Archive for July, 2009

Inquest confirms death by soup and water diet

July 28, 2009

This week, BBC news covered the case of a 26-year-old woman who died after following a strict diet of soup and water.

The woman, 26, weighed 9st 2lb at the time of her death. She had lost six stone after dieting to lose weight she put on as a side effect of medication. The result of this extreme diet was a drastic lack of sugar leading to a metabolic chemical reaction called ketoacidosis – where the body attempts to recover the sugar loss by metabolising its own fat reserves.

Coroner Terence Carney recorded a verdict of accidental death and said he was certain she had no intention to cause herself harm.

The BBC report states: Mr Carney said: This phenomenon – this poison if you like – which developed within her body was made by her body itself.

“It arises as a result of the body reacting to a lack of sugar within itself and that was in part a consequence of the intensive diet with which Helen was attempting to balance her weight.

“The sad truth of the matter is there has been a development within her body, a natural phenomena, which has set up this poisoning of her body’s system and has led to her death.

“It is a problem which can develop very rapidly and without the individual appreciating the consequences.”

This article reminded me of the Chalasani and Fischer case report published in Journal of Medical Case Reports last year, “South Beach Diet associated ketoacidosis: a case report. A true and clinically relevent reflection of the dangers of restricting food intake? Or an unfortunate case for us all to learn from?


Update on oral medicine: the latest dental cases

July 22, 2009

Cases Network welcomes case reports from all areas of health care, and we’re pleased with how many cases are submitted from the fields of dentistry and oral medicine.

Here is an overview of some of our recent dental cases:

A great case report on treatment for severe wearing of the teeth caused by gastroesophageal reflux disease and bruxism in a 54-year-old Turkish man. Here, the authors describe how the maxillary and mandibular anterior and posterior teeth were prepared for metal-ceramic restorations.

In many adults with periodontal disease the positioning of teeth prevents proper cleaning. This case report gives an interdisciplinary (periodontic, orthodontic, restorative) approach for treatment.

Cantore et al. report the case of a rare horizontal radicular fracture located between the middle- and apical-third of the upper left-central incisors followed-up over 4 years.

A 23-year-old Turkish woman with malaligned anterior teeth was rehabilitated with ceramic veneers due to her rejection of orthodontic treatment. Türkaslan and Ulusoy describe how ceramic veneers can be an alternative treatment to orthodontic therapy.

If you are interested in reviewing dental case reports for either journal, please get in touch!

Cases Network – Image of the month

July 17, 2009

Every month we select an image from Cases Journal or the Journal of Medical Case Reports (JMCR) that we feel is that little bit extra special.

Below is our choice for this month:

Metastatic tubulopapillary renal cell carcinoma (TPRCC)

Metastatic tubulopapillary renal cell carcinoma (TPRCC)

The patient in this case was diagnosed with tubulopapillary renal cell carnicoma (TPRCC) – the second most common histologic subtype of kidney cancer. On first presentation, the tumour was confined to the pelvis, but two years later, he presented with this rapidly growing mass, located on the midline anterior chest wall. A biopsy of the mass confirmed the diagnosis of metastatic TPRCC.

After three months of treatment, the patient also developed severe headaches and blurred vision and was diagnosed with choroidal metastasis. Choroidal metastiasis from TPRCC is currently very exceptional.

The authors recommend a high index of suspicion and adequate investigation of patients with visual complaints and history of renal carcinoma.

For all the clinical details, read the full case report here.

Title: “Choroidal metastasis from tubulopapillary renal cell carcinoma: a case report”

Authors: Ibrahim Elghissassi, Hanane Inrhaoun, Nabil Ismaili and Hassan Errihani

To see a selection of our previous ‘Image of the month’ choices, visit our facebook site here.

EmailFor your chance to nominate a case report for the ‘Image of the month’, simply email us at:

New journal website features

July 9, 2009

We are constantly making improvements to our journal websites in order to give our readers and authors an easy-to-use site.

Our technical team are currently working on redesigning the journal pages to give them a more modern look, so watch this space!

In the meantime, a couple of additions you may find useful:

1) Sharing articles – on all published articles you will see a ‘Share” button at the top right which lets you share and discuss the article to your friends and colleagues. Hover over this button and you’ll see the option to share the article via Twitter, Facebook, FriendFeed and others or to add to your social bookmarks using Delicious, Google and others. You can also use the button to print the article or email it to a friend.

2) RSS feeds – an easy way to keep up to date with all the latest case reports. Simply click the orange RSS logo on the journal browse pages to receive all the latest articles delivered straight to your desktop via your RSS reader.

Let us know what other features you’d like to see!

Morgellons disease, illuminating an undefined illness

July 2, 2009

Morgellons disease, illuminating an undefined illness: a case seriesMorgellons disease is a physical human illness with life-altering effects that, although described in various forms for over 300 years, is still surrounded by confusion and controversy. Morgellons is fast becoming a major condition in the 21st century, with over 13,000 people from the U.S. and 15 other countries registered on the ‘Morgellons Research Foundation‘ website.

The term “Morgellons” was first used in 1674 to describe the unusual dermal condition of a child. It has since then shifted predominantly to adults and is largely characterized by the presence of skin lesions and “extruding fibres”.

Morgellons disease (MD) has been linked with many theories and conspiracies since it first appeared on the Internet in 2002. These range from parasites to a chemical spill, a failed government experiment and even to alien abductions.

Given the growing use of the label “Morgellons disease”, characterizing the illness using verifiable clinical data seems an imperative first step for clinicians, with the aim of improving diagnosis consistency. Representing the first formal description of MD from detailed examination of all body systems, this week William T Harvey and colleagues published their case series in the Journal of Medical Case Reports (JMCR).

The quantification of physical and laboratory abnormalities in this article, allows the creation of a practical clinical boundary to distinguish probable Morgellons from non-Morgellons patients. Although presumed as a delusional phenomenon for decades, the factual data obtained in this case series, support the argument that Morgellons manifest formally as a skin condition, an immune deficiency state and a chronic inflammatory process.

During peer-review, reviewers considered that this new case series “provides solid ground for debate and discussion… which will surely benefit patients with these symptoms” and is an “excellent paper that is recommended strongly”. So to read the full details the case series, click here, or visit the JMCR home page.

Have you treated patients who have presented with self-diagnosed Morgellons disease? Have you seen symptoms similar to those described in Harvey’s cases? We would love to hear your comments – simply click below. If you have experience of this in the clinic and would like to publish a case report, then view our instructions for authors.

Videos from “Celebrating case reports, the stories in healthcare”

July 1, 2009

If you missed out on Cases Network’s meeting “Celebrating case reports, the stories in health care” at the Royal College of Physicians last month, you can catch up on our speakers’ talks as the videos are now online.

It was a fascinating conference, and we were delighted to have such great speakers taking part and sharing their views and experiences of medical case reports.

The sessions sparked lively debate on the day, and we hope you will continue the discussion in the comments below.

Thanks again to all our speakers and delegates for making it such an interesting and memorable day!

Elizabeth Slade, Publisher