- Clinicians wrote about unusual cases this year, including a hairy tongue and a vitamin D overdose.
- Medical case reports are published to outline rare signs and symptoms and innovative treatments.
Clinicians wrote about fascinating cases in 2022, including that of a man who developed a black, hairy tongue following a stroke and that of another man who took 80 times the recommended amount of vitamin D.
Clinicians publish case reports in scientific journals about unusual or rare things that happen to patients to inform their peers without needing to do comprehensive research, which can be time-consuming and expensive.
Case reports tend to shed light on unexpected symptoms, rare side effects, or innovative approaches to treatment, but usually more research is needed to support the findings.
This year, for example, Insider reported on a woman who was given a diagnosis of breast cancer after going to the dentist with a swollen jaw; a man with a "giant" gallstone; and a woman who took six times the recommended dose of CBD.
Below are three other interesting case reports from 2022.
A man overdosed on vitamin D after taking 80 times the recommended amount
A case report published in BMJ Case Reports in July described a middle-aged man who was hospitalized with diarrhea, weight loss, and ringing in his ears after taking 80 times the recommended amount of vitamin D for a month.
The clinicians wrote that a private nutritionist had told the unnamed man to take the vitamin D supplement alongside 19 others.
Vitamin D is fundamental for bone health and obtained naturally from sunlight and foods like mushrooms and oily fish. If taken in large amounts, usually from supplements, it can be toxic to organs including the kidneys, gut, and heart.
A blood test showed that the man's vitamin D levels were at seven times the recommended amount, that his calcium levels were dangerously high, and that his kidneys were at risk of damage.
Vitamin D regulates the amount of calcium in the body, so an overdose can cause high calcium levels, which can result in neurological symptoms including drowsiness, psychosis, and coma. It takes about two months for the body to clear half the amount of vitamin D taken, so symptoms can last for weeks, the report's authors said.
They said that the man's case was uncommon but that excessive levels of vitamin D can have "debilitating" effects on the body.
They said that while taking the recommended dose of vitamin D is safe, they encouraged people to speak with a doctor before starting an alternative therapy or over-the-counter medications.
A man had to quit sex after he developed rare 'post-orgasmic illness syndrome'
A case study published in the medical journal Urology Case Reports in November described a 27-year-old man who'd quit having sex until he was prescribed an antihistamine that stopped him from experiencing flu-like symptoms every time he ejaculated.
The unnamed man from Michigan experienced symptoms including coughing, a runny nose, sneezing, and a hive-like rash after he ejaculated, whether he masturbated or had sex.
Doctors believe it was due to post-orgasmic illness syndrome, which causes flu-like and allergy-like symptoms after a person orgasms after sexual activity or masturbation or spontaneously during sleep. Symptoms can last up to a week.
The report suggested that while the cause is unknown, the condition has affected at least 60 people in the past 20 years.
There are no proven treatments, but the report said an antihistamine called fexofenadine led to a 90% reduction in the patient's symptoms — including the rash — allowing him to have sex again.
The report's authors said fexofenadine needed to be studied more to know whether it could help others with POIS.
A man developed a black, hairy tongue after changing his diet
A report published in JAMA Dermatology in March described a man in his 50s who developed a black, hairy tongue after a stroke forced him to eat a diet of pureed food.
The dermatologists wrote in the report that black hairy tongue is more likely to occur in people on a pureed diet. It forms because of a lack of abrasion or stimulation on the top of the tongue, leading to a buildup of a protein called keratin. As a result, conical projections covering the tongue called filiform papillae get long and take on a hairlike appearance.
A person may also get a hairy tongue because they have poor oral hygiene, smoke cigarettes, use oxidizing mouthwashes or oral antibiotics, drink excessive amounts of coffee or tea, or have conditions that suppress the immune system such as HIV or cancer.
In this case, the report said, most of the man's tongue had a thick, black coating, sparing the sides and middle part.
Black hairy tongue is a temporary, harmless condition that usually gets better by brushing the tongue with a toothbrush or using a tongue scraper.
The clinicians wrote that the man's condition resolved after 20 days with "proper cleansing."