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BMJ Case Reports

Hideharu Hagiya
No abstract text is available yet for this article.
February 18, 2019: BMJ Case Reports
Rajendra Prasad Anne, Venkataseshan Sundaram, Sourabh Dutta, Praveen Kumar
Intrauterine transfusion is one of the mainstays of treatment in isoimmunised pregnancies guided by the changes in middle cerebral artery Doppler of the fetus. The common postnatal complications associated with Rh isoimmunisation are high unconjugated bilirubin requiring blood exchange transfusions, cholestasis due to bile inspissation, thrombocytopenia and anaemia. Hyperferritinaemia is an uncommon adverse effect observed in Rh isoimmunised pregnancies. In this case report, we describe the clinical course of a Rh isoimmunised neonate with hyperferritinaemia and transfusion acquired cytomegalovirus disease which resolved...
February 18, 2019: BMJ Case Reports
Shamick Biswas, Nihar Vijay Kathrani, Saini Jitender, Arun Kumar Gupta
We report the first case of a post-traumatic direct carotid cavernous fistula (CCF) treated with the XCalibur aneurysm occlusion device, which is a balloon mounted stent with flow diversion effect. Two devices were deployed across the fistula in an overlapping manner, resulting in complete occlusion of the fistula. Flow diversion with this device can provide a safe and alternative treatment option in direct CCF.
February 18, 2019: BMJ Case Reports
Harini Bejjanki, Olanrewaju A Olaoye, Alfonso H Santos, Abhilash Koratala
No abstract text is available yet for this article.
February 15, 2019: BMJ Case Reports
Akanksha Agrawal, Nathan Davis, Ronan Hsieh, Seth Stallard
No abstract text is available yet for this article.
February 15, 2019: BMJ Case Reports
Yunzu Michele Wang, Jun Qin Mo, Dennis John Kuo, Victor Wong
We describe an unusual case of pre-B lymphoblastic leukaemia presenting with a unilateral maxillary sinus mass in which biopsies of the primary mass and the bone marrow demonstrated conflicting immunophenotyping results. The extramedullary mass was consistent with a precursor B-cell malignancy, while the bone marrow was initially reported as a possible mature B-cell malignancy. The treatments for the two are fundamentally different, which necessitated a delay in the initiation of his chemotherapy until a clear diagnosis was made...
February 15, 2019: BMJ Case Reports
Davyd Greenish, Karen Watura, Ian Harding
A 73-year-old man underwent bilateral spinal decompression of L4/5 for severe spinal canal stenosis, requiring minimal analgesia and providing immediate relief. Two days post-operatively, he presented with new onset bilateral leg pain and difficulty mobilising. MRI demonstrated spinal epidural lipomatosis (SEL), which was not present pre-operatively, at L5/S1. Further surgery was performed with decompression of L5/S1 through removal of epidural fat. At both 3 weeks and 5 months follow-up clinics, the patient was asymptomatic...
February 15, 2019: BMJ Case Reports
Carla Steytler, Ahmed A Darwish, Sergey Popov, Cathy Morley-Jacob, Daniel C Aronson
Neuroblastoma metastasizing to the ovary is rare. We report the 10th case and review the scarce literature. A 5-year-old girl with stage M neuroblastoma presented with an upper abdominal and a pelvic mass. Evaluation after induction showed very good tumour response with three remaining localisations: two abdominal and one pelvic. At gross total resection, the pelvic mass appeared to be the enlarged and abnormal right ovary and was removed completely. Pathology showed an ovarian metastasis. On completion of her postoperative treatment, she achieved complete remission...
February 15, 2019: BMJ Case Reports
Saqib Mehdi, Vishwajeet Singh, Rahul Janak Sinha, Siddharth Pandey
No abstract text is available yet for this article.
February 13, 2019: BMJ Case Reports
Gurpreet Anand, Andrea Bink, Felix Beuschlein, Christoph Schmid
A 47-year-old Caucasian man was referred to our clinic with a severe clinical and biochemical phenotype of endogenous hypercortisolism for further evaluation and treatment. In addition to confirming adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome, we found left temporal hemianopsia, massively increased prolactin, increased growth hormone/insulin-like growth factor 1 values, hypogonadotropic hypogonadism and central hypothyroidism. As the cause of these abnormalities we revealed an invasive macroadenoma of the pituitary secreting ACTH, prolactin and growth hormone, resulting not only in a clinically predominant picture of Cushing's syndrome but also causing hypogonadotropic hypogonadism and central hypothyroidism...
February 13, 2019: BMJ Case Reports
Jasmene Uppal, Brent Burbridge, Terra Arnason
Osteonecrosis, also known as avascular necrosis, is a condition that causes significant morbidity and loss of function. It is a common complication seen with supraphysiological steroid use. Early diagnosis is critical as it impacts prognosis. We report a 20-year-old man who developed bilateral osteonecrosis of the hip following 6 years of low-dose steroid replacement therapy for panhypopituitarism secondary to a transsphenoidal resection of a growth hormone-secreting pituitary macroadenoma. The patient presented with several weeks of right-sided hip pain and significant loss of function...
February 13, 2019: BMJ Case Reports
Kiyoshi Shikino, Masatomi Ikusaka
No abstract text is available yet for this article.
February 13, 2019: BMJ Case Reports
Lorena Falk, Delwyn Dyall-Smith, Wilhelm Stolz, Brigitte Coras-Stepanek
No abstract text is available yet for this article.
February 13, 2019: BMJ Case Reports
Michael S Lundin, Manohar R Chintu
No abstract text is available yet for this article.
February 13, 2019: BMJ Case Reports
Yasmin Aghajan, Denise M Malicki, Michael L Levy, John Ross Crawford
Paediatric high-grade gliomas, including glioblastoma and anaplastic astrocytoma, make up 8%-12% of paediatric central nervous system tumours 1 and have poor prognosis, with 2-year survival less than 30% 2 and overall survival less than 10%. The only known prognostic factors in this population include extent of resection and tumour histological grade. We present the case of a 9-year-old boy with disseminated anaplastic astrocytoma treated with subtotal resection, craniospinal radiation and temozolomide, with 8-year survival despite metastatic disease at presentation and subtotal resection...
February 13, 2019: BMJ Case Reports
Manjunath Maruti Pol, Surabhi Vyas, Priyanka Singh, Yashwant Singh Rathore
A 70-year-old woman was referred to our hospital from primary health centre with complaints of pain in the abdomen, swelling and discharging sinus in the right hypochondrium since 2 years. She had received anti-tubercular treatment for 18 months as the wedge biopsy of the sinus tract suggested granulomatous lesion. As the symptoms did not subside she was referred to our hospital. Her blood investigation reports at our hospital were normal. Ultrasound of the abdomen suggested cholelithiasis with normal common bile duct...
February 13, 2019: BMJ Case Reports
Sindhuja Kesavan, Ramakrishnan Parthasarathi, Prakhar Gupta, Chinnusamy Palanivelu
The pararectal space or presacral space is a potential site for various cysts and tumours because it consists of many types of embryonic tissues. Although epidermoid cyst is a well-known entity, encountering a pararectal epidermoid cyst is relatively rare. The incidence of cystic tumours in the pararectal space has been reported to be 1 in 40 000 to 63 000 patients. Most of the tumours are asymptomatic and are incidentally discovered during routine imaging studies. Herein, we report a case of pararectal epidermoid cyst in a 51-year-old woman which was managed laparoscopically in a gastroenterology institute in South India...
February 13, 2019: BMJ Case Reports
James Foley, Rawan Elhelali, Dineo Moiloa
Bilateral patellar tendon rupture is an extremely rare occurrence, especially in otherwise healthy individuals without systemic disease. The authors report the case of a man who presented with simultaneous, spontaneous bilateral rupture of his patellar tendons. He had a history of unilateral patellar tendinopathy but no other predisposing risk factors such as steroid or fluoroquinolone use. He underwent surgical repair and following intensive rehabilitation, he returned to baseline physical activity 6 months post injury...
February 13, 2019: BMJ Case Reports
Anthony A Donato, Ronald Krol
Programmed cell death-1 (PD-1) inhibitors stimulate immune recognition of tumour cells in cancer patients, but have significant autoimmune side effects including pneumonitis. We report the case of a patient with asthma and mild eosinophilia who developed unusual pulmonary side effect of bronchiectasis, severe eosinophilia (absolute eosinophil count: 3200 c/mm3 ) and elevated IgE levels (7050 IU/mL; normal: <164 IU/mL) 4 months into therapy with the PD-1 inhibitor pembrolizumab. Aspergillus fumigatus IgG was elevated at 15...
February 13, 2019: BMJ Case Reports
John Williamson, Saif Huda, Dinesh Damodaran
Recreational use of nitrous oxide as a 'legal high' is increasing in the UK. Physicians should be 'street wise' to this increasing prevalence and aware of the potential neurological complications which may result from misuse. We describe a 17-year-old male patient who presented to neurology with a severe myelopathy following prolonged recreational use of nitrous oxide. MRI demonstrated characteristic changes affecting the dorsal columns and blood tests demonstrated a 'functional' B12 deficiency. Clinical and radiological improvement was noted following initiation of vitamin B12 replacement...
February 13, 2019: BMJ Case Reports
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