American Journal of Medical Case Reports

Tuberculosis remains one of the most important cause of preventable mortality and morbidity worldwide. Cardiovascular involvement in tuberculosis, though relatively rare, can be hemodynamically life threatening if not identified or diagnosed appropriately. Here we are reporting a case of sputum positive pulmonary tuberculosis with dilated cardiomyopathy which improved after administration of antitubercular drug along with decongestive therapy.

American Journal of Medical Case Reports. 2015, 3(2), 49-52. DOI: 10.12691/ajmcr-3-2-9
Pub. Date: February 02, 2015

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Pseudotumor Gastric AL Type Amyloidosis Mimicking Malignancy. A Case Report

by Imed Ben Ghorbel, Nabil BelFeki, Thouraya Ben Salem and Mohamed Habib Houman

Case Report

Amyloidosis is an abnormal extracellular deposition of insoluble proteins, which is associated with an involvement of the gastrointestinal tract in 50 to 70% of cases. In primary amyloïdosis (light chain amyloïdosis), localized gastric involvement is a rare finding which can mimick malignancy. We report the case of a 75-year-old woman, admitted with upper digestive outlet obstruction and generalized edema. Upper endoscopy revealed fundic burgeoning ulcerative process. Gastric biopsy concluded to AL type amyloidosis and no malignant tumor was found. Etiological treatment consisted of melphalan and prednisone every 6 weeks. The patient improved from her gastric complaints, and edema. The current decline is 24 months.

American Journal of Medical Case Reports. 2015, 3(2), 46-48. DOI: 10.12691/ajmcr-3-2-8
Pub. Date: January 30, 2015

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Unexpected Acute Myocardial Infarction Due to Disseminated Intravascular Coagulation

by Motoharu Shibusawa, Takaaki Matsumura, Hisashi Tsutsumi, Yuuji Itou and Yoshiaki Shibata

Case Report

An autopsy case of gastric cancer accompanied by disseminated intravascular coagulation (DIC) that resulted in unexpected acute myocardial infarction (AMI) is reported. A 66-year-old man was introduced to our hospital and was diagnosed with gastric cancer accompanied by bone marrow carcinomatosis with DIC. On the fourteenth day of admission, he experienced dyspnea. He died on the fifteenth day. An autopsy was performed. The autopsy findings revealed myocardial infarction from the lateral to anterior and posterior ventricular walls, thromboembolism in the right coronary artery, and nonbacterial thrombogenic carditis of the mitral valve. A diagnosis of AMI was made by the autopsy findings. In cases accompanied by DIC, thrombus may develop in coronary arteries, resulting in AMI. In these patients, the typical symptoms of AMI and ST-segment elevation and pathologic Q waves on electrocardiogram are often not observed. The importance of this phenomenon warrants consideration in clinical practice.

American Journal of Medical Case Reports. 2015, 3(2), 42-45. DOI: 10.12691/ajmcr-3-2-7
Pub. Date: January 30, 2015

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Systemic Lupus Erythematosus Revealing Splenic Marginal Zone Lymphoma. A Case Report

by Bel Feki N, Smiti Khanfir M, Said F, Hamzaoui A, Ben Salem T, Ben Ghorbel I, Lamloum M, Ben Romdhane N and Houman MH

Case Report

Autoimmune manifestations are common in splenic marginal zone lymphoma (SMZL) and are sometimes the presenting feature of the disease. We report Herein the case of a 72-year old woman presenting with systemic lupus erythematosus revealing SMZL. To our knowledge, there are only 3 case reports of SLE associated to SMZL. In case of authentic autoimmune disease with unusual clinical features Physician awareness is recommended, to rule out associated lymphoproliferative syndrome.

American Journal of Medical Case Reports. 2015, 3(2), 40-41. DOI: 10.12691/ajmcr-3-2-6
Pub. Date: January 30, 2015

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A Serious Diagnosis often Missed: Salicylate Induced Pulmonary Edema (SIPE)

by Lakshmi Kant Pathak, Vimala Vijayaraghavan and Chirag Chavda

Case Report

Salicylate induced pulmonary edema is mostly a un recognized diagnosis as most physicians have little or no experience in treating it. Therefore there are only 140 possible case reports of SIPE in literature making it a rare entity. Failure to recognize this condition may lead to significant morbidity and mortality. Therefore the objective of this case report is to make aware of the possibility of this diagnosis in patients presenting with neurological changes, fever, and dyspnea and anion-gap metabolic acidosis. It also discusses the best current practice guidelines on treatment of this condition based on present literature. A more definitive guideline on its diagnosis and treatment needs further research and study.

American Journal of Medical Case Reports. 2015, 3(2), 37-39. DOI: 10.12691/ajmcr-3-2-5
Pub. Date: January 28, 2015

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Hypoglyceamia due to Paranoeplastic Secretion of Insulin in a Patient with Metastasizing Colon Cancer

by Nadia Charfi, Lilia Affes, Mouna Elleuch, Wafa Ben Saada, Nabila Rkik, Faten Hadj Kacem, Mouna Mnif, Fatma Mnif and Mohamed Abid

Case Report

Paraneoplastic hypoglycemia by insulin secreting is rarely described in literature. We review rare cases of paraneoplastic hypoglycemia due to insulin secreting non islet cell tumor diagnosed in a 51 years old patient. This man has an advanced colon cancer with hepatic metastasize. He was admitted in our department for frequent, severe, organic hypoglycemia. Hormonal finding showed elevated serum levels of insulin and c peptide associated with normal serum levels of IGF1 and IGF2. The patient was treated by diet, prednisolone, diazoxid and the metastasize was surgically removed. So that, Hypoglycemia disappeared quickly after the treatment.

American Journal of Medical Case Reports. 2015, 3(2), 34-36. DOI: 10.12691/ajmcr-3-2-4
Pub. Date: January 28, 2015

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Cutaneous Leukocytoclastic Vasculitis, Pleural Effusion and Splenic Abscess as Unusual Presentation of Typhoid Fever

by Imed Ben Ghorbel, Nabil BelFeki and Mohamed Habib Houman

Case Report

We report a case of typhoid fever with an unusual presentation: prolonged fever with cutaneous vasculitis, pleural effusion and splenic abscess. The diagnosis was made upon Widal serology, and after ruling out other causes of leukocytoclastic vasculitis. The outcome was favourable with antibiotics alone and without surgery.This is the second case of cutaneous leukocytoclastic vasculitis associated with typhoid fever in adults.

American Journal of Medical Case Reports. 2015, 3(2), 32-33. DOI: 10.12691/ajmcr-3-2-3
Pub. Date: January 28, 2015

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Fever of Unknown Origin with Psychiatric Complaints in a Patient with Rubinstein-Taybi Syndrome

by İbrahim Taymur, Buket Belkız Güngör, Cenk Aypak, Ahmet İnel and Özgür Dağlı

Case Report

Rubinstein–Taybi syndrome (RTS) is a rare genetic disorder characterized by mental retardation, postnatal growth deficiency, microcephaly, specific facial characteristics, broad thumbs, and big toes. Presence of dental problems and inadequate follow-up in RTS, as well as difficulty in self-care, poses a substantial health threat. This case report describes the evaluation of a 27-year-old female RTS patient diagnosed with fever of unknown origin (FUO) with psychiatric complaints and underlines the importance of physical examination including oral cavity in patients with difficulties in expressing their physical complaints.

American Journal of Medical Case Reports. 2015, 3(2), 30-31. DOI: 10.12691/ajmcr-3-2-2
Pub. Date: January 26, 2015

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The Corpus Callosum Agenesis: A Case Report

by Derbali F, Ben Fradj F, Rezgui A, Karmani M, Hajji R, Ben Abdallah O, Mzabi A and Laouani C

Case Report

Agenesis of corpus callosum is the most frequent cerebral malformations. Diagnosis is based on brain imaging. It is most often asymptomatic. Hyperhidrosis can be part of his clinical picture. We present the case of a 49 year old patient, unemployed, with a history of frontal lobe epilepsy and extra pyramidal syndrome. He consulted for a left hemiparesis with sweating attacks. Physical examination showed facial dysmorphism, psychomotor retardation, hemiparesis predominantly left brachiocephalic and bilateral pyramidal syndrome. Brain imaging showed, in addition to cerebral ischemia, a corpus callosum agenesis. This observation helped to highlight a rare disease whose clinical presentation is nonspecific. This malformation is to seek at prenatal, postnatal and even at the adulthood. Hyperhidrosis attacks without obvious underlying pathology should suggest this diagnosis.

American Journal of Medical Case Reports. 2015, 3(2), 27-29. DOI: 10.12691/ajmcr-3-2-1
Pub. Date: January 25, 2015

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