Recurrent syncope driven by unique ‐variant angina pectoris
Key Clinical MessageThe patient's vasospastic variant angina manifested as syncope with asymptomatic ischemic episodes, and repeated 24-h dynamic electrocardiogram and coronary angiography examinations combined with coronary provocation spasm tests were necessary for its diagnosis and management. (Source: Clinical Case Reports)
Source: Clinical Case Reports - February 2, 2024 Category: General Medicine Authors: Guang Yang, Yanna Lei, Minglong Xin, Wenhu Xu, Guangxian Zhao, Xueying Jin, Meina Piao, Xiang Li, Xian Wu Cheng Tags: CASE REPORT Source Type: research

Endoscopic view of the vertebra during laser balloon ablation of paroxysmal atrial fibrillation
Key Clinical MessageLeft atrial posterior wall on the vertebra is often difficult to obtain stable tissue contact with ablation-catheter. Laser balloon ablation is effective because the compression from the vertebra can be visualized through endoscopy.AbstractWhen performing pulmonary vein isolation (PVI) with radiofrequency, left atrial posterior wall on the vertebra is often difficult to obtain stable tissue contact with ablation-catheter because of the movement of the ablation point. Laser balloon ablation is effective for the achievement of durable PVI in cases with such anatomical characteristics because the compressi...
Source: Clinical Case Reports - February 2, 2024 Category: General Medicine Authors: Shun Sasaki, Yuki Shibuya, Hitoshi Minamiguchi, Takashige Sakio, Yuma Hamanaka, Takashi Kanda, Yasuhiro Ichibori, Nobuhiko Makino, Atsushi Hirayama, Yoshiharu Higuchi Tags: CASE IMAGE Source Type: research

Three cases highlighting possible discrepancies in the interpretation of transgender DXA scores
We present the baseline (prior to beginning GAHT), 6-month, and 1-year follow-up DXA data along with pertinent labs to include 25-OH vitamin D, calcium, and alkaline phosphat ase, for 2 transgender males (assigned female at birth) and 1 transgender female (assigned male at birth) undergoing GAHT who had lowZ-scores andT-scores suggestive of osteoporosis. Multiple studies have analyzed the BMD data of individuals taking GAHT over time, which identify possible causes for low baselineZ-scores for transgender females, but less so for transgender males. Other than positional statements, guidelines remain unclear regarding diagn...
Source: Clinical Case Reports - February 2, 2024 Category: General Medicine Authors: Sebastian C. De  La Torre, Cassandra M. Godar, Mohamed K. M. Shakir, Thanh D. Hoang Tags: CASE SERIES Source Type: research

Leukocytoclastic vasculitis caused by sulfamethoxazole ‐trimethoprim
Violaceous round papules and a surrounding rim of macular purpura coalescing into plaques on both feet 8  days after starting sulfamethoxazole-trimethoprim. Key Clinical MessageLeukocytoclastic vasculitis is a rare, small-vessel vasculitis that can be caused by sulfamethoxazole-trimethoprim. Most presentations involve skin rash but serious systemic involvement is possible. The precise mechanism is unclear but genetic and immune-based tissue damage has been postulated. The rash often resolves with discontinuation of sulfamethoxazole-trimethoprim with or without steroids. (Source: Clinical Case Reports)
Source: Clinical Case Reports - February 2, 2024 Category: General Medicine Authors: Parjanya Bhatt, Nadine Montreuil, Ayoola Olayiwola, Tanya Quiroz, Felipe Ruiz, Folusakin Ayoade Tags: CASE REPORT Source Type: research

The clinical and genetic characteristics of maternally inherited diabetes and deafness (MIDD) with mitochondrial m.3243A   >  G mutation: A 10‐year follow‐up observation study and literature review
Key Clinical MessageMaternally inherited diabetes and deafness (MIDD) is often caused by the m.3243A  >  G mutation in mitochondrial DNA. Unfortunately, the characteristics of MIDD, especially long-term outcomes and heteroplasmic changes, have not been well described previously. The purpose of this study was to describe the clinical and genetic features of a family with MIDD after 10 years of foll ow-up.A 33-year-old male patient with typical characteristics of MIDD, including early-onset diabetes, deafness, and low body mass index, was admitted to our department. Further investigation revealed that the vast major...
Source: Clinical Case Reports - February 2, 2024 Category: General Medicine Authors: Shasha Zheng, Juanjuan Wang, Minxian Sun, Pei Wang, Wei Shi, Zhongzhi Zhang, Zhongjing Wang, Hongmei Zhang Tags: CASE REPORT Source Type: research

Myeloid sarcoma presenting as fingertip necrosis with underlying suppurative tenosynovitis: A case report
We report an unusual case presentation of a patient with necrotic tissue changes of the right second and third fingers, found to have myeloid sarcoma withStaphylococcus-positive tenosynovitis and underlying acute myeloid leukemia, to highlight the importance of comprehensive evaluation in patients with atypical wounds. (Source: Clinical Case Reports)
Source: Clinical Case Reports - January 31, 2024 Category: General Medicine Authors: Grace Bloomfield, Francisca Finkel, Abdel Mun ’em Al Hourani, Shivani Gupta, Esha Jain, Amanda Magee Tags: CASE REPORT Source Type: research

Late ‐onset aspirin‐related hemolysis and subsequent subdural hemorrhage in patient with glucose‐6‐phosphate dehydrogenase deficiency
Key Clinical MessageAspirin-related hemolysis in G6PD deficiency could be late-onset during long-term administration. Hemolytic anemia could continue for a relatively long time in elder patient with G6PD deficiency, which might be related to other adverse events.AbstractAspirin-related hemolysis in G6PD-deficient individuals was generally reported among patients who received high-dose supplements within several days after ingestion. The safety of long-term and low-dose (50 –325 mg/day) aspirin in patients coexist G6PD deficiency and cardiovascular disease is neglected in clinical practice. In this case, we observed a l...
Source: Clinical Case Reports - January 30, 2024 Category: General Medicine Authors: Jianle Li, Yicong Chen, Weisheng Deng, Jinsheng Zeng Tags: CASE REPORT Source Type: research

Prolonged generalized osteomalacia associated with a sinonasal cavity phosphaturic mesenchymal tumor: A case report
We presented a patient with a 5-year history of progressive osteomalacia who recently experienced a major pathological bone fracture. Laboratory findings showed a persistent low serum phosphate, normal calcium, elevated alkaline phosphatase activity, high parathyroid hormone levels, and increased renal excretion of phosphate. According to ultrasonography and nuclear imaging, there was no evidence of parathyroid adenoma. During further diagnostic assessment, a sinonasal cavity tumor was found and resected. Histologically, the tumor was composed of bland spindle cell proliferation in the background of a calcified matrix with...
Source: Clinical Case Reports - January 30, 2024 Category: General Medicine Authors: Mehdi Montazer, Naser Tayyebi Meibodi, Elmira Teymouri, Zohreh Mousavi, Sedigheh Reisian, Motahare Ebrahimnejad Tags: CASE REPORT Source Type: research

Predicting valuable missense variants with AlphaMissense in a multiple pulmonary infection patient
Clinical course of the patient. Sulfamethoxazole and ceftriaxone (day 12 –17), linezolid (day 18), moxifloxacin (day 136–140), meropenem (day 141–161), faropenem and rifampicin (day 161). (A, B) Contrast-enhanced CT of the pulmonary at day 65. (C, D) Contrast-enhanced CT of the pulmonary at day 132. Key Clinical MessageAlphaMissense is proficient in predicting the clinical classification of missense variants. we utilized AlphaMissense to find disease-relevant variants within a polymicrobial pulmonary infection case. Exome sequencing was performed in this patient, and AlphaMissense and Phenolyzer were combined to inve...
Source: Clinical Case Reports - January 30, 2024 Category: General Medicine Authors: Tianyuan Wang, Jindi Ma, Yuan Shu, Bao Hong, Zhouhan Wang, Yingfeng Lu, Xiaopeng Yu, Xi Huang, Yimin Zhang Tags: CASE REPORT Source Type: research

A challenging transseptal mitral valve in valve case report: Success and safety
We reported a 72-year-old patient with mitral bioprosthesis degeneration successfully receiving TMVI. The procedure has lower morbidity and mortality rate than the surgical approach but can be accompanied by several complications, especially when conducted by an inexperienced operator. (Source: Clinical Case Reports)
Source: Clinical Case Reports - January 30, 2024 Category: General Medicine Authors: Azin Alizadehasl, Samira Eslami, Kimia Vakili, Seifollah Abdi, Ata Firouzi, Rasoul Azarfarin, Amir Abdi Tags: CASE REPORT Source Type: research

Disabling tinnitus and third nerve palsy following pontine hemorrhage: Application of ICF framework
This report describes a 31-year-old male with hypertension who developed a pontine hemorrhage. The neurological deficits included left-third nerve palsy, right-sided weakness, and disabling tinnitus. Tinnitus is linked to central auditory pathway disruption. Magnetic resonance imaging revealed the hemorrhagic lesion and additional micro-hemorrhages. The International Classification of Functioning, Disability, and Health (ICF) enhances rehabilitation by characterizing multifaceted stroke disability. The ICF profile revealed impairments in body structures/functions, limitations in activities/participation, and positive/negat...
Source: Clinical Case Reports - January 30, 2024 Category: General Medicine Authors: Vijaya Prakash Krishnan  Muthaiah, Ignacio Novoa Cornejo, Sabarish Hariharan, Murugaraj Thyagarajan, Krishnamoorthy Gunasekaran Tags: CASE REPORT Source Type: research

Ovarian leiomyoma accompanied by a neglected abdominal wall leiomyoma: A case report and literature review
Key Clinical MessageOvarian leiomyoma and abdominal wall leiomyoma are both rare clinical entities. Here, we report the rare case with ovarian leiomyoma accompanied by a neglected abdominal wall leiomyoma to raise the awareness of clinicians of ovarian leiomyoma and multiple occurrences of benign leiomyoma for appropriate diagnosis. (Source: Clinical Case Reports)
Source: Clinical Case Reports - January 30, 2024 Category: General Medicine Authors: Jing Li, Mingxing Sui, Xiaodan Sun Tags: CASE REPORT Source Type: research

Atypical anterior wall fracture extending to anterior inferior iliac spine with preservation of pelvic brim: A case report and literature review
We report on a 33-year-old case of an acetabular anterior wall fracture extending to the anterior inferior iliac spine. He was prepared for the stress test and hip stability checked, that was unstable in extension and external rotation. The joint was exposed with the Smith –Peterson approach. Hip congruency was restored, and the AIIS fragment was stabilized by open reduction. Acetabular anterior wall fracture involving AIIS with preservation of pelvic brim is a rare equivalent of anterior wall fracture that jeopardizes hip stability and should be managed surgically. Anterior approaches are preferred in order to visualize...
Source: Clinical Case Reports - January 29, 2024 Category: General Medicine Authors: Reza Zandi, Shahin Talebi, Akbar Ehsani, Narges Bazgir Tags: CASE REPORT Source Type: research

Sarcomatoid hepatocellular carcinoma mimics hepatic abscess on contrast ‐enhanced ultrasound
A 71-year-old male patient with a mass located in the liver was described by imaging, including routine abdominal ultrasound, contrast-enhanced ultrasound, plain computer tomography, and enhanced computer tomography. A diagnosis of sarcomatoid hepatocellular carcinoma (SHCC) was confirmed by pathological examination. Key Clinical MessageSarcomatoid hepatocellular carcinoma (SHCC) is a rare subtype of hepatocellular carcinoma characterized by abdominal pain or persistent fever with an inflammatory reaction. Here, we report a case of SHCC mimicking hepatic abscess described by not only ultrasonography but also computer tomog...
Source: Clinical Case Reports - January 29, 2024 Category: General Medicine Authors: Haibo Luo, Xiaoling Leng, Guiwu Chen, Wenqin Liu, Yanhua Xie Tags: CASE IMAGE Source Type: research

An unusual case of Zieve's syndrome in a 36 ‐year‐old male with latent autoimmune diabetes of adult and disseminated intravascular coagulation
Key Clinical MessageZieve's syndrome, associated with chronic alcoholism, manifests as hemolytic anemia, transient hyperlipidemia, and cholestatic jaundice. Key symptoms comprise nausea, abdominal pain, and jaundice. Diagnosis relies on recognizing the triad in those with an alcohol use history. Supportive management includes blood transfusions and alcohol cessation. The exact pathophysiology remains uncertain, with hypotheses ranging from alcohol-induced liver damage to autoimmune processes. The report emphasizes diagnostic complexities, particularly when concurrent with autoimmune disorders such as latent autoimmune diab...
Source: Clinical Case Reports - January 29, 2024 Category: General Medicine Authors: Rushit Zalavadiya, Jugal Hiren Bhatt, Irfan Nagori, Nency Kagathara, Srijana Neupane Tags: CASE REPORT Source Type: research