Cases Blog

The patient’s perspective: What are they so excited about?
"..a great cutting-edge idea!” – Robert Dellavalle MD, PhD, MSPH
“a welcome idea that chimes well with other initiatives
around the world - this is a great idea from JMCR” – Professor Robert Hunter BSc, MBChB, MD, FRCPsych
“a great addition to JMCR” – Christian A. Koch, MD, PhD, FACP, FACE
“..a fantastic idea… looking forward to see how it develops” - Jean Karl Soler MD MSc MMCFD
What are our Associate Editors so excited about? Well, we are pleased to announce that Journal of Medical Case Reports has now opened its doors to accepting case reports with comments from the patient in question. The 'Patient's perspective' feature is a simple way to add another dimension to a case report. We think inviting the patient to comment on their condition, course of treatment or even providing some background on their daily activities will add an extra layer of detail to the case report.
'Patient's perspectives' are of course also welcome in JMCR's new sister publication, Cases Journal, edited by Richard Smith.
By including patient-written narratives, we aim to capture information about each patient's case that would otherwise be lost.
If you would like to be among the first to publish a case report with your patient then please follow our instructions and submit online. All accepted case reports will be indexed in PubMed Central.
Posted by Miriam Kingsley at 10:31 Comments (0)
Announcing Cases Journal: JMCR's new sister publication
We are delighted to announce the launch of a new sister journal to JMCR - Cases Journal.
Edited by Richard Smith, the journal will publish any case report that is understandable, ethical, authentic, and includes all information essential to its interpretation. Case reports do not have to be unusual - the journal's ethos is that every case report, no matter how 'everyday' is important. As Smith says in the journal's launch editorial, "Clinicians have the privilege of dealing with individuals in all their
complexity and magnificence. Every person, every "case" can teach us
something."
Cases Journal will work in collaboration with Journal of Medical Case Reports. Articles from both journals will be incorporated into the database of case reports that BioMed Central is creating. If case reports submitted to JMCR do not meet our acceptance criteria, authors will be considered by Cases Journal. Likewise, the most important case reports submitted to Cases Journal will be put forward for review in JMCR.
We hope that Cases Journal will go on to publish many thousands of case reports, including many from physicians who have never published before - we particularly encourage submissions from general practitioners. JMCR will be the home of the most interesting, important case reports that advance medical knowledge, and we hope will eventually receive an impact factor.
So whether you have a case report that gives an important clinical lesson, or whether it's something more commonplace, we look forward to your case reports!
Posted by Elizabeth.Slade at 11:09 Comments (0)
Neonatal renal vein thombosis and elevated maternal lipoprotein: our most accessed case report
With over 800 downloads since publication, 'Elevated maternal lipoprotein (a) and neonatal renal vein thrombosis: a case report' becomes our most accessed case report this month. Subbiah and Parimi report on a full-term neonate with renal vein thrombosis (RNV) and her mother, with full clinical details and accompanying Doppler scan imaging. Although RNV is well-reported in neonates, this case report is one of the few to describe it in relation to inherited prothrombotic risk factors. The association between maternal thrombophilia and neonatal thrombotic complications is still unknown.
The image above shows a renal Doppler flow study demonstrating an increased resistive index of
the right renal artery with suboptimal wave forms of the right renal
vein. You can read the full case report including downloadable images and details of the patient's follow-up here.
Posted by Miriam Kingsley at 16:26 Comments (0)
Image highlight: Rare osseous metaplasia
Histopathological polyp specimen demonstrating adenomatous surface epithelium and osseous metaplasia with surface osteoclasts
This week's image is taken from a recently published case report by Dr Victoria White of the Department of Colorectal Surgery, Derby City General Hospital, Derby.

A 63-year-old woman, who drank 2 to 3 litres of gin per week, presented with a history of melaena. Colonoscopy revealed her to have a pedunculated ulcerating polyp. Histological examination demonstrated multiple areas of osseous metaplasia within the polyp stroma. Heterotopic ossification in colonic adenomas is a particularly rare phenomenon, with the majority of cases occurring within malignant lesions. The suggested mechanisms for its aetiology still remain unclear. [View full case report and more images]
Posted by Miriam Kingsley at 10:43 Comments (0)
New Associate Editor: Introducing Alistair Tindall
We are delighted to announce a new addition to the JMCR Editorial Board. Alistair Tindall MSc FRCS (Tr. & Orth.) will take the position of Associate Editor handling orthopaedics and trauma case reports.
As an Open Access advocate, Mr Tindall comments, "I think case reports
can add almost as much as a 'full paper'. They highlight new presentations of
common diseases that should be borne in mind by the clinician. They also act as
a short review on common topics and the discussion should present a nice
synopsis of current knowledge in a particular field."
His new role on Journal of Medical Case Reports will compliment his other editorial position as Editor-in-Chief of Clinical Medicine: Trauma and Intensive Medicine." The launch of JMCR brings a new perspective into the way the traditional case report affects the modern physician's approach to continued education and professional learning. Alistair notes, "A good case report will educate, entertain and stimulate. It may not be relevant to day to day practice, but it is by looking at interesting cases that we learn most about the art and practice of medicine."
Alistair is a trauma and orthopaedic surgeon in a general hospital in South East London, but has a particular interest in orthopaedics in the developing world. His current research interests are in cell engineering and autologous chondrocyte implantation, and has carried out extensive research into lower limb work.
Alistair will be a great asset to our existing Editorial Board - we are sure that he will enjoy working with us on our unique online journal!
Posted by Miriam Kingsley at 15:25 Comments (0)
Our 300th open access case report
Yesterday, the 300th case report was published in Journal of Medical Case Reports. The landmark manuscript by Francois Maillot et al., draws some interesting conclusions on how environmental factors may have an influence on the clinical expression of monogenic inherited metabolic diseases. Read the full case report, free here.
Journal of Medical Case Reports is growing very quickly, and to find out how to get involved, whether you wish to submit your own case report, review or comment on any of our case reports then please contact our editorial office.
Congratulations to the authors, who will receive a JMCR T-shirt!
Posted by Miriam Kingsley at 12:53 Comments (0)
Scabies in an HIV-positive patient: our most accessed case report
This month's most-read case report describes an unusual case of Norwegian scabies in an HIV-positive man.
The article from Ramachandran Vignesh et al has been downloaded over 950 times in the last 30 days.
"Atypically distributed cutaneous lesions of Norwegian scabies in an HIV-positive man in South India: a case report", describes the 16-year old patient's presentation of severe crusted scabies over much of his body, including the head and neck. The patient was treated with Ivermectin and topical Permethrin, with a complete resolution of the condition four weeks later.
Stay up to date with the latest case reports by signing up to our article alerts.
Posted by Elizabeth.Slade at 11:06 Comments (0)
New! Image highlight: Tuberculosis of the ileum
Welcome to the new ‘Image highlight’ section of our JMCR blog. Since launch, we have published hundreds of fascinating photographs, histology slides, X-rays, CT scans and more, so this is our opportunity to highlight some great images from our case reports that you may have missed. This week's image is taken from a recently published case report by Dr Taraneh Dormohammadi Toosi et al., Imam Khomeini Hospital, Iran:
X-ray of small bowel barium transit showing narrowing
and irregularity of the terminal ileum and ulceration in its wall, highly
suspicious for tuberculosis.
Journal of Medical Case Reports 2008, 2:90
A 14-year-old girl presented with complaints of
paraplegia, ataxia, fever and fatigue that had started a few months earlier,
which had progressively worsened in the last three weeks. Her laboratory
results were indicative of macrocytic anemia with a serum B12 level <100 (normal,
160-970) pg/ml and hypersegmented neutrophils and MRI revealed brain atrophy.
Her fever workup eventually led to the diagnosis of tuberculosis, documented by
bone marrow aspiration smear & culture. A small bowel series showed that
tuberculosis had typically involved the terminal ileum which had resulted in
vitamin B12 deficiency. She was treated for vitamin B12 deficiency and
tuberculosis. Her fever ceased and her hemoglobin level returned to normal. This is the first report of macrocytic anemia with unusual manifestations such as brain atrophy and seizures due to intestinal tuberculosis. [View full case report and more images]
Posted by Miriam Kingsley at 16:16 Comments (0)
JMCR Award - winner announced!
Congratulations to Dr Phuong Mai, winner of the inaugural JMCR Award for best case report. Dr Mai's article, ‘A possible new syndrome with growth-hormone secreting pituitary adenoma, colonic polyposis, lipomatosis, lentigines and renal carcinoma in association with familial testicular germ cell malignancy: A case report' received several nominations, and was judged by Professor Michael Kidd, JMCR's Editor-in-Chief, to be the winning case report.
The award was announced at BioMed Central's Research Awards ceremony at the Royal Society of Medicine in London last week.
Thanks to all of you who nominated case reports for the award, and remember that any case report published in JMCR this year will be eligible for next year's award!
Posted by Elizabeth.Slade at 17:32 Comments (0)
Medscape features JMCR case reports
Medscape, the online medical information and education resource, begins this week to highlight articles published in Journal of Medical Case Reports.
The first article to be featured is 'Rectus sheath hematoma: three case reports' in which Selin Kapan et al. describe how this rare disease was identified and treated in three patients.
JMCR is featured in Medscape's Family Medicine journals collection, and the Medscape team will be regularly featuring new case reports on the website, meaning the journal's most clinically relevant and educational case reports will be brought to an even wider audience.
Posted by Elizabeth.Slade at 12:13 Comments (0)
Shortlist announced for JMCR award
Journal of Medical Case Reports will be making a special award for the best case report published in the
journal to date, as part of the BioMed Central Research Awards.
We are pleased to announce the shortlist of nominees for this award:
Minocycline-induced hypersensitivity syndrome presenting with meningitis and brain edema: a case report
Nicolas
Lefebvre, Emmanuel Forestier, David Farhi, Veronique Remy, Olivier
Lesens, Mahsa Mohseni Zadeh, Daniel Christmann and Yves Hansmann
Journal of Medical Case Reports 2007, 1:22
A
new syndrome with growth-hormone secreting pituitary adenoma, colonic
polyposis, lipomatosis, lentigines and renal carcinoma in association
with familial testicular germ cell malignancy: A case report
Phuong
L Mai, Larissa Korde, Joan Kramer, June Peters, Christine M Mueller,
Susan Pfeiffer, Constantine A Stratakis, Peter A Pinto, Gennady
Bratslavsky, Maria Merino, Peter Choyke, W. Marston Linehan and Mark H
Greene
Journal of Medical Case Reports 2007, 1:9
Reactive arthritis developing after pneumococcal conjunctivitis: a case report
Amit S Verma and Dorian Dwarika
Journal of Medical Case Reports 2007, 1:2
The winner will be announced at the awards ceremony to be held at the Royal Society of Medicine here in London on Wednesday 19th March.
Congratulations to all the nominees, and watch this space for the announcement of the winner.
Posted by Elizabeth.Slade at 11:50 Comments (0)
Express yourself: Wear the JMCR T-shirt!

For those of you who have
published with JMCR, reviewed for us or just
enjoy browsing the Open Access case reports
online, we hope you will support the journal by word of mouth to your friends
and colleagues. Now, you can also show your support by wearing a T-shirt! For every T-shirt purchased, BioMed
Central will make a donation to Computer Aid International, a
charity which provides refurbished computers for use in the developing world.
You can also spread the word in your university of hospital by downloading a free JMCR poster to display.
Posted by Miriam Kingsley at 15:29 Comments (0)
New side-effect of cancer therapy? The author’s perspective

Bevacizumab, the popular colorectal cancer and non-small cell lung cancer therapy antibody, has shown signs of a previously unreported side-effect. Dr Dorothy Gujral, St Lukes Cancer Centre, Royal Surrey County Hospital, reports the first case of periodontitis in a patient whilst receiving bevacizumab. She reports, “This case is, to the best of our knowledge, the first report of a patient developing periodontal disease whilst receiving bevacizumab. Although it would be difficult to exclude all other risk factors in this patient, the onset of periodontal disease on commencement of bevacizumab and that the disease remained stable on discontinuation of the drug points to this as the cause.”
We know that bevacizumab has been linked to hypertension and bowel perforations, and that the The Food and Drug Administration voted to reject the use of bevacizumab for breast cancer therapy in December 2007 – but does its safety record need further investigation in light of the new finding of suspected bevacizumab-induced periodontal disease? Trials are underway already; this particular patient was enrolled in a randomised, double-blind, multicentre, 2-stage, phase III study: the AVAiL trial (AVAstin In Lung cancer - Trial No. BO17704) - a study in which the primary objective is to evaluate safety and efficacy of two doses of bevacizumab in combination with gemcitabine and cisplatin and determine the optimal dose of bevacizumab. Dorothy Gurjal comments: “We continue to use bevacizumab in this setting but patients now receive pre-treatment and follow up dental examinations and are advised on good dental care.”
Patient follow-up
The
patient in question in this new case report has now completed the course of
bevacizumab; the periodontal disease has subsequently remained stable. She now
continues on a regular two-monthly clinical examination and CT scanning. Read the full case report here.
Case reports and the bid to improve patient care
Sharing reports of side-effects and unusual disease progression is becoming easier – much of this can be put down to the Open Access model of publishing which allows free information to all. Dr Gurjal adds, “Case reports provide a medium for discussion of possible adverse drug reactions, mechanisms for the adverse reactions and possible prevention steps in the future. This facility is not available through other reporting channels. Journal of Medical Case Reports being an online journal with open access allows rapid dissemination of important information to healthcare professionals around the world. Benefits to patient care can be translated very quickly.”
Posted by Miriam Kingsley at 16:24 Comments (0)
Cardiology is one of the busiest areas for publication of case reports in the journal so far, and (fittingly for Valentine’s day) we invite you to take a look at some of our most interesting cardiology case reports:
Atrial fibrillation-related cardiomyopathy: a case report
Following a history of worsening dyspnoea and palpitations, a 58 year-old male was diagnosed with dilated cardiomyopathy. Thyroid function and electrocardiogram tests were normal. Trans-thoracic echocardiography revealed a dilated left ventricle. The patient had been consuming one bottle of a highly caffeinated commercially available beverage (1000 ml) per week for 6 months.
Congenital absence of inferior vena cava and thrombosis: a case report
A 54 year-old male was admitted with abdominal pain and localised swelling over the right flank. Examination revealed palpable 'snake-like' tortuous and tender lumps on the abdominal wall. Past history revealed chronic non-healing venous leg ulcers, and varicose vein ligation at a very young age upon which Deep Vein Thrombosis (DVT) was diagnosed. A CT scan was performed to search for intra-abdominal cancer.
The first report of endovascular repair of a previously stented, ruptured chronic Stanford type B thoracic aortic dissection re-presenting with a type III endoleak of the original repair in an 82-year-old male.
A pulmonary artery false aneurysm after right middle lobectomy: a case report
A 69-year-old male underwent a right middle lobectomy for a Stage 1A squamous cell carcinoma of his right middle lobe. The patient was readmitted five weeks postoperatively with pyrexia and an episode of haemoptysis. X-ray showed haziness in the right mid-zone and the patient was treated for a presumed chest infection. A week later, he was readmitted with continuing haemoptysis, swinging pyrexia and increasing shortness of breath at rest. Bronchoscopy revealed granulation tissue near the middle lobe bronchial stump, which bled profusely on biopsy. CT scan showed a false aneurysm of the right descending interlobar pulmonary artery and complete lower lobe collapse and consolidation.
As the cardiology section of Journal of Medical Case Reports continues to grow, we are on the look-out for cardiologists to join our pool of reviewers. If you would be interested in reviewing for the journal, please get in touch.
Posted by Miriam Kingsley at 20:40 Comments (0)
Nominations for the JMCR award for best case report are due to close this week - don't miss your chance to
put forward your choice!
All case reports published in the journal in 2007 are eligible, and the presentation to the authors of the winning case report will be made at the BioMed Central Research Awards at the Royal Society of Medicine in March.
Nominating is easy - simply fill in the short online form.
Browse the website to remind yourself of the highlights of 2007 - as valued readers, reviewers, editors and authors, we want to hear from you!
Posted by Elizabeth.Slade at 16:26 Comments (0)
