Brentuximab-induced pneumonitis and organizing pneumonia: a case report with literiture review.

Introduction and importance: Brentuximab vedotin (BV) is an anti-CD30 antibody approved for various cancers, including refractory Hodgkin lymphoma (HL), anaplastic large-cell lymphoma (ALCL) among others. In general, BV has been found to be well-tolerated, with the most frequently reported side effects being peripheral neuropathy and neutropenia. BV-induced pneumonitis is extremely rare. To the best of our knowledge, this is the sixth reported instance of BV-induced lung toxicity. Case presentation: This case presents a female patient in her forties diagnosed with cutaneous T-cell lymphoma undergoing BV treatment. She developed acute hypoxic respiratory failure, ultimately, underwent a diagnostic evaluation including a computed tomography (CT) scan, which showed bilateral airspace consolidations and ground-glass opacities, suggestive of organizing pneumonia and diffuse alveolar damage. Bronchoscopy with bronchoalveolar lavage and transbronchial biopsy ruled out infection, and pulmonary lymphoma and confirmed the diagnosis of BV-induced pneumonitis. The patient had significant clinical improvement after stopping the offending agent, and starting steroids, with optimal clinical recovery at 8 weeks follow-up. Clinical discussion: Drug-related pneumonitis poses a significant concern in the management of cancer patients. Numerous chemotherapeutic agents, such as bleomycin, cyclophosphamide, methotrexate, thalidomide, and others, have been associated with pulmonary-related toxicities. These adverse effects primarily stem from direct toxicity or immunosuppression-related infections. Less commonly, immune-mediated injury may occur. Conclusion: Physicians must have a high index of suspicion for BV-induced pneumonitis, hence, early recognition with subsequent holding of the causative agent, initiation of immunosuppression with steroids, and occasionally steroid-sparing medications, prevent an otherwise fatal outcome.

The Delayed Presentation of Bilateral Subdural Hematoma Secondary to Epidural Anesthesia for Elective Vaginal Delivery: A Case Report and Review of the Literature.

Epidural anesthesia (EA) involves reaching the spinal epidural space with an anesthetic drug injection. This procedure provides pain relief during labor. Although EA can lead to some complications, subdural hemorrhage (SDH) is a rare adverse event associated with it. We report the case of a 25-year-old female patient who presented to our emergency department with a one-month history of headaches and associated blurred vision following a normal vaginal delivery with EA. She was initially treated as a case of post-dural puncture headache (PDPH), with no improvement. Finally, the diagnosis of bilateral SDH was made based on a brain MRI. She required surgical intervention, which led to a positive prognosis and a full return of normal baseline neurological functions. Only a few reports in the literature have indicated the possibility of cranial subdural hematoma formation associated with spinal or epidural analgesia. Our patient experienced a delay in her diagnosis and treatment, as SDH following EA is a rare entity. It is important to follow up with such patients and consider other possibilities when symptoms fail to resolve. Also, reporting these cases is crucial to assist clinicians in early diagnosis and treatment, and to avoid disastrous outcomes.

A Case of Bacterial Thyroid Abscess: A Rare Complication With Potentially Serious Consequences.

Thyroid abscess is a rare but potentially serious condition that can affect young females. It is characterized by a localized collection of pus within the thyroid gland, often resulting from a bacterial infection. The occurrence of thyroid abscesses is a rare complication even in immune-compromised individuals. Nevertheless, when they do occur, they can present with symptoms such as neck swelling, pain, fever, and other systemic manifestations. The diagnostic tool of choice for thyroid abscess is ultrasound, and the mainstay of treatment involves a combination of abscess drainage and antibiotics. In this case report, we describe the case of an 11-year-old girl who presented with neck swelling and pain and was subsequently diagnosed with thyroid abscess. The patient was successfully managed with incision and drainage, followed by a course of antibiotics.

A Case of Pulmonary Alveolar Proteinosis in a 15-Year-Old Female Patient.

Pulmonary alveolar proteinosis (PAP) is an extremely rare pulmonary disease that can be classified into primary, secondary, or congenital types. It typically presents with a pattern of interstitial lung disease. This rare condition is even rare in the adolescent or pediatric age group, making this case particularly rare and interesting. We report a case of a 15-year-old girl who presented with a four-month history of dry cough and exertional dyspnea. After performing a high-resolution computed tomography (HRCT) scan and bronchoalveolar lavage (BAL) with analysis of the BAL fluid, she was eventually diagnosed with PAP. She was then referred to a higher qualified center, where a whole lung lavage (WLL) was performed, resulting in significant improvement of her symptoms.

Case of left atrial myxoid sarcoma with lung metastases presented as a cardiogenic shock: a case report and literature review.

Cardiac tumors are a rare condition that typically presents with nonspecific symptoms. Among the histologic patterns, myxoid sarcomas are rarely identified and may have a less favorable prognosis. Reporting a case of this type of cardiac tumor can increase awareness about this condition and aid in early diagnosis, potentially leading to better outcomes. Case presentation: We are presenting a case of a 41-year-old female with left atrial myxoid sarcoma, which was presented with a cardiogenic shock picture. She underwent surgical excision of the mass and was discharged in good condition. After discharge, she deteriorated and was found to have lung metastases. Clinical discussion: Primary cardiac sarcomas, due to their rarity and poor prognosis, are often diagnosed at an advanced stage of the disease and lack sufficient data to establish a standard course of treatment. The cornerstone of therapy is surgical resection. However, novel therapeutic approaches must be developed. Conclusions: Primary cardiac tumors should be suspected in adult patients with progressive dyspnea, and a biopsy should also be done to determine the histopathological pattern of the mass and estimate the overall prognosis and outcomes.

Left Ventricular Myxoma: A Case Report.

Cardiac myxomas are the most common primary cardiac neoplasms, with only a small percentage being found in the left ventricle. Herein, we describe a 25-year-old male who presented with a complaint of chest pain for almost three months and was found to have a 2x2 cm encapsulated tumor attached by a 2-3 mm stalk to the mid-septum, 5 cm below the aortic annulus, via echocardiography. Additionally, a chest CT angiography was performed and revealed a small defect in the left ventricle with a low attenuation density originating from the septum. The tumor was later managed surgically with a median sternotomy approach, and left ventricular myxoma was confirmed histopathologically. Even though cardiac myxomas are incredibly uncommon, they are usually located in the left and right atria and are very unlikely to present in the left ventricle. This incident highlights the importance of taking cardiac myxoma into account as a potential differential diagnosis in cases of chest pain to prevent any further complications.

A Case of Systemic Lupus Erythematosus (SLE)-Induced Immune Thrombocytopenia Presented With a Subdural Hematoma.

Systemic lupus erythematosus (SLE) is an autoimmune disease that can cause various health problems, including issues with the blood. One common blood-related symptom in SLE is immune thrombocytopenia (ITP), which leads to low platelet counts. In some cases, SLE patients with ITP may develop a rare but serious complication called subdural hematoma (SDH), which is a type of bleeding in the brain. This combination of conditions can be challenging to manage and has a high mortality rate. In a specific case, a 14-year-old girl with chronic ITP developed a sudden headache and was diagnosed with childhood-onset SLE, leading to the development of SDH. The treatment plan had to be adjusted, and a splenectomy was considered. It's important to be aware of the association between SLE, ITP, and SDH, especially in pediatric patients, and to conduct appropriate investigations in cases of severe headaches, to rule out life-threatening causes.