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02)-%2 0ATIENTCASEREPORT 02)-%2 )PXUPXSJUFBQBUJFOUDBTFSFQPSU (%.29#/(%. 1 UBLISHED PATIENT CASE REPORTS PROVIDE ESSENTIAL SOURCES OF INFORMATION FOR THE OPTIMUM CAREOFPATIENTSBECAUSECASEREPORTS CANDESCRIBEIMPORTANTSCIENTIlCOB SERVATIONSTHATAREMISSEDORAREUN DETECTABLE IN CLINICAL TRIALS PROVIDE INSIGHTFUL INFORMATION THAT EXPANDS OUR KNOWLEDGE AND SPAWNS NEW RE SEARCHANDPROVIDEINFORMATIONTHAT STRAYSFROMTHECLASSICALTEXTBOOKCASE ANDLEADSTOBETTERANDSAFERPATIENT CARE)NDEEDACASEREPORTOF+APOSIS SARCOMA IN A YOUNG HOMOSEXUAL MAN IS THE SEMINAL OBSERVATION TO THE DEVELOPMENT OF ACQUIRED IM MUNEDElCIENCYSYNDROME3EMINAL PATIENTCASEREPORTSLINKEDTHE&OOD AND $RUG !DMINISTRATIONAPPROVED INDICATION FOR THE ANOREXIC AGENTS FENmURAMINE AND DEXFENmURAMINE WITH PRIMARY PULMONARY HYPERTEN SION AND SUBSEQUENTLY SPAWNED TRI ALS THAT EVALUATED THE MECHANISM INCIDENCE AND RISK FACTORS OF THIS ADVERSE EFFECT CULMINATING IN THEIR WITHDRAWALFROMTHEMARKET -ANYBIOMEDICALJOURNALSPUBLISH CASEREPORTSANDPROVIDEAUTHORSWITH GUIDELINES THAT PROVIDE INSTRUCTION FOR ACCEPTANCE CRITERIA CONTENT AND FORMAT4HETYPESOFRELEVANTPATIENT CASE REPORTS THAT MERIT PUBLICATION ARELISTEDIN!PPENDIX!4HISARTICLE 1VSQPTF (VJEFMJOFT GPS XSJUJOH QBUJFOU DBTF SFQPSUT XJUI B GPDVT PO NFEJDBUJPO SFMBUFESFQPSUTBSFQSPWJEFE 4VNNBSZ 5IF GPSNBU PG B QBUJFOU DBTF SFQPSU FODPNQBTTFT UIF GPMMPXJOH GJWF TFDUJPOT BO BCTUSBDU BO JOUSPEVDUJPO BOE PCKFDUJWFUIBUDPOUBJOBMJUFSBUVSFSFWJFXB EFTDSJQUJPOPGUIFDBTFSFQPSUBEJTDVTTJPO UIBUJODMVEFTBEFUBJMFEFYQMBOBUJPOPGUIF MJUFSBUVSF SFWJFX B TVNNBSZ PG UIF DBTF BOEBDPODMVTJPO5IFBCTUSBDUPGBQBUJFOU DBTF SFQPSU TIPVME TVDDJODUMZ JODMVEF UIF GPVSTFDUJPOTPGUIFNBJOUFYUPGUIFSFQPSU 5IF JOUSPEVDUJPO TFDUJPO TIPVME QSPWJEF UIFTVCKFDUQVSQPTFBOENFSJUPGUIFDBTF SFQPSU*UNVTUFYQMBJOXIZUIFDBTFSFQPSU JT OPWFM PS NFSJUT SFWJFX BOE JU TIPVME JODMVEF B DPNQSFIFOTJWF MJUFSBUVSF SFWJFX UIBU DPSSPCPSBUFT UIF BVUIPST DMBJNT 5IF DBTF QSFTFOUBUJPO TFDUJPO TIPVME EFTDSJCF UIF DBTF JO DISPOPMPHJDBM PSEFS BOE JO *OEFY UFSNT %SVHT BEWFSTF SFBDUJPOT (VJEFMJOFT3FQPSUT8SJUJOH "N + )FBMUI4ZTU 1IBSN WILL PROVIDE GUIDELINES FOR WRITING THECASEANDACONCLUSION3UPPLE PATIENTCASEREPORTSWITHAFOCUSON MENTARYPARTSSUCHASTABLESlGURES GRAPHS AND ILLUSTRATIONS PROVIDE ES MEDICATIONRELATEDREPORTS SENTIALDATAANDWILLENHANCETHEARTI 'PSNBUPGUIFQBUJFOUDBTFSFQPSU CLESmOWANDCLARITY'ENERALLYMOST #ASE REPORTS SHOULD ENCOMPASS OFTHEDATACONTAINEDINSUPPLEMEN THE FOLLOWING lVE SECTIONS AN AB TARY PARTS SHOULD NOT BE DUPLICATED STRACTANINTRODUCTIONANDOBJECTIVE INTHETEXT0ATIENTCASEREPORTSCAN WITHALITERATUREREVIEWADESCRIPTION DESCRIBEASINGLECASEREPORTORASE OF THE CASE REPORT A DISCUSSION THAT RIESOFCASEREPORTS#ASEREPORTSARE INCLUDES A DETAILED EXPLANATION OF GENERALLYnWORDSINLENGTH THE LITERATURE REVIEW A SUMMARY OF WITHnREFERENCES4HETITLEOFTHE (%.29 #/(%. -3 0(!2-$ &##- "#00 #'0 IS !SSOCIATE 0ROFESSOROF0HARMACY0RACTICE!RNOLD-ARIE3CHWARTZ#OLLEGEOF 0HARMACY(EALTH3CIENCES,ONG)SLAND5NIVERSITY"ROOKLYN.9 AND$IRECTOROF0HARMACOTHERAPY%DUCATION2ESEARCHAND2ESIDEN CY0ROGRAMS$EPARTMENTSOF0HARMACYAND-EDICINE+INGSBROOK *EWISH-EDICAL#ENTER"ROOKLYN !DDRESSCORRESPONDENCETO$R#OHENATTHE$EPARTMENTOF0HAR FOPVHI EFUBJM GPS UIF SFBEFS UP FTUBCMJTI IJTPSIFSPXODPODMVTJPOTBCPVUUIFDBTFT WBMJEJUZ5IFEJTDVTTJPOTFDUJPOJTUIFNPTU JNQPSUBOU TFDUJPO PG UIF DBTF SFQPSU *U PVHIUUPFWBMVBUFUIFQBUJFOUDBTFGPSBDDV SBDZWBMJEJUZBOEVOJRVFOFTTDPNQBSFBOE DPOUSBTUUIFDBTFSFQPSUXJUIUIFQVCMJTIFE MJUFSBUVSFEFSJWFOFXLOPXMFEHFTVNNB SJ[FUIFFTTFOUJBMGFBUVSFTPGUIFSFQPSUBOE ESBX SFDPNNFOEBUJPOT 5IF DPODMVTJPO TFDUJPOTIPVMECFCSJFGBOEQSPWJEFBDPO DMVTJPOXJUIFWJEFODFCBTFESFDPNNFOEB UJPOTBOEBQQMJDBCJMJUZUPQSBDUJDF $PODMVTJPO 1BUJFOU DBTF SFQPSUT BSF WBMV BCMF SFTPVSDFT PG OFX BOE VOVTVBM JOGPS NBUJPOUIBUNBZMFBEUPWJUBMSFTFBSDI "N+)FBMUI4ZTU1IBSN7PM0DU MACY+INGSBROOK*EWISH-EDICAL#ENTER3CHENECTADY!VENUE "ROOKLYN.9HCOHENLIU AOLCOM #OPYRIGHT Ú !MERICAN 3OCIETY OF (EALTH3YSTEM 0HARMA CISTS)NC!LLRIGHTSRESERVED $/)AJHP 02)-%2 0ATIENTCASEREPORT CASEREPORTSHOULDBEDESCRIPTIVEAC CURATEANDSUCCINCT !BSTRACT#ASEREPORTSSHOULDIN CLUDEANABSTRACTOFnWORDS 4HE AVAILABILITY OF AN ABSTRACT WILL ALLOW FOR EASIER RETRIEVAL FROM ELEC TRONIC DATABASES AND HELP RESEARCH ERS DISCERN THEIR LEVELS OF INTEREST IN THE CASE REPORT 4HE ABSTRACT SHOULD INCLUDE THE SAME FOUR SEC TIONS AS THE MAIN TEXT IN A SUCCINCT FORMINTRODUCTION AND OBJECTIVE CASE PRESENTATION DISCUSSION AND CONCLUSIONBUT THE FORMAT MAY VARYDEPENDINGONAJOURNALSSTYLEIF SUBMITTEDFORPUBLICATION )NTRODUCTION 4HE INTRODUCTION SECTIONSHOULDBECONCISEANDSALIENT AND IMMEDIATELY ATTRACT THE ATTEN TION AND INTEREST OF THE READER 4HE INTRODUCTIONSHOULDPROVIDETHESUB JECT PURPOSE AND MERIT OF THE CASE REPORT)TSHOULDPRESENTBACKGROUND INFORMATION THAT PROVIDES CLARITY TO THESUBJECTOFDISCUSSION4HISSHOULD BEFOLLOWEDBYANEXPLANATIONOFWHY THE CASE REPORT IS NOVEL OR MERITS REVIEW!FOCUSEDCOMPREHENSIVELIT ERATURE REVIEW THAT CORROBORATES THE AUTHORS CLAIMS SHOULD ACCOMPANY THEINTRODUCTION)FFEWCITATIONSARE FOUNDTHEYSHOULDALLBECITEDCHRON OLOGICALLYHOWEVERIFMANYCITATIONS ARE FOUND THE SEMINAL HISTORICAL ANDMOSTPERTINENTREFERENCESSHOULD BECITED4HESIGNIlCANTDETAILSFROM THE LITERATURE REVIEW AND HOW THOSE DETAILS COMPARE AND CONTRAST TO THE CURRENT CASE SHOULD BE EXPLAINED IN THE DISCUSSION NOT IN THE INTRODUC TION ! BRIEF ONE OR TWOSENTENCE DESCRIPTIONOFTHEPATIENTCASESHOULD BEPROVIDEDANDISANEXCELLENTSEGUE FORTHECASEPRESENTATIONSECTION4HE INTRODUCTION SHOULD NOT BE MORE THAN THREE PARAGRAPHS AND DOES NOT NEED TO BE LABELED WITH A HEADING IE)NTRODUCTION ! LITERATURE REVIEW SHOULD LIST THESTRATEGYANDEXTENTOFTHESEARCH AND SHOULD INCLUDE THE DATABASE SEARCHED THE DATES THAT THE DATA BASE WAS SEARCHED THE LANGUAGES COVERED AND THE SEARCH TERMS USED 4HELITERATURESEARCHSHOULDPROVIDE ENOUGHDETAILFORTHEREADERTOEASILY REPRODUCETHESEARCH$ATABASESTHAT ARE COMMONLY SEARCHED BECAUSE OF THEIRCOMPREHENSIVENESSOFBIOMEDI CAL CONTENT INCLUDE -%$,).% AND %-"!3% (OWEVER IT IS IMPORTANT THAT THE BREADTH OF THE SEARCH USES DATABASES THAT CONTAIN INFORMATION THATMAYNOTBEFOUNDIN-%$,).% OR %-"!3% &OR EXAMPLE A CASE REPORT OF AN ADVERSE DRUG EVENT OR MEDICATIONERRORSHOULDINCLUDEARE VIEWOFANADVERSEREACTIONDATABASE SUCH AS #LIN!LERT OR DATABASES THAT REVIEW PHARMACY PUBLICATIONS SUCH AS )NTERNATIONAL 0HARMACEUTICAL!B STRACTS AND )OWA $RUG )NFORMATION 3ERVICE!CASEREPORTDESCRIBINGTHE COLLABORATION OF A PHARMACIST AND A NURSE THAT IMPROVES A PATIENTS CARE SHOULDINCLUDEASEARCHINTHENURS INGDATABASESUCHASTHE#UMULATIVE )NDEX TO .URSING AND !LLIED (EALTH ,ITERATURE&URTHERMORETOMAXIMIZE THELITERATURESEARCHlNDINGSAUTHORS SHOULDMETICULOUSLYSEARCHTHEREFER ENCELISTSOFREVIEWARTICLESANDMETA ANALYSES &INALLY CLINICIANS OUGHT TO BE COGNIZANT THAT EARLY REPORTS MAY NOTBEDETECTEDINALITERATURESEARCH BECAUSE OF CHANGES IN CONCEPTS NO MENCLATURE AND TERMINOLOGY SINCE THEIRPUBLICATIONDATE #ASE PRESENTATION 4HE DESCRIP TIONOFTHEPATIENTCASEISONEOFTHE MOST INTEGRAL SECTIONS OF THE CASE REPORT)TSHOULDDESCRIBETHECASEIN CHRONOLOGICAL ORDER AND IN ENOUGH DETAIL FOR THE READER TO ESTABLISH HIS OR HER OWN CONCLUSIONS ABOUT THE CASES VALIDITY ! CASE REPORT THAT CONTAINS DETAILED AND RELEVANT PA TIENT INFORMATION ALLOWS THE READER WITH A DIFFERENT CLINICAL EXPERTISE TO UNCOVER IDIOSYNCRACIES THAT ARE NOT DETECTED OR DESCRIBED BY THE AUTHOR AND STIMULATES FURTHER INQUIRY AND COMMENTARY 4HE CASE PRESENTATION SHOULD ONLY INCLUDE INFORMATION THATPERTAINSTOTHECASEANDREFRAIN FROM PROVIDING CONFUSING AND SU PERmUOUS DATA $AILY PATIENT PROG RESS INCLUDING NORMAL VITAL SIGNS ROUTINE LABORATORY RESULTS TYPICAL CONSULTATION WITH OTHER DISCIPLINES STEPDOWN TRANSFERS TO WARDS AND OTHERIRRELEVANTPATIENTINFORMATION MUSTBEAVOIDED4HEAUTHORSHOULD ESTABLISH A CAUSAL AND TEMPORAL RE LATIONSHIPANDINDICATETHEEFFECTOF TREATMENTANYUNANTICIPATEDEFFECTS THEPATIENTSlNALOUTCOMEANYFUR THER PROPOSED TREATMENTS AND THE PATIENTS PRESENT STATUS AT THE TIME OFTHEREPORT 0ATIENTSDEMOGRAPHICSANDHISTORY 0ATIENT DEMOGRAPHICS SUCH AS AGE HEIGHTWEIGHTSEXRACEANDOCCUPA TIONMUSTBEINCLUDED!LTHOUGHTHE RACEOROCCUPATIONOFTHEPATIENTMAY APPEARASSUPERmUOUSTHISTYPEOFIN FORMATIONMAYUNCOVERPHARMACOGE NOMIC OR ENVIRONMENTAL INmUENCES )N ORDER TO LIMIT THE POSSIBILITY OF IDENTIFYING THE PATIENT THE PATIENTS INITIALS DATE OF BIRTH AND OTHER IDENTIlERSMUSTNOTBEUSED0RECISE DATESINCLUDINGTHEMONTHDAYAND YEAROFADMISSIONOROTHERIMPORTANT EVENTSSHOULDBEAVOIDEDTHEYCAN AIDINIDENTIFYINGTHEPATIENTANDDE TRACTTHEREADERFROMTHECASEREPORT BYCALCULATINGELAPSEDTIME)NABRIEF SUMMARY AND IN A NARRATIVE FORM THEPATIENTSCHIEFCOMPLAINTPRESENT ILLNESS MEDICAL HISTORY FAMILY AND SOCIALHISTORYANDUSEOFRECREATIONAL DRUGS SHOULD BE LISTED (EADINGS FOREACHPARTOFTHEPATIENTSHISTORY SHOULDNOTBEUSED4HETYPEOFPHYS ICAL EXAMINATION PERFORMED SHOULD BE DESCRIBED AND ANY ABNORMALITIES SHOULDBEREPORTED 0ATIENTSLABORATORYANDDIAGNOSTIC DATA4HEPATIENTSLABORATORYVALUES ANDDIAGNOSTICDATATHATSUPPORTTHE CASEREPORTANDRULEOUTADIFFERENTIAL DIAGNOSIS SHOULD BE REPORTED 0ERTI NENT POSITIVE OR NEGATIVE LABORATORY RESULTS MUST BE PROVIDED 7HEN THE REFERENCERANGEOFALABORATORYVALUE IS NOT WIDELY KNOWN OR ESTABLISHED ITSHOULDBEPROVIDEDINPARENTHESES $IAGNOSTIC PROCEDURES THE TIMELINE INWHICHTHEYWEREADMINISTEREDAND A BRIEF REPORT OF THE RESULTS SHOULD BE INCLUDED! VERBATIM DESCRIPTION "N+)FBMUI4ZTU1IBSN7PM0DU 02)-%2 0ATIENTCASEREPORT OFAPATHOLOGISTSREPORTMUSTNOTBE USED INSTEAD A SALIENT REPORT OF THE RESULTS SHOULD BE INCLUDED 0ICTURES OF HISTOPATHOLOGY ROENTGENOGRAMS ELECTROCARDIOGRAPHS AND OTHER DI AGNOSTIC TESTS SKIN MANIFESTATIONS WOUNDSANDOTHERANATOMICALPARTS MAYBEPROVIDEDANDADDTOTHEIN TEREST OF THE REPORT !NY IDENTIFYING FEATURES OF A PATIENTS PHOTOGRAPH SHOULD BE BLOCKED OUT )NSTITUTIONAL POLICIES AND PATIENT PERMISSION FOR OBTAINING AND USING PHOTOGRAPHS MUSTBEFOLLOWED 0ATIENTS MEDICATION HISTORY 4HE PATIENTS MEDICATION HISTORY SHOULD INCLUDE THE MEDICATIONS NAME STRENGTH DOSAGE FORM ROUTE AND DATES OF ADMINISTRATION 4HE BRAND ORGENERICNAMEOFTHEDRUGANDTHE NAME OF THE MANUFACTURER MAY BE RELEVANT TO THE CASE AND SHOULD BE LISTED"RANDANDGENERICDRUGSMAY HAVE DIFFERENT BIOAVAILABILITY FAC TORS OR MAY CONTAIN DIFFERENT lLLERS PRESERVATIVES ADDITIVES OR DYESALL OF WHICH MAY BE PERTINENT TO CASES REGARDINGTHEDRUGSPHARMACOKINET ICSEFlCACYANDADVERSEEFFECTS3INCE AMEDICATIONHISTORYMAYOFTENOMIT HERBALS VACCINES DEPOT INJECTIONS AND NONPRESCRIPTION MEDICATIONS THEAUTHORSHOULDSPECIFYTHEHISTORY OF EACH OF THESE MEDICATION TYPES 4HE DATES A MEDICATION WAS DISCON TINUED SHOULD BE IDENTIFIED SINCE MEDICATIONSMAYHAVELASTINGEFFECTS FOR MONTHS AFTER DISCONTINUATION 4HEAUTHORSHOULDVERIFYANDINFORM THEREADEROFTHEPATIENTSHISTORYOF MEDICATIONADHERENCE )NORDERTOEVALUATETHEAPPROPRI ATENESSOFAMEDICATIONSDOSAGEREGI MENLABORATORYVALUESTHATDESCRIBE RENAL AND HEPATIC ORGAN FUNCTIONS SHOULD BE PROVIDED 2ENAL FUNCTION VALUES SHOULD INCLUDE SERUM CRE ATININEBLOODUREANITROGENANDTHE TOTAL mUID VOLUME INTAKE AND EXCRE TION WHEN A URINARY CATHETER IS IN PLACE #ALCULATION METHODS USED TO ESTIMATE THE PATIENTS RENAL FUNCTION SHOULD BE IDENTIlED ,IVER FUNCTION TESTS SUCH AS THE )NTERNATIONAL .OR MALIZED 2ATIO SERUM ALBUMIN AND ALBUMINGLOBULIN RATIO AND HEPATIC ENZYME TESTS SUCH AS ASPARTATE AND ALANINEAMINOTRANSFERASESSHOULDBE PROVIDED !COMPREHENSIVEMEDICATIONHIS TORYSHOULDALSOINCLUDETHEPATIENTS ALLERGY STATUS 4HE ALLERGY HISTORY SHOULD INCLUDE THE DATE OF THE REAC TION THE NAME OF THE DRUG AND THE TYPE OF ALLERGIC MANIFESTATION 4HE NAMEOFTHEDRUGSHOULDBELISTEDAS EITHERTHEGENERICORBRANDNAMEAND COMBINATIONPRODUCTSSHOULDBELIST EDASSUCH!LLERGIESTOCOMBINATION PRODUCTSSUCHAS5NASYNAND:OSYN CAN BE MISLABELED AS A PENICILLIN AL LERGY RATHER THAN A SULFONE ALLERGY ORVICEVERSA3IMILARLYANALLERGYTO 3EPTRAOR"ACTRIMCANBEMISLABELED AS AN ALLERGY TO SULFONAMIDE RATHER THAN TO TRIMETHOPRIM OR VICE VERSA 3OME NONALLERGIC ADVERSE DRUG REAC TIONS SUCH AS DRUGINDUCED SEIZURES MAYNOTBEINCLUDEDINTHEALLERGYHIS TORY NEVERTHELESS THE AUTHOR SHOULD INVESTIGATEANDREPORTSUCHDATA 7HENAVAILABLEDRUGSERUMLEVELS OUGHTTOBELISTEDALONGWITHTHETIME THEY WERE DRAWN AND THEIR RELATION SHIPTOTHEDOSAGEOFTHEMEDICATION ADMINISTERED EG TROUGH PEAK $RUG SERUM LEVELS SHOULD DELINEATE BETWEEN TOTAL AND FREE LEVELS EG PHENYTOIN VALPROIC ACID 3INCE THERE MAY BE INTRALABORATORY VARIA TIONSINDRUGSERUMREFERENCERANGES THE REFERENCE RANGE SHOULD ALWAYS BE PROVIDED IN PARENTHESES 7HEN PERTINENTTOTHECASETHEMETHODOF DRUGSERUMLEVELASSAYSHOULDALSOBE INCLUDED 0ATIENTS DIET 4HE PATIENTS DIET HISTORY OUGHT TO BE INCLUDED IN THE CASE REPORT &OOD CAN INTERACT WITH MEDICATIONSYIELDINGLOWERORHIGHER SERUM DRUG LEVELS OR INCREASING OR DECREASINGTHEDRUGSPHARMACOLOGIC EFFECT 4HE PATIENTS DIET CAN HAVE CONSEQUENTIAL EFFECTS ON A DISEASE STATE $IETARY CAUSES OF ADVERSE EVENTS SUCH AS ALLERGIC REACTIONS SHOULD BE RULED OUT BEFORE SUSPECT INGADRUGALLERGY "N+)FBMUI4ZTU1IBSN7PM0DU $ISCUSSION 4HE DISCUSSION SEC TION IS THE MOST IMPORTANT SECTION OF THE CASE REPORT 4HE DISCUSSION SHOULD EVALUATE THE PATIENT CASE FOR ACCURACY VALIDITY AND UNIQUENESS COMPARE AND CONTRAST THE CASE RE PORT WITH THE PUBLISHED LITERATURE AND DERIVE NEW KNOWLEDGE AND AP PLICABILITY TO PRACTICE 4HE AUTHOR MUSTCONlRMTHATTHECASEREPORTIS VALIDBYENSURINGTHEACCURACYOFTHE DATA PRESENTED AND BY ESTABLISHING A TEMPORAL AND CAUSAL RELATIONSHIP &OR DRUGINDUCED ADVERSE EFFECTS A VALIDATEDNOMOGRAMTOESTABLISHTHE PROBABILITY OF CAUSALITY SUCH AS THE .ARANJO NOMOGRAM MUST BE USED 4HE AUTHOR SHOULD COMPREHENSIVELY LIST THE LIMITATIONS OF THE CASE AND SHOULD DESCRIBE THE SIGNIlCANCE OF EACHLIMITATION 4HEAUTHORSHOULDBRIEmYSUMMA RIZE THE PUBLISHED LITERATURE DERIVED FROM THE LITERATURE REVIEW AND MAY PROVIDEADETAILEDSUMMARYOFAFEW CITATIONS!TABLELISTINGTHEPERTINENT FACTS OF THE CASES DETECTED FROM THE LITERATUREREVIEWISASIMPLEMETHOD FORPROVIDINGEXTENSIVEDETAILEDDATA INANINTERPRETABLEFORM4HEAUTHOR SHOULD COMPARE AND CONTRAST THE NUANCES OF THE CASE REPORT WITH THE PUBLISHED LITERATURE AND SHOULD EX PLAIN AND JUSTIFY THE DIFFERENCES AND SIMILARITIES 4HE DISCUSSION SECTION OFACASEREPORTISINNOWAYDESIGNED TO PROVIDE COMPREHENSIVE DETAILS OF EACH CITATION OF AN ALLINCLUSIVE AND EXTENSIVE LITERATURE REVIEWTHIS SHOULD BE SAVED FOR REVIEW ARTICLES !LL THE REFERENCES CITED SHOULD BE CRITICALLY EVALUATED 4RANSFERRING AN UNREAD REFERENCE CITED IN ANOTHER ARTICLEISUNETHICALANDWILLPLACETHE AUTHOROFTHECASEREPORTATRISKOFER RORANDEMBARRASSMENT 4HE AUTHOR SHOULD NEXT SUMMA RIZETHEESSENTIALFEATURESOFTHECASE REPORTJUSTIFYWHYTHISCASEISUNIQUE AND DRAW RECOMMENDATIONS AND CONCLUSIONS #ONCLUSION "ASED ON THE EVI DENCEREVIEWEDINTHEDISCUSSIONSEC TIONTHEAUTHORMUSTPROVIDEAJUSTI 02)-%2 0ATIENTCASEREPORT lEDCONCLUSION4HEAUTHORMUSTBE CAREFUL NOT TO MAKE lRM JUDGMENTS AND SWEEPING RECOMMENDATIONS BASED ON SPECULATION ON LIMITED AND TENUOUS INFORMATION OR ON A FEWCASEREPORTS(OWEVERJUSTIlABLE EVIDENCEBASED RECOMMENDATIONS SHOULD BE STATED 4HE AUTHOR MAY SUGGEST THAT CLINICIANS BE COGNIZANT OF THE INSIGHT LEARNED FROM THE CASE OR SUGGEST HEIGHTENED VIGILANCE PRUDENT MANAGEMENT AVOIDANCE FURTHERSTUDYBEFORETAKINGACTIONOR NEWIDEASFORINVESTIGATION(OWTHE INFORMATIONDISCOVEREDFROMTHECASE REPORTWILLAPPLYTOTHEAUTHORSPRAC TICESHOULDBEDESCRIBED4HISSECTION SHOULD BE CONCISE AND NOT EXCEED ONE PARAGRAPH 'UIDELINES FOR WRIT INGPATIENTCASEREPORTSINACHECKLIST FORMAT !PPENDIX " CAN FACILITATE ANDENHANCETHEMANUSCRIPTWRITING PROCESS $PODMVTJPO 0ATIENTCASEREPORTSAREVALUABLERE SOURCESOFNEWANDUNUSUALINFORMA TIONTHATMAYLEADTOVITALRESEARCH 3FGFSFODFT 'OTTLEIB'*2OGOZ!6OGEL*6ETAL!PRE LIMINARY COMMUNICATION ON EXTENSIVELY DISSEMINATED+APOSISSARCOMAINAYOUNG HOMOSEXUAL MAN !M * $ERMATOPATHOL $OUGLAS * -UNRO * +ITCHIN! ET AL 0UL MONARY HYPERTENSION AND FENmURAMINE "R-ED* !TANASSON 0 7EISS " 3CHMID % ET AL 0ULMONARYHYPERTENSIONANDDEXFENmURA MINE,ANCET,ETTER 7EIR %+ 2EEVE (, (UANG *- ET AL !NOREXIC AGENTS AMINOREX FENmURAMINE AND DEXFENmURAMINE INHIBIT POTASSIUM CURRENTINRATPULMONARYVASCULARSMOOTH MUSCLE AND CAUSE PULMONARY VASOCON STRICTION#IRCULATION !BENHAIM , -ORIDE 9 "RENOT & ET AL !PPETITESUPPRESSANTDRUGSANDTHERISKOF PRIMARYPULMONARYHYPERTENSION.%NGL *-ED $E"AKEY,$E"AKEY34HECASEREPORT) 'UIDELINES FOR PREPARATION )NT * #ARDIOL -C#ARTHY ,( 2EILLY +% (OW TO WRITE A CASEREPORT&AM-ED .ARANJO#!"USTO53ELLERS%-ETAL! METHOD FOR ESTIMATING THE PROBABILITY OF ADVERSE DRUG REACTIONS #LIN 0HARMACOL 4HER 4VNNBSZ 0ATIENT CASE REPORTS ARE VALUABLE RESOURCESOFNEWANDUNUSUALINFOR MATIONTHATMAYLEADTOVITALRESEARCH ANDADVANCESINCLINICALPRACTICETHAT IMPROVE PATIENT OUTCOMES #ASE RE PORTSSHOULDCONTAINANABSTRACTAND "QQFOEJY"$SJUFSJBGPSQVCMJTIBCMF DBTFSFQPSUT FOURSECTIONSANINTRODUCTIONCASE 0UBLISHABLE PATIENT CASE REPORTS INCLUDE PRESENTATIONDISCUSSIONANDCONCLU CASESTHAT SION 4HE INTRODUCTION PROVIDES THE SUBJECT PURPOSE AND MERIT OF THE s !DVANCEMEDICALSCIENCEANDSPAWNRESEARCH CASEREPORTANDTHESTRATEGYUSEDFOR s $ESCRIBERAREPERPLEXINGORNOVELDIAGNOSTIC FEATURESOFADISEASESTATE THELITERATUREREVIEW4HEPATIENTCASE s 2EPORT THERAPEUTIC CHALLENGES CONTROVERSIES PRESENTATION SHOULD BE DESCRIPTIVE ORDILEMMAS ORGANIZED CHRONOLOGICALLY ACCURATE s $ESCRIBEANEWSURGICALPROCEDURE SALIENT AND PRESENTED IN A NARRATIVE s 2EPORT HOW A DRUG CAN ENHANCE A SURGICAL PROCEDURE FORM 4HE DISCUSSION SHOULD COM s 4EACH HUMANISTIC LESSONS TO THE HEALTH CARE PARE AND CONTRAST THE CASE REPORTS PROFESSIONAL lNDINGS WITH THE LITERATURE REVIEW s 2EVIEW A UNIQUE JOB DESCRIPTION OF A HEALTH CAREPROFESSIONALTHATIMPROVESPATIENTCARE ESTABLISHACAUSALANDTEMPORALRELA s 2EPORT NEW MEDICAL ERRORS OR MEDICATION TIONSHIP AND VALIDATE THE CASE WITH ERRORS APROBABILITYSCALE4HELITERATURERE s $ISCOVERADEVICEMALFUNCTIONTHATRESULTSIN PATIENTHARM VIEWSHOULDBEEXTENSIVEANDSHOULD ADVERSE EFFECTS AND PATIENT TOXICITY SUPPORT THE JUSTIlCATION OF THE CASE s $ESCRIBE OFARADIOPAQUEAGENT REPORT4HEDISCUSSIONSECTIONSHOULD s $ESCRIBELIFETHREATENINGADVERSEEVENTS ENDWITHABRIEFSUMMARYOFTHECASE s $ESCRIBE DANGEROUS AND PREDICTABLE ADVERSE EFFECTSTHATAREPOORLYAPPRECIATEDANDRARELY WITH RATIONAL RECOMMENDATIONS AND RECOGNIZED CONCLUSIONS 4HE CONCLUSION SECTION s $ESCRIBERAREORNOVELADVERSEDRUGREACTIONS MUSTPROVIDEABRIEFCONCLUSIONWITH s $ESCRIBE A THERAPEUTIC FAILURE OR A LACK OF THERAPEUTICEFlCACY EVIDENCEBASEDRECOMMENDATIONS s $ESCRIBERAREORNOVELDRUGnDRUGDRUGnFOOD ORDRUGnNUTRIENTINTERACTIONS s 2EPORT UNLABELED OR UNAPPROVED USES OF A MEDICATION s %XPLORE THE USE OF PHARMACOGENOMICS TO MANAGEDISEASES s 5SE LIFESAVING TECHNIQUES NOT PREVIOUSLY DOCUMENTED s 5SE PHARMACOECONOMIC PRINCIPLES THAT IM PROVEPATIENTCARE s 5NCOVERBARRIERSTOPATIENTADHERENCE s $ISCOVERANINTERACTIONBETWEENADRUGANDA LABORATORY TEST THAT YIELDS A FALSEPOSITIVE OR FALSENEGATIVERESULT s $ESCRIBETHEEFFECTOFDRUGSINPREGNANCYAND LACTATION s $ETECTNOVELPHARMACOKINETICORPHARMACO DYNAMICPRINCIPLESAND s 5SETECHNOLOGYTOIMPROVEPATIENTOUTCOMES "QQFOEJY#(VJEFMJOFTGPSXSJUJOH QBUJFOUDBTFSFQPSUNBOVTDSJQUT 4HE FOLLOWING CHECKLIST IS COMPREHENSIVE SOME ITEMS MAY NOT APPLY TO ALL TYPES OF CASE REPORTS )!BSTRACT )NTRODUCTIONANDOBJECTIVE #ASEREPORT $ISCUSSION #ONCLUSION )))NTRODUCTION $ESCRIBETHESUBJECTMATTER 3TATETHEPURPOSEOFTHECASEREPORT 0ROVIDEBACKGROUNDINFORMATION 0ROVIDEPERTINENTDElNITIONS $ESCRIBETHESTRATEGYOFTHELITERATUREREVIEW ANDPROVIDESEARCHTERMS *USTIFYTHEMERITOFTHECASEREPORTBYUSING THELITERATUREREVIEW )NTRODUCETHEPATIENTCASETOTHEREADER -AKE THE INTRODUCTION BRIEF AND LESS THAN THREEPARAGRAPHS )))0ATIENTCASEPRESENTATION $ESCRIBETHECASEINANARRATIVEFORM 0ROVIDE PATIENT DEMOGRAPHICS AGE SEX HEIGHTWEIGHTRACEOCCUPATION !VOID PATIENT IDENTIlERS DATE OF BIRTH INI TIALS $ESCRIBETHEPATIENTSCOMPLAINT ,ISTTHEPATIENTSPRESENTILLNESS ,ISTTHEPATIENTSMEDICALHISTORY ,ISTTHEPATIENTSFAMILYHISTORY ,ISTTHEPATIENTSSOCIALHISTORY ,IST THE PATIENTS MEDICATION HISTORY BEFORE ADMISSIONANDTHROUGHOUTTHECASEREPORT %NSURETHATTHEMEDICATIONHISTORYINCLUDES HERBALSVACCINESDEPOTINJECTIONSANDNON PRESCRIPTION MEDICATIONS AND STATE THAT THE PATIENTWASASKEDFORTHISHISTORY ,ISTEACHDRUGSNAMESTRENGTHDOSAGEFORM ROUTEANDDATESOFADMINISTRATION 6ERIFYTHEPATIENTSMEDICATIONADHERENCE 0ROVIDE RENAL AND HEPATIC ORGAN FUNCTION DATAINORDERTODETERMINETHEAPPROPRIATE NESSOFMEDICATIONDOSINGREGIMENS "N+)FBMUI4ZTU1IBSN7PM0DU 02)-%2 0ATIENTCASEREPORT ,ISTTHEPATIENTSDRUGALLERGYSTATUSINCLUDINGTHENAMEOFTHEDRUG BRANDORGENERICANDTHEDATEANDTYPEOFREACTION ,IST THE PATIENTS ADVERSE DRUG REACTION HISTORY AND THE DATES OF THE REACTION 0ROVIDEPERTINENTSERUMDRUGLEVELSANDINCLUDETHETIMEOFEACHLEVEL TAKENANDITSRELATIONSHIPTOADOSE 0ROVIDETHEPATIENTSDIETARYHISTORY 0ROVIDEPERTINENTlNDINGSONPHYSICALEXAMINATION 0ROVIDEPERTINENTLABORATORYVALUESTHATSUPPORTTHECASE 0ROVIDE THE REFERENCE RANGE FOR LABORATORY VALUES THAT ARE NOT WIDELYKNOWNORESTABLISHED ,ISTTHECOMPLETEDDIAGNOSTICPROCEDURESTHATAREPERTINENTANDSUP PORTTHECASE 0ARAPHRASETHESALIENTRESULTSOFTHEDIAGNOSTICPROCEDURES 0ROVIDEPHOTOGRAPHSOFHISTOPATHOLOGYROENTGENOGRAMSELECTROCAR DIOGRAMSSKINMANIFESTATIONSORANATOMYASTHEYRELATETOTHECASE /BTAINPERMISSIONFROMTHEPATIENTTOUSETHEPATIENTSPHOTOGRAPHS ORFOLLOWINSTITUTIONALGUIDELINES 0ROVIDETHEPATIENTSEVENTSINCHRONOLOGICALORDER %NSUREATEMPORALRELATIONSHIP %NSUREACAUSALRELATIONSHIP %NSURETHATTHEPATIENTCASEPRESENTATIONPROVIDESENOUGHDETAILFOR THEREADERTOESTABLISHTHECASESVALIDITY )6$ISCUSSION #OMPAREANDCONTRASTTHENUANCESOFTHECASEREPORTWITHTHELITERA TUREREVIEW %XPLAINORJUSTIFYTHESIMILARITIESANDDIFFERENCESBETWEENTHECASE REPORTANDTHELITERATURE ,ISTTHELIMITATIONSOFTHECASEREPORTANDDESCRIBETHEIRRELEVANCE #ONlRMTHEACCURACYOFTHEDESCRIPTIVEPATIENTCASEREPORT %STABLISHATEMPORALRELATIONSHIP %STABLISHACAUSALRELATIONSHIP 2EPORTTHEVALIDITYOFTHECASEREPORTBYAPPLYINGAPROBABILITYSCALE SUCHASTHE.ARANJONOMOGRAM 3UMMARIZETHESALIENTFEATURESOFTHECASEREPORT *USTIFYTHEUNIQUENESSOFTHECASE $RAWRECOMMENDATIONSANDCONCLUSIONS 6#ONCLUSION 0ROVIDEAJUSTIlEDCONCLUSION 0ROVIDEEVIDENCEBASEDRECOMMENDATIONS $ESCRIBEHOWTHEINFORMATIONLEARNEDAPPLIESTOONESOWNPRACTICE ,ISTOPPORTUNITIESFORRESEARCH %NSURETHATTHISSECTIONISBRIEFANDDOESNOTEXCEEDONEPARAGRAPH "N+)FBMUI4ZTU1IBSN7PM0DU
