Case Presentation: A 35‐year‐old Caucasian female presented with progressive abdominal distension and jaundice. An extensive work up was done which included exploratory laparotomy demonstrating hepatomegaly and liver biopsy showed histopathology consistent with Budd Chiari syndrome. Although MRI and Doppler ultrasound were negative for hepatic vein occlusion, the patient was presumed to have idiopath‐ic Budd Chiari […]

Learning Objectives: 1. Recognize thromboembolism as an atypical presentation of Inflammatory Bowel Disease (IBD). 2. Understand the relationship between IBD and hypercoagulability. Case Information: A 35 year old non‐smoking female with no past medical history and no family history of neurologic, clotting, or GI disorders presented to the hospital with headache and diplopia. On exam […]

Background: Hydralazine is a popular and effective antihypertensive and afterload reducing agent. It is frequently used in patients with congestive heart failure and renal insufficiency, or when patients cannot tolerate angiotensin converting enzyme (ACE) inhibitors.. Hydralazine is known to cause a drug induced lupus syndrome, but pulmonary and renal involvement is rarely reported. Method: We […]

Case Presentation: We present a twenty‐one year old AA female with a past history significant only for premature birth, referred by her physician for evaluation of a single brief episode of dyspnea at rest and an abnormal CXR. ROS disclosed a history of intermittent palpitations. On examination, vital signs were unremarkable. Lung examination revealed rightward […]

Case Presentation: A 69 year old AA male, transferred from nursing home, with AMS and seizures after lack of medications and oral intake for 3 days. PMHx included CKD, Parkinson's with dementia and DM 2. On examination, patient was afebrile with mild tachycardi, focal seizures were present responsive to D50, lorazepam and phenytoin. Remainder of […]

Case Presentation: A 55‐year‐old male with history significant for end stage liver disease secondary to hepatitis B, was admitted for evaluation of a two month history of nightly fevers with associated left upper quadrant abdominal pain, fatigue, and nonproductive cough. An initial evaluation was unrevealing as to a source for his fever, and the patient […]

Case Presentation: 34 yr old female with no past medical and surgical history was admitted with 4 days of vomiting, fever and shortness of breath. On examination, she was febrile and icteric.Lung exam revealed bibasilar dullness to percussion but no added sounds.Heart sounds were muffled. The rest of the exam was unremarkable. Lab results showed […]

Presentation: A 44 year old woman presented with a two week history of myalgias and fevers. Three weeks prior to admission the patient received a 10 day course of trimethoprim‐sulfamethoxazole (T‐S) for sinusitis. Her symptoms improved. One week after treatment, she developed myalgias, fevers, and an erythematous patch on her left flank. Continued fevers and […]

Background: Polycystic kidney disease (PKD) is a common genetically linked renal disorder affecting one in 1000 people in the USA. Colonic Diverticular disease occurs in twenty percent of the population and the majority of acute diverticulitis is treated in the inpatient setting. Studies have shown an increased incidence of diverticulitis in patients with PKD. However, […]

Case Presentation: An 81 year‐old woman with atrial fibrillation presented with bleeding gums and was found to be coagulopathic due to coumadin therapy. Fresh frozen plasma (FFP) was ordered. She tolerated the first transfused unit without incident. Prior to the completion of the second unit, the patient became febrile, developed acute respiratory distress, tachycardia and […]