Pembrolizumab is a programmed cell death receptor-1 (PD-1) blocking immune checkpoint inhibitor (ICI) that is a mainstay of cancer treatment. Pembrolizumab has a lower incidence of colitis and diarrhea compared to other ICIs. The current study presents the case of a 30-year-old female patient on pembrolizumab with stage IV colon cancer who presented with diarrhea (50 times a day) and symptoms of colitis.
View Article and Find Full Text PDFBaclofen is a commonly used medication for managing muscle spasticity with the potential of causing life-threatening adverse effects, including encephalopathy as well as withdrawal symptoms including confusion and hallucinations following abrupt discontinuation. Severe toxicity with baclofen is common in patients with kidney disease, hence the importance of dose reduction and monitoring in patients with renal impairment. This article reports a case of encephalopathy with low-dose baclofen in an otherwise healthy young adult concurrently taking ibuprofen and baclofen and aims to underscore the importance of potential drug interaction and patient education when initiating baclofen.
View Article and Find Full Text PDFWe report a case of non-bacterial thrombotic endocarditis in a 52-year-old woman due to ovarian cancer that was complicated by acute ischemic stroke through pulmonary arteriovenous malformation. Echocardiography showed tricuspid valve vegetation and a positive bubble study that revealed pulmonary arteriovenous malformation in the absence of patent foramen ovale. The patient opted for palliative management and was discharged home with comfort care.
View Article and Find Full Text PDFActive surveillance and treatment of hypomagnesemia along with strict avoidance of concurrent offending agents is essential to prevent its grave clinical consequences among patients on carboplatin therapy.
View Article and Find Full Text PDFMyopericarditis is an entity known to present with typical symptoms of viral prodrome and diffuse ST elevation (STE) and/or PR depressions on electrocardiogram (EKG). Atypical presentations of myocarditis such as focal STE have been cited in the literature, reflecting true coronary ischemia. However, myocarditis or pericarditis presenting with focal ST depressions is rarely seen.
View Article and Find Full Text PDFA 66-year-old male with a history of human immunodeficiency virus infection and metastatic bladder cancer presented to our hospital for a further workup of a focal seizure involving the patients left upper extremity. The patient was undergoing active chemotherapy at the time of admission and had a CD4 count of 111. Magnetic resonance imaging of the brain revealed multiple ring-enhancing lesions in the right frontal lobe associated with vasogenic edema, and mass effect at the right frontal horn of the lateral ventricles.
View Article and Find Full Text PDFJ Investig Med High Impact Case Rep
April 2018
Tuberculosis is one of the top 10 causes of death worldwide according to the World Health Organization. Central nervous system involvement is usually the least common presentation of tuberculosis occurring in about 1% of all cases but yet can have very devastating outcomes. Lupus nephritis is one of the most common complications of systemic lupus erythematosus with up to two thirds of patients presenting with some degree of renal dysfunction.
View Article and Find Full Text PDFJ Investig Med High Impact Case Rep
December 2017
Neoplastic lesions that demonstrate neuroendocrine features are rare. However, esophageal tumors containing both adenocarcinomatous and neuroendocrine components are exceedingly rare. Mixed adenoneuroendocrine carcinomas (MANECs) are gastrointestinal tumors with both adenocarcinomatous and neuroendocrine differentiation.
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