Case Presentation: We present a case of a 64-year-old woman with metastatic neuroendocrine pancreatic carcinoma with abrupt left facial and oculomotor cranial nerve palsy as well spastic tetraplegia after one dose of Ipilimumab/Nivolumab. She had a history of sudden onset diplopia, fever and ground-level fall a few hours after her initial dose of immunotherapy. Initial […]

Case Presentation: A 34-year-old man with hypertension on chlorthalidone and recent COVID-19 infection treated with Paxlovid presented to the ED with three days of shortness of breath, dizziness, and diarrhea. On exam, he was alert, neurologically non-focal, and underweight by BMI. Initial lab work was significant for severe hyponatremia (< 100 mmol/L) and hypokalemia (2.3 […]

Case Presentation: A 48-year-old female was referred to Neuromuscular Medicine (NMM) for left-sided spasticity. She has a past medical history of low back pain, opioid addiction, and constipation. The patient in early 2022 had a right cerebral artery (RCA) aneurysm and underwent surgical clipping. She experienced a right hemispheric ischemic stroke postoperatively, which caused left […]

Case Presentation: A 58-year old male with no self-reported history presented to the hospital with hematochezia. Digital rectal exam revealed external hemorrhoids, shallow anal ulcers, a palpable internal rectal mass and frank blood. During his hospital course he required multiple blood transfusions for hemoglobin levels of 5-6 g/dL with ongoing rectal bleeding. CT and MRI […]

Case Presentation: A 72-year-old female with chronic kidney disease and recently diagnosed IgG lambda monoclonal gammopathy presented to clinic with six months of progressive weakness and failure to thrive. She reported breathlessness after several steps, a 10-kilogram weight loss, frequent falls, lightheadedness, easy bruising, and dysphagia. There was concern for light chain (AL) amyloidosis, before […]

Case Presentation: An 87-year-old man presented to the emergency room for exertional dyspnea, productive cough, and generalized weakness progressive over the past month. Four weeks prior he was hospitalized for community-acquired pneumonia and received a 10-day course of a third-generation cephalosporin with minimal improvement. He continued to have a productive cough and exertional shortness of […]

Case Presentation: A 36- year-old female with asthma presented with worsening anasarca, malaise, headache, and subjective cognitive decline over three weeks. She had been to numerous hospitals and clinics for her symptoms. Despite various treatments, including Ciprofloxacin for presumed UTI, her symptoms continued to progress. A urinalysis at an outside hospital showed 4+ protein. On […]

Case Presentation: 69-year-old female with a past medical history of coronary artery disease with prior percutaneous coronary intervention of the right coronary artery and left circumflex coronary artery, hypertension, hyperlipidemia, and COPD presented to an outside hospital with acute onset dyspnea and right-sided chest pain. ECG was obtained immediately upon arrival and was notable for […]

Case Presentation: A 54-year-old- man with past medical history of Acquired immunodeficiency syndrome, recurrent Herpes simplex virus lesion, prurigo nodularis, presented with generalized weakness for one week. On physical examination, diffuse cervical, inguinal and popliteal lymphadenopathy was noted. Echocardiogram showed moderate pericardial effusion, which prompted the patient to undergo emergent pericardiocentesis in the setting of […]

Case Presentation: A 54 year-old African American female with a past medical history of hypertension and sickle cell anemia presented with acute onset of headache, blurry vision and confusion with multiple falls over ten days. On presentation, her vitals were within normal limits. She was lethargic and only able to answer simple questions. Physical examination […]