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Annals of Internal Medicine: Clinical Cases
Scopus
ISSN 2767-7664 · American College of Physicians · 1.003 artikel di indeks
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Artikel Jurnal
De Novo Esophageal Small-Cell Neuroendocrine Carcinoma in a Patient With Achalasia: A Case Report
Esophageal neuroendocrine carcinoma (NEC) is rare and aggressive, representing 0.4% to 2% of esophageal cancers, with small-cell NEC comprising 95% of cases. Achalasia is known to increase the risk for esophageal malignancy, particularly squamous cell carcinoma. We describe an 81-year-old woman…
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Artikel Jurnal
Coexistence of Wild-Type Transthyretin Cardiac Amyloidosis and Monoclonal Gammopathy in a Patient With Polycythemia Vera
Polycythemia vera is a type of myeloproliferative neoplasm characterized by panmyelosis, with a predominant increase in erythrocyte mass. In contrast, monoclonal gammopathy of undetermined significance is classified as a premalignant plasma cell disorder and is characterized by elevated levels of…
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Artikel Jurnal
From a Papule to Friable Papillary Projections: A Case of Old World Cutaneous Leishmaniasis
This case aims to characterize an unusual cutaneous manifestation in a patient with confirmed cutaneous leishmaniasis, highlighting clinical features that are often underrecognized and may contribute to diagnostic uncertainty. By exploring this atypical presentation, it underscores the potential…
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Artikel Jurnal
Report of Concomitant Intracranial Cysts in Unrelated Patients With Heterozygous Germline NF1 Pathogenic Variants
Neurofibromatosis 1 (NF1) is one of the most common genetic diseases of the central nervous system. The nature of intracranial lesions that are associated with NF1 are yet to be fully defined. Arachnoid, velum interpositum, and odontogenic cysts are among the more common intracranial cystic lesions…
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Isolated Cutaneous Perianal Crohn Disease With Rare Perineal Involvement
We present a rare case of isolated perianal Crohn disease (iPCD) with perineal involvement in a 28-year-old woman who remained free of luminal gastrointestinal symptoms for more than 10 years. The diagnosis was significantly delayed due to clinical overlap with hidradenitis suppurativa and…
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Attenuated Cardiac–Ocular Phenotype of Sanfilippo Syndrome (MPS IIIA) Presenting With Hypertrophic Cardiomyopathy and Cone-Rod Dystrophy
We describe a 39-year-old woman with cone-rod dystrophy and hypertrophic obstructive cardiomyopathy complicated by an apical aneurysm, ventricular tachycardia, and ischemic stroke, ultimately requiring heart transplantation. Histopathology revealed myocardial storage vacuoles, and biochemical and…
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Artikel Jurnal
Isolated Subcutaneous Sarcoidosis (Darier–Roussy Disease) Without Systemic Involvement: Diagnostic Challenge and Remission Following Intralesional Therapy
Subcutaneous sarcoidosis (Darier–Roussy disease) is a rare variant of cutaneous sarcoidosis characterized by painless subcutaneous nodules. We present the case of a 55-year-old woman with a firm, nontender mass overlying her right triceps region, initially misdiagnosed as cellulitis. Biopsy…
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Artikel Jurnal
Unmasking the Diagnosis: A Case of Hemicrania Continua
Hemicrania continua is a rare unilateral headache disorder characterized by autonomic symptoms and complete resolution when treated with indomethacin. We present a case of a woman with a continuous unilateral headache without autonomic features, who had been self-medicating with over-the-counter…
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Artikel Jurnal
Radiation Therapy for Endobronchial Chronic Lymphocytic Leukemia Causing Extrinsic Airway Compression—A Novel Treatment Strategy
Here, we report a case of a very rare manifestation of chronic lymphocytic leukemia (CLL)—lobar lung collapse and partial airway occlusion from direct endobronchial involvement of the disease, complicated by bacterial infections requiring antibiotics. Because this was the only symptomatic site of…
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Artikel Jurnal
Silica Nephrolithiasis From Commonly Used Over-the-Counter Vitamins and Supplements: A Case Report
Silica and calcium carbonate are very rare constituents of renal calculi, historically associated with chronic ingestion of magnesium trisilicate. We present a case of silica and calcium carbonate first-time nephrolithiasis in a 47-year-old man taking multiple over-the-counter vitamins and…
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Artikel Jurnal
An Unusual Rash in a Febrile Adult
We report a 38-year-old man who presented with nonpruritic flagellate erythema, symmetrical polyarthritis, daily high-grade fevers, and unintentional weight loss. Skin biopsy supported the diagnosis of adult-onset Still disease (AOSD), which was established after exclusion of alternative diagnoses…
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Artikel Jurnal
Platelets Disappear Overnight: A Case Report of Vancomycin-Induced Immune Thrombocytopenia
While vancomycin-induced thrombocytopenia (VITP) is typically characterized by gradual platelet decline and recovery, more rapid and severe reexposure presentations remain poorly described in the literature. This case describes a 70-year-old woman with no known history of vancomycin exposure or…
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Artikel Jurnal
Complete Response to Pembrolizumab in Prostate Cancer With Microsatellite Instability–High, Deficient Mismatch Repair, Tumor Mutational Burden–High, and Programmed Death–Ligand 1 Positivity
A 72-year-old man initially presented with prostate cancer and a metastatic right rib lesion. He developed rapid progression on androgen deprivation therapy in 7 months and subsequent treatment with enzalutamide in 3 months. Biomarker studies after progression to castration-resistant prostate…
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Artikel Jurnal
Left Wrist Osteomyelitis Secondary to Mycoplasma orale: A Case Report
Mycoplasma orale is a fastidious oropharyngeal commensal that rarely causes invasive disease. We report a 73-year-old immunocompromised man with destructive, culture-negative wrist osteomyelitis/septic arthritis refractory to multiple antibiotic regimens. Broad-range bacterial polymerase chain…
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Artikel Jurnal
Long-Standing Shunts and Recurrent Cerebrospinal Fluid Pseudocyst Causing Small Bowel Obstruction in an Adult
We report a rare case of a recurrent cerebrospinal fluid (CSF) pseudocyst causing small bowel obstruction in an adult with a long-standing ventriculoperitoneal (VP) shunt for congenital hydrocephalus. Cerebrospinal fluid pseudocysts are uncommon complications of VP shunts and are most frequently…
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Artikel Jurnal
Fulminant Vibrio vulnificus Infection Following Dog Scratch in a Transplant Recipient Who Is Immunosuppressed: A Case Report
A 58-year-old man who is immunosuppressed presented with severe left leg pain 1 day after sustaining a scratch from his dog, which had been swimming in warm coastal water. He quickly developed necrotizing bullae secondary to Vibrio vulnificus bacteremia, progressing to septic shock and multiorgan…
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Artikel Jurnal
Tremors and Memory Loss From Hypomagnesemia and Hypocalcemia Secondary to Long-Term Proton Pump Inhibitor Use
Proton pump inhibitors (PPIs) are commonly prescribed for short-term use but are often taken chronically, including through over-the-counter (OTC) access. Long-term use has been linked to hypomagnesemia and hypocalcemia, which may cause serious complications. A 47-year-old man on PPIs for 5 years…
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Artikel Jurnal
Insulin Autoimmune Syndrome Presenting With Recurrent Hypoglycemia and Extreme Hyperinsulinemia
Insulin autoimmune syndrome (IAS) is a rare but important cause of hypoglycemia. Herein, we describe a case of a 67-year-old White man with recurrent episodes of confusion and fatigue relieved by food intake. Biochemical evaluation revealed profound hyperinsulinemia and an elevated C-peptide level…
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Artikel Jurnal
The Pacemaker Cable as an Unexpected Cause of Recurrent Pulmonary Embolism
Recurrent pulmonary embolism (PE) is uncommon. We report a 39-year-old man with a pacemaker who developed recurrent PEs while receiving rivaroxaban, warfarin, and therapeutic enoxaparin. Evaluation for autoimmunity and thrombophilia was negative. Each episode was preceded by fever, malaise, and…
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Artikel Jurnal
Spontaneous Ecchymosis as Initial Presentation of Acquired Hemophilia A
Hemophilia A, a deficiency of clotting factor VIII, can be congenital, presenting with joint bleeding in childhood, or acquired, a rare subtype presenting as spontaneous bleeding most commonly seen in older adult patients. This report outlines an older adult patient with no history of bleeding…
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