Archives of Clinical and Medical Case Reports
EISSN : 2575-9655
Current Publisher: Fortune Journals (10.26502)
Total articles ≅ 321
Latest articles in this journal
Archives of Clinical and Medical Case Reports; doi:10.26502/acmcr
Archives of Clinical and Medical Case Reports, Volume 5, pp 129-136; doi:10.26502/acmcr.96550337
Herein, we first reported a case of undifferentiated sarcoma with epithelioid features harboring TFE3 amplification. A 66-year-old woman with a history of chronic lymphocytic leukemia and chemotherapy presented with a 4 cm palpable nodule in the left lower leg. Microscopically, the large epithelioid tumor cells with remarkable pleomorphism and the small round tumor cells intermingled with each other in a diffuse sheet or a hemangiopericytoma-like vascular growth pattern. Atypical mitotic figures and lymph node metastasis were found while tumor necrosis was absent. Immunohistochemically, the tumor was positive for vimentin, TFE3, and CD34. TFE3 gene amplification was identified by fluorescence in situ hybridization. The patient was alive and well without recurrence or metastasis for 12 months after tumor resection. The tumor should differentiate from PEComa, alveolar soft part sarcoma, epithelioid sarcoma, epithelioid angiosarcoma, and epithelioid rhabdomyosarcoma.
Archives of Clinical and Medical Case Reports, Volume 5, pp 151-155; doi:10.26502/acmcr.96550341
A fifty-one-year-old woman presented with pain related to metastatic breast cancer. The palliative care team was consulted for acute pain management intervention. At home, she was taking methadone for pain control. However, shooting pains down her legs had progressed to an unmanageable level, to the point where she was confided to bed. She was admitted to the hospital and was started on a hydromorphone PCA without complete pain control. Intravenous lidocaine was trialed and significantly improved the patient’s pain and decreased the need for other opioid medications. After these results, she was started on a lidocaine drip without side effects noted.
Archives of Clinical and Medical Case Reports, Volume 5, pp 110-117; doi:10.26502/acmcr.96550335
Déjà vécu is an extremely rare type of identifying paramnesia characterised by the ongoing sensation of having experienced things before. Having the delusional conviction that this sensation is true, patients frequently exhibit recollective confabulation. We here describe an 84-year-old woman with idiopathic, partial déjà vécu, where her symptoms were limited to people and events. An extensive psychiatric and somatic work-up ruled out cerebrovascular disease, epilepsy, dementia, psychosis, or intoxication as a potential underlying cause. Proposed to be a functional disturbance of the limbic system with the involvement of a network that comprises at least the hippocampus and entorhinal cortex, the pathophysiology of déjà vécu is in need of further elucidation. Our patient and her family were offered psychoeducation, which led to acceptance and improved coping. During the two-year follow-up, the déjà vécu sensations continued unaltered, but all involved were less bothered by them, with the patient’s functioning improving both personally and socially.
Archives of Clinical and Medical Case Reports, Volume 5, pp 156-161; doi:10.26502/acmcr.96550342
Background: Viral myocarditis is a leading cause of mortality and cardiovascular morbidity. Its clinical manifestation is heterogeneous varying from asymptomatic courses to presentations with ventricular arrhythmias, heart failure and cardiogenic shock. Right ventricular endomyocardial biopsy is the gold standard in confirming the diagnosis; however, this may not be readily available in some clinical settings. For identification of the viral causative agent, the expanded use of polymerase chain reaction (PCR) techniques may facilitate precise viral genomic diagnosis and improve outcomes. Case presentation: We report a case of a 56 -year-old female patient who presented to the hospital with chest pain mimicking an acute coronary syndrome and stable monomorphic ventricular tachycardia. She had a medical history notable for permanent pacemaker placement due to high-degree atrioventricular block, Brugada-like syndrome and venous thromboembolic disease. Her high-sensitivity troponin was elevated, evidence of myocardial injury, and an echocardiogram showed an ejection fraction of 55% with no wall motion abnormalities. She was managed with IV Amiodarone with subsequent cardioversion. Coronary angiography performed after cardioversion ruled out ischemia as the cause of her ventricular tachycardia. Examination of the nasopharyngal swap by PCR showed a Human Parainfluenza Virus type 3 (HPIV-3), the most likely culprit for her myocardial injury. The presumptive diagnosis of myocarditis complicated with ventricular tachycardia was made after ruling out other common etiologies. Conclusion: This case illustrates a mild presentation of myocarditis and the diagnostic challenge that may ensue due to the lack of specificity of their clinical presentation and the limitation to perform biopsies or cardiac magnetic resonance imaging.
Archives of Clinical and Medical Case Reports, Volume 5, pp 162-170; doi:10.26502/acmcr.96550343
Although the pathogenesis of acne has been elucidated, many patients do not notice improvement with standard treatments alone. Acne is a multifactorial disease, and although there are different aggravating factors such as diet, external stimuli, and stress that varies among individuals, the correct approach to tackling these factors has likely not been considered. Hence, we recommend using Kampo, a traditional Japanese medicine. Kampo examines a patient physically and mentally through unique concepts such as qi, blood, and fluid, and treats using Kampo medicines. With Kampo, both the illness and other aspects such as the general health and well being of the patient are examined and treated. We believe that if Kampo is employed in identifying and treating the aggravating factors of acne of each patient, both the overall therapeutic effect and patients’ motivation for treatment will be improved. This paper classifies the aggravating factors of acne into five categories, decreased barrier function of the skin, excessive secretion of sebum, exacerbation before menstruation, gastrointestinal symptoms, and stress, and introduces effective Kampo medicines in each case.
Archives of Clinical and Medical Case Reports, Volume 5, pp 54-55; doi:10.26502/acmcr.96550325
Archives of Clinical and Medical Case Reports, Volume 5, pp 43-47; doi:10.26502/acmcr.96550323
Langerhans cell histiocytosis (LCH) constitutes a rare group of disorder derived from the macrophages and dendritic cells. The cells in LCH show close similarity to the langerhans cells found in the skin and mucosa and stain positive for CD1a, S100, and CD207 antigens. These cells display the same intracytoplasmic organelles on electron microscopy as seen in Langerhans cells i.e. Birbeck granules. LCH is ten times more prevalent in the paediatric age group as compared to adult population. Females are affected more commonly as compared to the males. LCH can have single- or multi-system types of involvement. Unifocal or multifocal pattern is seen in singlesystem type of disease. The multisystem pattern is often seen in the paediatric population while unisystem pattern is seen in adults. We present case report of a 35 yrs old male patient with multisystemic involvement.
Archives of Clinical and Medical Case Reports, Volume 4, pp 280-284; doi:10.26502/acmcr.96550197
Archives of Clinical and Medical Case Reports, Volume 4, pp 273-279; doi:10.26502/acmcr.96550196