Clinical and Transfusion Approach to Neonatal Thrombocytopenia Associated With Systemic Lupus Erythematosus: A Case Report.

Autoimmune diseases present a clinical challenge for young women of childbearing age since pregnancy can affect their progression and lead to complications for both mother and baby. Systemic lupus erythematosus (SLE) is of particular interest in this context due to its association with an increased risk of spontaneous abortion, foetal death, pre-eclampsia, intrauterine growth restriction, preterm delivery, and various neonatal manifestations, including thrombocytopenia. In this context, autoimmune neonatal thrombocytopenia, caused by the transplacental transfer of maternal autoantibodies, may be the first sign of an undiagnosed autoimmune disease in the mother.

Secondary HIV Cholangiopathy as a Cause of Acute Cholangitis: A Case Report.

HIV-associated cholangiopathy (HAC) is a rare but clinically important hepatobiliary complication occurring in patients with advanced immunosuppression, particularly those with cluster of differentiation 4+ (CD4+) counts below 100 cells/μL. It is most often triggered by opportunistic infections and can present as a spectrum of biliary abnormalities that result in cholestasis and obstruction. We present the case of a 58-year-old man with a history of HIV infection (B24) under regular follow-up, with an undetectable CD4 count and elevated viral load, who presented to the emergency department with jaundice, severe right upper quadrant and epigastric abdominal pain, nausea, vomiting, and a 10 kg weight loss over the past month.

Endoscopic and Histopathologic Findings of Rituximab-Associated Colitis in a Patient With Scleroderma.

Rituximab is a chimeric monoclonal antibody that targets the CD20 antigen found on B lymphocytes. It is widely used in the treatment of haematological malignancies and, more recently, autoimmune diseases such as rheumatoid arthritis and scleroderma. While its safety profile is generally considered to be acceptable, a range of gastrointestinal adverse effects have been reported, including colitis.

Arthritis Mutilans: A Devastating Manifestation of Psoriatic Disease Without Dactylitis in a 61-Year-Old Patient.

Arthritis mutilans (AM) is the most severe and least common form of psoriatic arthritis (PsA), characterized by digital shortening due to osteolysis and often associated with profound functional disability. We report a case of a 61-year-old male with longstanding plaque psoriasis and poor treatment adherence who developed AM affecting the interphalangeal joints of the left foot, with significant joint deformity and extensive skin involvement (30% body surface area). Imaging revealed severe bone breakdown, leading to the affected phalanges of the foot appearing shortened or telescoped.

Procalcitonin and CRP as Predictors of Anastomotic Dehiscence in Adult Patients.

Introduction Intestinal anastomotic leakage is a serious postoperative complication associated with high morbidity and mortality. Although acute-phase reactants such as procalcitonin (PCT) and CRP have been proposed as early biomarkers, their predictive utility remains insufficiently established in low-resource settings. This study aimed to evaluate the usefulness of PCT and CRP in detecting anastomotic leakage in adult patients undergoing intestinal surgery at a secondary-level hospital.

Atypical Histoid Leprosy With Virchowian Features: A Report of a Histologically Deceptive Case.

Histoid leprosy is an uncommon clinicopathological variant of Hansen's disease, characterized by distinct immunological, clinical, histological, and bacteriological features. It is regarded as an intensified form of multibacillary leprosy, marked by an enhanced cellular and humoral immune response. Clinically, this condition typically presents with well-defined papules and nodules on otherwise normal-appearing skin, frequently located on the face, trunk, and extremities of the body.

Giant Mesenteric Cyst: Diagnostic Challenges and Surgical Management in a Clinical Case.

Mesenteric cysts are rare intra-abdominal cystic lesions of uncertain etiology, often diagnosed incidentally due to their variable and nonspecific clinical presentation. We present the case of a 36-year-old male patient with chronic abdominal pain and distension, in whom computed tomography (CT) revealed a giant mesenteric cyst. Complete surgical resection was performed via laparotomy, and histopathological examination confirmed its benign nature.

Coincidental Coexistence of Human T-lymphotropic Virus Type 1 (HTLV-1)-Associated Myelopathy/Tropical Spastic Paraparesis and Myasthenia Gravis in a Patient With Chronic HTLV-1 Infection: A Case Report.

Human T-lymphotropic virus type 1 (HTLV-1) infection profoundly alters central immune regulation via molecular mechanisms involving the viral proteins transactivator X and HTLV-1 basic leucine zipper factor, which promote the proliferation of autoreactive T lymphocytes and the dysfunction of regulatory T cells, resulting in persistent inflammation of the central nervous system. These alterations not only explain the occurrence of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) but have also been associated with the development of autoimmune diseases such as myasthenia gravis (MG). While the connection between chronic HTLV-1 infection and MG is still anecdotal, a small number of case studies and limited molecular research suggest a potential link.

Acute Coronary Syndrome in a Young Woman With Protein S Deficiency and Von Willebrand Disease Type 1: A Case of Mixed Hemostatic Disorders.

Acute myocardial infarction (AMI) in young adults without conventional cardiovascular risk factors is rare and is often associated with non-atherosclerotic causes, including hereditary thrombophilias. Although protein S deficiency is classically associated with venous thrombosis, it has increasingly been implicated in arterial events. The postpartum period is a state of physiological hypercoagulability, which can reveal underlying prothrombotic conditions.

Nummular Eczema as the Initial Extrahepatic Manifestation of Hepatitis C Virus Infection: A Case Report.

Although dermatological manifestations are common in hepatitis C virus (HCV) infection, nummular eczema is rarely reported in this context. We describe the case of a 73-year-old man with a seven-month history of pruritic lesions on the posterior thorax, unresponsive to symptomatic treatment. Physical and dermoscopic examination revealed well-demarcated, coin-shaped plaques with peripheral erythema and fine desquamation.

Transmesocolic Cystojejunoanastomosis in a Mexican Patient With a Giant Post-acute Pancreatic Pseudocyst Following Acute Pancreatitis: A Case Report.

Giant pancreatic pseudocysts (GPPCs) are a rare but challenging condition, particularly when they reach a size that compromises the surrounding anatomy and the available therapeutic resources. Here, we present the case of a 45-year-old man with a history of severe acute pancreatitis who developed a 5.5-litre cystic collection located in the right hepatorenal space, extending into the infrahepatic retrocolic compartment and displacing the duodenum.

Surgical Resection and Abdominal Wall Reconstruction of a Rapidly Progressive Desmoid Tumor: A Case Report.

Desmoid tumors (DTs) are rare, locally invasive soft tissue neoplasms characterized by fibroblastic proliferation and a lack of metastatic potential. Despite their histologically benign nature, their infiltrative behavior and unpredictable progression present significant therapeutic challenges, particularly when located in the abdominal wall, where resection and reconstruction may be necessary. We present the case of a 37-year-old woman with a rapidly enlarging, painful mass in the right rectus abdominis muscle.

Vertebral Coccidioidomycosis With Craniocervical Junction Instability and Ventral Displacement of C1 in a Pregnant Woman: A Case Report and Literature Review.

Coccidioidomycosis is an invasive fungal disease caused by species, posing a significant risk of disseminated infection. Vertebral involvement, though rare, can lead to instability, epidural abscess, and neurological deficits. In such cases, the integration of antifungal therapy and surgical intervention becomes critical, yet no standardized surgical protocol exists.

Total Knee Arthroplasty for Severe Crystalline-Induced Arthropathy: A Case Report From a Third-Level Hospital.

Gout is an inflammatory arthritis caused by monosodium urate crystal deposition, leading to progressive joint destruction and functional impairment. While pharmacologic treatment remains the standard, advanced cases with intra-articular and intraosseous tophi may require surgical intervention. Total knee arthroplasty (TKA) has been reported as a viable option for managing severe tophaceous gout with structural bone defects, improving joint function and pain control when conservative therapy fails.

Beyond the Joints: Rheumatoid Meningitis as a Neurological Manifestation of Rheumatoid Arthritis.

Rheumatoid meningitis (RM) is a rare and severe extra-articular neurological manifestation of rheumatoid arthritis. Headache is one of the most common symptoms along with focal neurological deficits, neuroinfective symptoms, including seizures, and altered mental status are prevalent. We present a case of a 58-year-old Mexican woman with a history of rheumatoid arthritis since 2018, with positive cyclic citrullinated peptide antibodies and rheumatoid factor.

Clinical Presentation and Surgical Management of a Grynfelt Hernia: Report of a Clinical Case and Literature Review.

Grynfelt's lumbar hernia is the rarest of all abdominal wall hernias, accounting for between 1.5% and 2% of cases, with only 300-350 instances described to date. Lumbar hernias can be congenital or acquired, often triggered by trauma or surgery (iatrogenic).

Giant Mesenteric Cavernous Lymphangioma in an Adult as a Cause of Chronic Intestinal Subocclusion: A Case Report.

Giant mesenteric cavernous lymphangioma is a rare lymphatic malformation in adults and an uncommon cause of chronic bowel obstruction. Although these lesions are typical of the paediatric population, their occurrence in adults poses significant diagnostic challenges due to their clinical and radiological similarity to malignant neoplasms such as liposarcoma, lymphoma and gastrointestinal stromal tumours. This report describes the case of a 58-year-old man with chronic bowel obstruction in whom the initial diagnosis suggested malignancy.

Fitness costs of Mycobacterium tuberculosis resistant to rifampicin is compensated by rapid Th2 polarization mediated by early and high IL-4 production during mice infection.

It was a general belief that drug resistance in Mycobacterium tuberculosis (Mtb) was associated with lesser virulence, particularly rifampicin resistance, which is usually produced by mutations in the RNA polymerase Beta subunit (RpoB). Interestingly, this kind of bacterial mutations affect gene transcription with significant effects on bacterial physiology and metabolism, affecting also the bacterial antigenic constitution that in consequence can produce diverse immune responses and disease outcome. In the present study, we show the results of the Mtb clinical isolate A96, which is resistant to rifampicin and when used to infect BALB/c mice showed hypervirulence, apparently by rapidly polarization of the Th2 immune response through early and high production of IL-4.

Gastroduodenal Obstruction Due to Bouveret's Syndrome: A Case Report.

Bouveret's syndrome is a rare disorder that causes upper gastrointestinal obstruction, typically in elderly patients with a history of chronic cholelithiasis. We present an unusual case of a 58-year-old woman with untreated vesicular lithiasis who developed Bouveret's syndrome. She presented with severe abdominal pain, nausea, vomiting, and abdominal distension.

Hereditary Spiny Keratoderma in a Pediatric Patient: A Case Report and Literature Review.

A 14-year-old male with disseminated superficial porokeratosis and a family history of the same lesions on his maternal side presented with spiny keratoderma. Spiny keratoderma is a dermatosis characterized by multiple punctate keratotic neoformations on the palms and soles. It is considered a rare disease, with fewer than 84 cases reported in the world medical literature to date.

Reduction Mammoplasty Using the McKissock Technique With a Free Nipple Graft: A Safe Approach.

Mammary hypertrophy, or macromastia, is an increase in breast tissue volume due to multiple etiologies and still unknown pathophysiology. We report the case of a 45-year-old patient with juvenile macromastia, which caused cervical pain and decreased quality of life. It was decided to perform a reduction mammoplasty with a modified McKissock technique with a free nipple graft; the resected glandular tissue was 1039 grams in the right breast and 1029 grams in the left breast.

Types of Injuries and the Severity of Shoulder Dysfunction Associated with Diabetes Mellitus in Patients with Functional Impairment: A Case-Control Study.

Background/objectives: Patients with diabetes have been reported to experience a higher prevalence of shoulder disorders compared to those without diabetes or with other medical conditions. However, the specific types of shoulder injuries and the extent of functional impairment associated with diabetes mellitus remain unclear. This study aimed to assess the association between diabetes and specific shoulder injuries, as well as the degree of functional impairment in affected patients.

The MESH-RTL Project for prevention of abdominal wound dehiscence (AWD) in high-risk patients: noninferiority, randomized controlled trial.

Purpose: To compare reinforced tension line (RTL) and mesh techniques in the onlay position for preventing abdominal wound dehiscence (AWD) in a noninferiority clinical trial.

Methods: Patients > 18 years old who underwent midline laparotomy and who were considered at high risk on the modified Rotterdam risk scale were included. The outcomes analyzed were the incidence of AWD and surgical site occurrence (SSO).

Endoscopic Characterization of Giant Choledocholithiasis and Its Correlation With Primary Choledocholithiasis.

Introduction: Gallstone disease is extremely prevalent in Western society, and the prevalence of common bile duct (CBD) stones with concomitant cholelithiasis increases significantly in the elderly. Different variants influence the treatment of this pathological entity, such as the origin of the stones, their location and quantity, comorbidities of the patient, impaction, and size of the lithos, the latter being an independent predictive factor. In most situations, choledocholithiasis can be resolved with endoscopic retrograde cholangiopancreatography (ERCP); however, in complex cases, such as giant choledocholithiasis (GC), advanced surgical, endoscopic, and percutaneous techniques are required to remove gallstones.