Journal of medical case reports
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Systemic Epstein-Barr-virus-positive T cell lymphoproliferative disease of childhood is an extremely rare disorder, characterized by clonal proliferation of Epstein-Barr-virus-infected T cells with an activated cytotoxic phenotype. The disease is more frequent in Asia and South America, with only few cases reported in Western countries. A prompt diagnosis, though often difficult, is a necessity due to the very aggressive clinical course of the disease. ⋯ Though extremely rare, this disease can occur in Europe, and a comprehensive diagnostic approach is thus recommended in all case of Epstein-Barr-virus-positive lymphoproliferative disorders. Unfortunately, at present no specific treatment is available; however, prompt administration of anti- Epstein-Barr virus treatment and rapid attempts to control the hemophagocytic syndrome are indicated.
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Left atrial myxomas are rare benign tumors of the heart. They vary widely in size, and very little is known about their growth rate. The reported growth rates of left atrial myxomas from several published case reports appears to vary from no growth, to between 1.3 to 6.9 mm/month in diameter within patients with established myxoma who have not undergone surgery. ⋯ To the best of our knowledge, our case is the first to provide images of absence and presence of myxoma from transthoracic echocardiography scans taken a year apart, with estimated growth rate of 2.2 mm/month. Rapidly growing myxoma may be mistaken for thrombus, and may require urgent surgical excision to reduce the risk of associated complications such as thrombo-embolic events, sudden cardiac death and removal of a possibly malignant tumor. The potential for rapid growth should be considered if there is a plan to delay surgery. Furthermore, it would be pertinent to consider annual echocardiography in patients presenting with clinical features suggestive of cardiac myxoma such as constitutional symptoms, as these tumors may be rapid growing and may only become apparent on subsequent echocardiography.
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Massive intentional verapamil overdose is a toxic ingestion which can cause multiorgan system failure and has no currently known antidote. ⋯ Intravenous fat emulsion therapy may be an effective antidote for massive verapamil toxicity.
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We report a case series of successful treatment of intractable renal colic using parenteral lidocaine. ⋯ Parenteral lidocaine treatment can reduce pain dramatically or subtly.
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The outcome of cerebral ischemic stroke associated with cannabis use is usually favorable. Here we report the first case of cannabis-related stroke followed by neuropsychiatric sequelae. ⋯ Stroke related to cannabis use can be followed by severe neuropsychiatric sequelae. Concomitant alcohol intoxication is essential neither to the occurrence of this neurologic event nor to its severity.