https://www.journalijmpcr.com/index.php/IJMPCR <p style="text-align: justify;"><strong>International Journal of Medical and Pharmaceutical Case Reports (IJMPCR) (ISSN: 2394-109X)</strong> aims to publish case reports in the areas of medical and pharmaceutical sciences. By not excluding papers based on novelty, this journal facilitates the research and wishes to publish papers as long as they are technically correct and scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled, OPEN peer-reviewed, open-access INTERNATIONAL journal.</p> en-US [email protected] (International Journal of Advances in Nephrology Research) [email protected] (International Journal of Advances in Nephrology Research) Wed, 16 Sep 2026 13:30:30 +0000 OJS 3.3.0.21 http://blogs.law.harvard.edu/tech/rss 60 https://www.journalijmpcr.com/index.php/IJMPCR/article/view/527 <p>B-cell acute lymphoblastic leukaemia (B-ALL) is a haematological malignancy characterised by the clonal proliferation of B-lymphoid precursors. Cytogenetic and molecular alterations are central to B-ALL classification and diagnosis according to the 2024 World Health Organization (WHO) guidelines. Although recurrent abnormalities are well characterised, rare chromosomal alterations may provide insights into leukaemogenesis and prognosis. Here, we report the case of a 33-year-old woman diagnosed with B-ALL. Bone marrow flow cytometry identified 82% blasts expressing CD19, CD79a, CD22, and CD10, with partial cytoplasmic IgM and nuclear TdT expression and absence of CD34, consistent with B-precursor ALL. BCR::ABL1 p190 and p210 transcripts were negative by nested RT-PCR. Cerebrospinal fluid (CSF) flow cytometry detected 4.9% immature B cells with a phenotype similar to bone marrow blasts, confirming central nervous system (CNS) involvement at diagnosis. Conventional cytogenetics revealed 46,XX,t(6;19)(q21;p13). The patient received Hyper-CVAD chemotherapy and intrathecal therapy, achieving complete bone marrow remission with undetectable measurable residual disease and a normal karyotype. Subsequent CSF assessments were negative for leukaemic involvement. Three isolated CNS relapses occurred at 7, 11, and 17 months after diagnosis, with 82.7%, 95.9%, and 5.1% leukaemic cells in the CSF, respectively, despite treatment with intrathecal chemotherapy and CNS radiotherapy. The patient died 20 months after diagnosis. This case expands knowledge of rare cytogenetic abnormalities in B-ALL and highlights the need for further studies to clarify the biological and potential prognostic implications of t(6;19)(q21;p13).</p> Heloísa Zorzi Costa, Maria Eduarda Cunha-Silva, Andressa Oliveira Martin Wagner, Iris Mattos Santos-Pirath, Chandra Chiappin Cardoso, Sharbel Weidner Maluf, Maria Claudia Santos-Silva Copyright (c) 2026 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://www.journalijmpcr.com/index.php/IJMPCR/article/view/527 Wed, 16 Sep 2026 00:00:00 +0000 https://www.journalijmpcr.com/index.php/IJMPCR/article/view/528 <p>Neuroleptic malignant syndrome (NMS) and lithium toxicity are life-threatening complications of psychotropic medication exposure with substantially overlapping clinical manifestations, potentially delaying recognition when they occur together. We report a fatal case of a 40-year-old man with bipolar affective disorder who presented seven days after intentional ingestion of lithium, lorazepam, olanzapine, divalproex, and quetiapine. He developed persistent high-grade fever, altered sensorium, generalised rigidity, seizures, respiratory failure, rhabdomyolysis, stage 3 acute kidney injury (AKI), hyperkalaemia, transaminitis, and mixed metabolic and respiratory acidosis. NMS with suspected concomitant lithium toxicity was diagnosed clinically. Management included immediate withdrawal of psychotropic agents, bromocriptine, aggressive hydration, active cooling, correction of electrolyte abnormalities, peritoneal dialysis followed by continuous renal replacement therapy (CRRT), and multidisciplinary care involving nephrology, neurology, and psychiatry. Despite treatment, the patient developed refractory hyperthermia, worsening acidosis, refractory hypotension, and cardiac arrest with pulseless ventricular tachycardia progressing to asystole. This case highlights the diagnostic overlap between NMS and lithium toxicity, the potentially catastrophic consequences of delayed presentation after deliberate self-poisoning, and the importance of early recognition and appropriate renal replacement therapy in critically ill patients with severe AKI.</p> Saraswathi Yashaswini, Manjusha Yadla, P. Srinivas Copyright (c) 2026 Author(s). The licensee is the journal publisher. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0 https://www.journalijmpcr.com/index.php/IJMPCR/article/view/528 Wed, 23 Sep 2026 00:00:00 +0000