The American journal of the medical sciences
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Review Case Reports
1,25-Dihydroxyvitamin D Mediated Hypercalcemia in Seminoma.
Hypercalcemia has rarely been associated with seminomas. Due to the limited data available, the pathophysiology of hypercalcemia in seminoma has not been established in literature. We present a case of a 59-year-old male who presented with weakness, abdominal fullness, fatigue, constipation, and a 14 lb unintentional weight loss. ⋯ However, few cases present sufficient data to conclude the pathophysiology of hypercalcemia. In all four cases that presented 1,25-hydroxyvitamin D levels, the levels were elevated, suggesting seminomas are associated with 1,25-hydroxyvitamin D mediated hypercalcemia. Interestingly, one case was associated with increased 1,25-hydroxyvitamin D and increased PTHrP levels, suggesting there may be multiple mechanisms of hypercalcemia in seminomas.
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Review Case Reports
A rare case of spontaneous hemoperitoneum in a bone marrow transplant recipient on VV-ECMO.
A 53-year-old man with acute myeloid leukemia received an allogeneic hematopoietic cell transplant (HCT) from a matched unrelated donor. One month after his transplantation, he developed ARDS requiring initiation of VV-ECMO. He suffered from pancytopenia, managed with frequent transfusions, granulocyte-colony stimulating factor (G-CSF) and weekly thrombopoietin receptor agonist. ⋯ His family chose to discontinue ECMO and he passed away peacefully. Spontaneous splenic rupture after GM-CSF has never been reported in patients on VV-ECMO. This manuscript reviews the literature regarding the pathophysiology and clinical manifestation of this rare occurrence.
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Review Case Reports
Severe Hyponatremia Secondary to Syndrome of Inappropriate Antidiuretic Hormone (SIADH): A Rare Cause of Takotsubo (Stress) Cardiomyopathy.
Takotsubo cardiomyopathy is a reversible, stress-induced systolic abnormality of the left ventricular apex.1,2 It can carry significant morbidity and mortality for patients, largely due to associated complications that can occur in the acute setting. While it is most commonly linked with acute emotional or physical stressors, it is now recognized that many acute medical illnesses can precipitate the syndrome. Severe acute hyponatremia (<120 mmol/L) should be considered as a possible causative condition for Takotsubo cardiomyopathy, however reports of its occurrence in the literature are exceedingly rare.3-14 We present a case of a 73-year-old woman who was admitted for severe hyponatremia secondary to syndrome of inappropriate anti-diuretic hormone (SIADH) with a sodium level of 105 mmol/L and a concomitant diagnosis of Takotsubo cardiomyopathy, as well as a review of the epidemiology, pathophysiology, clinical features, diagnosis, treatment and clinical outcomes of Takotsubo cardiomyopathy.
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Review Case Reports
A Case of Winkia neuii (Actinomyces neuii) Vertebral Osteomyelitis and Review of the Literature.
This case report presents an unusual occurrence of Winkia (Actinomyces) neuii vertebral osteomyelitis in a 55-year-old male patient with diabetes mellitus. W. neuii is a distinct species formerly placed within the Actinomyces genus, exhibiting unique morphological and clinical characteristics. ⋯ The patient was successfully managed with a combination of intravenous ceftriaxone during hospitalization and an oral antibiotic regimen for an extended period. This case report contributes to the limited body of knowledge surrounding W. neuii, as well as actinomycotic vertebral osteomyelitis.
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Primary pulmonary lymphoma (PPL) is a rare type of lymphoma, representing <1 % of all primary lung cancers. Mucosa associated lymphoid tissue (MALT) lymphoma, the most common type of PPL, has an indolent slow growing course over years leading to frequent misdiagnoses. ⋯ A transthoracic biopsy confirmed it as MALT lymphoma. This case highlights the unusual manifestation in MALT lymphoma (being in disguise for a decade prior to diagnosis), thus emphasizing the role of meticulous evaluation of prior medical records and biopsy.