The American journal of case reports
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Review Case Reports
Durable Response of Leptomeningeal Metastasis of Breast Cancer to Salvage Intrathecal Etoposide After Methotrexate: A Case Report and Literature Review.
Leptomeningeal metastasis (LM) is recently on the rise as one of important clinical issues in the management of metastatic breast cancer (MBC). Clinical research on salvage intrathecal chemotherapy after failure of first-line treatment for MBC patients with LM has rarely been reported. ⋯ Intrathecal etoposide can be considered as an additional treatment option for LM in breast cancer. Further large clinical studies are necessary to investigate the effectiveness and safety of the treatment.
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This case report highlights serious cardiovascular adverse effects with a conventional dose of trazodone as a result of its potential interaction with omeprazole. ⋯ Due diligence and meticulous attention to detail needs to be exercised to uncover drug interactions as potential causes of lethal and nonlethal patient symptomatology, as in this case of syncope caused by concomitant use of trazodone and a widely prescribed medication, omeprazole.
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As the incidence of meningeal carcinomatosis (MC) in non-small cell lung cancer (NSCLC) patients has been increasing, MC has recently become an important clinical problem in the management of NSCLC. However, development of new treatments is lacking and a standard treatment guideline is not yet available. Research on salvage intrathecal chemotherapy after failure of first-line treatment for NSCLC patients with MC has rarely been reported in the literature. Here, we report the case of an NSCLC patient with MC who showed durable response to salvage intrathecal etoposide subsequent to failure of first-line methotrexate. ⋯ To our knowledge, this is the first case report in which intrathecal etoposide was successfully used to treat MC from NSCLC after failure of MTx. This case report might provide preliminary evidence of the feasibility of intrathecal etoposide as salvage intrathecal chemotherapy (ITC). Further clinical trials including larger numbers of patients are necessary to evaluate the role of this ITC regimen for NSCLC patients with MC.
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Review Case Reports
Atypical hemolytic-uremic syndrome: a case report and literature review.
Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by hemolysis, thrombocytopenia, and renal dysfunction. It is a disease related to genetic mutations in the alternative complement pathway and has a distinct pathophysiology but is difficult to differentiate from other thrombotic microangiopathies. ⋯ We have a very limited understanding of the genetics and epidemiology of atypical HUS, and the overlapping clinical features sometimes delay diagnosis and initiation of appropriate treatment of this rare disease.