Latest Articles

Open access Case Report | June 28, 2025
Diagnostic challenge and management of Guillain-Barre Syndrome in an infant: A Case Report
Tarik Jarkoč , Emina Vukas-Salihbegović , Sajra Užičanin , Lejla Prnjavorac , Odej Ali Abud , Berina Omanović Kulović
Year: 2025

Background: Guillain-Barré syndrome (GBS) is an acute, immune-mediated post-infectious polyradiculoneuropathy usually presenting with symmetrical ascending weakness, diminished deep tendon reflexes, and non-specific sensory symptoms. GBS is in essence an autoimmune disorder, and the underlying mechanism is thought to result from so-called molecular mimicry. This hypothesis is further supported by approximately 2/3 of the patients having a preceding infection. In most cases, the infectious trigger occurs in the gastrointestinal or respiratory tract, with the disease manifesting within four weeks. Even though it most commonly affects children aged 1 to 5 years old, there are rare cases reported in neonates and infants.

Case Presentation: We report a case of a 6-month-old infant with Guillain-Barré syndrome following a respiratory infection. The diagnosis was confirmed through cerebrospinal fluid analysis, EMNG, spine MRI, and clinical assessment. Positive human herpes virus 6 (HHV-6) in cerebrospinal fluid suggested a potential infectious trigger. The infant was treated with intravenous immunoglobulin and ganciclovir, requiring intensive care and mechanical ventilation. Recovery involved gradual neurological improvement and restored motor function over 30 days.

Conclusion: GBS is a rare disorder, especially in children and requires multidisciplinary management to prevent complications from occurring and thereby improve the prognosis of patients. Upon arrival at the emergency department, all patients should be carefully evaluated, looking for autonomic and respiratory dysfunction signs. Generally, pediatric patients have a better prognosis compared to adults. Initiation of treatment in the early stages of the disease leads to a faster recovery and consequently fewer sequelae.


Open access Case Report | June 08, 2025
Retro-Rectal Cystic Hamartoma: A Rare Etiology for an Anal Neoplasia – A Case Report
Mohamed Abdelreheem , Trong Anh Nguyen , Lars Leupolt , Eberhard Schneider
Year: 2025

Background: Retro-rectal cystic hamartoma, also known as a tailgut cyst, is a rare type of space-occupying lesion. It is a cystic hamartoma that predominantly forms in the retrorectal region and may serve as a potential etiology for anal neoplasia.

 

Case Presentation: A 58-year-old female patient was initially treated for squamous cell carcinoma of the anal canal, which was surgically removed on May 20, 2023, followed by radiotherapy. She also had a known tailgut cyst with a fistula connecting it to the perianal skin at the 6 o’clock position in the lithotomy view. The cyst had been asymptomatic until then. As a prophylactic measure to prevent potential malignant transformation, the decision was made to excise the tailgut cyst. The operation was performed laparoscopically and included perianal mobilization of the fistula. During follow-up, the patient developed perianal pain. A CT scan revealed a fluid collection at the site of the excised tailgut cyst. The collection was surgically drained and identified as a seroma without any signs of infection. The patient was discharged after seven days and experienced no further long-term complications.

 

Conclusion: Retro-rectal cystic hamartomas are rare and often asymptomatic. When symptomatic, they may present with lower abdominal pain, back pain, obstipation, urinary retention, or complications such as anal abscesses and fistulas. Research to date remains inconclusive regarding the incidence of malignant transformation.


Open access Case Report | June 08, 2025
Li Fraumeni Syndrome presenting atypically as Immune thrombocytopenia and early aging phenotype - A case report
Velu Nair , Manthan Kathrotiya , Ambika Gupta , Jayani Patel , Vijaykumar Shirure , Dhara Shah , Reena Trivedi , Sandip Kheni , Neha Motwani , Grishma Sukhwal , Chaitrangi Paranjape
Year: 2025

Background: Germline mutations in the TP53 gene are primarily associated with Li-Fraumeni syndrome (LFS), a hereditary cancer predisposition disorder. While the predominant manifestations are various malignancies, there is limited information regarding non-malignant clinical features, particularly affecting the skin and musculoskeletal systems, in TP53 mutation carriers. We report a rare case of LFS presenting with immune thrombocytopenia and changes of early aging and discuss the possible underlying pathophysiological mechanisms for these.

Case presentation: A 16-year-old female presented with complaints of spontaneous ecchymotic patches over both upper limbs, lower limbs, and chest along with menorrhagia. Comprehensive evaluation with bone marrow examination confirmed diagnosis of immune thrombocytopenia (ITP) which was treated with steroids, intravenous immunoglobulin (IVIG), and thrombopoietin receptor agonists (TPO-RAs), and the patient responded completely with normalization of platelet count. Given the positive family history of thrombocytopenia in the sister and early malignancy in the maternal family, a whole exome sequencing was done which showed a heterozygous pathogenic variant in the TP53 gene confirming a background of LFS.

Conclusion: A case of Li-Fraumeni syndrome with a positive family history presenting as primary ITP successfully managed with ITP-like treatment is a rare immunological complication and has not been reported in the literature to date.