Case Presentation: We report a unique case of a patient with SLE, manifesting as acute renal failure, thrombocytopenia, and altered mental status. TTP–Like Syndrome may present with a myriad of symptoms and laboratory abnormalities. This case highlights the diagnostic challenges raised by the occurrence of microangiopathic hemolysis in the setting of multi–organ involvement in a […]

Case Presentation: We are reporting a patient who presented with acute renal failure secondary to intrathecal methotrexate administration for treatment of acute lymphoblastic leukemia (ALL). This occurred despite normal renal function prior to methotrexate (MTX) initiation and vigorous hydration with urinary alkalinization during treatment. Discussion: A 47 year–old Hispanic gentleman presented to our hospital complaining […]

Case Presentation: Systemic Lupus Erythematous (SLE) is one of the most common multisystem autoimmune disorders in the world with a variable prevalence of 6:100,000. There are a number of possible cardiac manifestation of SLE, the most common forms being pericarditis, myocarditis, ischemic coronary artery disease, congestive heart failure. Here we present a rare case of […]

Case Presentation: Cholelithiasis and cholecystitis are the most common causes of fistulas between the biliary tract and gastrointestinal tract. Inflammation caused by cholecystitis leads to necrosis and erosion of structures surrounding the common bile duct, resulting in fistula formation. The following case provides an atypical presentation of multiple enterobiliary fistulas in a patient presenting with […]

Case Presentation: A 52–year–old female with history of well–controlled hypertension, diabetes on insulin, end–stage renal disease status post transplant and prior breast cancer presented with complaints of painless, progressive visual loss over the past five days. Her symptoms began with occipital headaches five days ago that were “pounding.” These did not radiate, progressively worsened and […]

Case Presentation: A 36–year–old man presented with acute neurologic changes. He described an inability to see objects in the lower left aspect of his visual field which quickly progressed to numbness in his left arm, leg and trunk. His only past medical history was hypertension which had been poorly treated due to medical noncompliance. His […]

Case Presentation: A 68–year–old male with history of coronary artery disease, diabetes and hypertension presented with worsening of dyspnea on exertion. Initial assessment showed new onset atrial fibrillation with RVR and patient underwent transesophageal echo–guided (TEE) cardioversion. TEE did not show a thrombus in the left atrium including left atrial appendage. A large atheroma was […]

Case Presentation: A 93–year–old woman with advanced Alzheimer’s disease was admitted from her nursing care facility with abdominal pain. She was Spanish–speaking only and was profoundly hearing impaired. She was unable to provide any history or further details even with the help of a translator. Nursing staff at her facility reported that she had exhibited […]

Case Presentation: This is a 65–year–old caucasian woman admitted after developing purple discoloration, pain, swelling, and loss of sensation of her right thumb. Her medical history was significant for mechanical mitral valve replacement six years prior to admission with appropriate warfarin anticoagulation subsequently. Her initial examination was significant for easily palpable bilateral radial pulses. Her […]

Case Presentation: An 88–year–old male presented with weakness. He had non–bloody diarrhea one week prior which had since resolved. He had associated anorexia and weakness. His weakness persisted and he developed a right–sided dull pain. He denied any sick contacts or ingestion of uncooked food. ROS was positive only for generalized weakness. Medical history includes […]