Case Presentation: A 56 year-old man with heart failure with preserved ejection fraction, aphasia and right-sided weakness from prior strokes presented with two days of difficulty with speech and ambulation. His vital signs were normal except for an oxygen (O2) saturation of 94% on 6 liters. On exam he was somnolent but able to follow [...]

Case Presentation: Stiff Person Syndrome (SPS) is a rare chronic autoimmune condition characterized by progressive muscle rigidity, postural instability, axial and limb stiffness, anxiety, phobias, and intermittent painful muscle spasms. The prevalence is estimated at 1-2 cases per million. Affected persons are aged 20-50 years with a female predominance. Its pathophysiology involves antibodies against the [...]

Case Presentation: A 22-year-old female with a past medical history of cholecystectomy and bipolar disorder presented with left upper quadrant spastic abdominal pain 9/10 in intensity, radiating to the epigastrium for the last 5 days, along with intermittent nausea, vomiting, and diarrhea. The patient described her bowel movements as a green ribbon-like consistency with no [...]

Case Presentation: A 51-year-old female with pseudomyxoma peritonei was admitted to the hospital for surgical debulking. She was started on Lovenox post-operatively. A week later she became hypotensive with acute hypoxic respiratory failure. She was intubated and started on vasopressor therapy with an improvement in her hemodynamics. CT angiogram of the chest depicted a pulmonary [...]

Case Presentation: A 44 year-old woman presented with light-headedness and numbness and tingling in her hands and feet. Her past medical history included gastric reflux with hiatal hernia and Roux-en-Y bypass with hernia repair 11 weeks prior to admission, complicated by a post-operative esophageal stricture. She reported difficulty maintaining oral intake for the three weeks [...]

Case Presentation: A 43-year-old man with end-stage renal disease (ESRD) presented with six months of progressively worsening abdominal distention, diffuse abdominal pain, early satiety, and unintentional thirty-pound weight loss. He previously had undergone peritoneal dialysis for four years, complicated by multiple episodes of peritonitis and removal and replacement of multiple peritoneal dialysis catheters. Six months [...]

Case Presentation: A 46-year-old woman with no past medical history presented with right upper quadrant pain, jaundice, and pruritus after undergoing a liver biopsy at an outside hospital. At the outside hospital, she had these same symptoms with hyperbilirubinemia and transaminitis. HIDA scan was negative. The liver biopsy showed marked portal and pan-lobular inflammatory infiltration [...]

Case Presentation: A 25-year-old man with a past medical history of sickle cell disease was transferred to our hospital for seizure-like activity and acute renal failure. Computed tomography (CT) head was unremarkable, urine drug screen was negative, and triage labs were significant for white blood cell count (WBC) of 20.7 cells/liter and an elevated creatine [...]

Case Presentation: A 70 year-old female with migraines, type 2 diabetes and hypertension presented with progressively worsening headaches, fatigue, fevers, and 20 lb weight loss over six months. She had extensive workup revealing elevated inflammatory markers and an MRI brain three months prior showing a mildly expansile lesion in the right sphenoid bone (Fig. 1A). [...]

Case Presentation: A 40-year-old African American female presented with dizziness. She was admitted at an outside hospital two weeks prior to admission for frank melena due to a bleed in the descending colon that eventually self-resolved. She was transfused two units of blood and discharged with a hemoglobin of 8.4 g/dL. She presented to our [...]