortality in high-risk population and are generally well tolerated, although adverse events can occur. Up to 3% of patients develop aminotransferases elevation, which usually normalizes with continued treatment and hardly is associated with clinical symptoms. Serious statin-related liver injury is exceedingly rare. Furthermore, literature regarding rechallenge with a second statin is extremely poor. Some authors caution that re-exposure to these drugs is associated with a more serious liver injury but safe switching to a second statin after drug-induced liver injury (DILI) is also reported. Case presentation We describe a case of a middle-aged woman who developed hepatocellular liver injury after simvastatin dose escalation; a rechallenge with low dose rosuvastatin caused rapid recurrence of DILI. Conclusions In our opinion, clinicians should be very cautious upon rechallenge and closely follow-up patients who experienced statin-induced liver injury when trying re-exposure to another statin.

Download Full-text

Herbal supplement (Combi-5) in the management of COVID 19 individual with mild to moderate symptoms: a case report

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2020-0430 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Augustine Anayochukwu Onyeaghala ◽

Emmanuella Ogechi Onyeaghala ◽

Chinedum Peace Babalola ◽

Oluwasanmi Olayinka Aina ◽

Dadik Jelpe

Keyword(s):

Case Report ◽

Controlled Trial ◽

Herbal Supplement ◽

Early Recovery ◽

Case Presentation ◽

Aged Woman ◽

Clinical Benefits ◽

Middle Aged Woman ◽

Zinc Supplements ◽

Short Time

Abstract Objective To explore repurposing known natural products for managing patients with mild to moderate symptoms of COVID-19. Case presentation We present a case report of a middle aged woman, who was positive to COVID 19, with mild to moderate symptoms; who self –managed at home using well formulated herbal supplement (Combi-5) taken along with vitamin C and Zinc supplements. She recovered within a short time. Conclusions While we may not conclude from this report that Combi-5 was solely responsible for the recovery of the patient, we strongly believe that it played significant role through different mechanisms in facilitating early recovery from the infection. Further studies are needed to evaluate the phytochemical and pharmacological constituents of the supplement; investigate its direct effect(s) on SARS CoV-2 and conduct randomized controlled trial to elucidate its clinical benefits.

Download Full-text

Copanlisib-Associated Skin Toxicity: A Peculiar Case of Copanlisib-Induced Skin Rash in a Patient with Refractory Follicular Lymphoma

Clinical Oncology and Research ◽

10.31487/j.cor.2020.03.07 ◽

2020 ◽

pp. 1-4

Author(s):

Dawood Findakly ◽

Surabhi Amar

Keyword(s):

Follicular Lymphoma ◽

B Cell ◽

Skin Toxicity ◽

Maculopapular Rash ◽

Phosphatidylinositol 3 Kinase ◽

Bone Marrow Biopsies ◽

Case Presentation ◽

Aged Woman ◽

Middle Aged Woman

Background: Phosphatidylinositol 3-kinase (PI3K) is an essential target in lymphoid tumors therapy. Copanlisib is a novel class of medication that targets PI3K and used for the treatment of relapsing or refractory B-cell lymphomas. Case Presentation: A 42-year-old woman presents to our hospital for worsening abdominal pain. Examination pertinent for axillary lymphadenopathy, and abdominal ascites. CT chest, abdomen and pelvis reported multiple lung nodules, pleural effusions, extensive retroperitoneal lymphadenopathy, and peritoneal carcinomatosis. Lymph node and bone marrow biopsies confirmed B-cell follicular lymphoma and fluorescent in situ hybridization (FISH) testing was positive for translocation t(14:18). Her disease was refractory to multiple chemotherapy regimens. Thus, initiated copanlisib therapy with a remarkable response, but the patient developed a diffuse maculopapular rash and skin biopsy-proven to be drug rash. Therefore, copanlisib was discontinued. Conclusion: Here, we report a case of a middle-aged woman who developed a rash after the fifth cycle of copanlisib therapy. This case report will create awareness of evolving possible side effects in this novel chemotherapeutic agent.

Download Full-text

Spontaneous bowel perforation in the setting of colonic involvement with scleroderma

BMJ Case Reports ◽

10.1136/bcr-2019-233220 ◽

2020 ◽

Vol 13 (1) ◽

pp. e233220

Author(s):

Weronika Stupalkowska ◽

Betania Mahler-Araujo ◽

John Bennett ◽

Stavros Gourgiotis

Keyword(s):

Bowel Perforation ◽

Multiorgan Failure ◽

Colonic Perforation ◽

Source Control ◽

Emergency Laparotomy ◽

Colonic Involvement ◽

Abdominal Symptoms ◽

Aged Woman ◽

Middle Aged Woman ◽

Physiological Reserve

Here we present a rare case of spontaneous colonic perforation in a middle-aged woman affected by systemic sclerosis (SSc). In spite of maximal medical support and prompt emergency laparotomy for source control the patient died due to multiorgan failure within 48 hours of admission. This case emphasises that although rarely, patients with scleroderma can present with colonic perforation which unfortunately due to their decreased physiological reserve, can lead to rapid and irreversible deterioration and subsequent death. It is therefore essential that clinicians faced with abdominal symptoms and signs in patients affected by SSc are able to quickly differentiate acute visceral perforation from benign causes.

Download Full-text

MENINGO-ENCEPHALITIS IN A MIDDLE-AGED WOMAN HOSPITALIZED FOR COVID-19

Wiadomości Lekarskie ◽

10.36740/wlek202105142 ◽

2021 ◽

Vol 74 (5) ◽

pp. 1274-1276

Author(s):

Pavel A. Dyachenko ◽

Olha I. Smiianova ◽

Anatoly G. Dyachenko

Keyword(s):

White Cell Count ◽

Lower Lobe ◽

Nasopharyngeal Swab ◽

Case Presentation ◽

Aged Woman ◽

Suspected Tuberculosis ◽

Middle Aged Woman ◽

History Of ◽

The Central Nervous System ◽

Csf Examination

The aim: To pay attention of clinicians to possible lesions of the central nervous system (encephalitis) in patients with COVID-19. Case presentation: A 44-year-old woman was admitted to our clinic because of 2-month-history of mild fever, bilateral lower lobe pneumonia, respiratory failure, generalized weakness, and some neurologic symptoms. SARS-CoV-2 RNA was detected in nasopharyngeal swab. Chest CT demonstrated bilateral pulmonary poly segmental consolidations in the mid and lower zones. Focal hyper intensive abnormalities in various parts of the left hemisphere were found at MR brain imaging in T2WI, and T2 FLAIR mode. Cerebrospinal fluid (CSF) examination showed a white cell count of 31/uL (normal <5/uL), protein 0.73 g/L (0.15-0.45), and glucose 1.4 mmole/L (2.2-3.9). Standard CSF neuroviral PCR panel and PCR for SARS-CoV-2 were negative. She was treated with ganciclovir, and dexamethasone. Due to suspected tuberculosis meningitis (cytosis, decreased level of protein and glucose), she also received ex juvantibus a course of anti-TB therapy (isoniazid, kanamycin, and levofloxacin) and made a steady improvement. Conclusion: This case shows that SARS-CoV-2 in association with other pathogens may cause various lesions of the CNS accompanied by severe neurological manifestations in adults.

Download Full-text