Case Presentation: A 48-year-old woman with history of anxiety, depression, chronic pain, and polysubstance abuse was brought to the hospital for unusual behavior. She was hospitalized one month prior for behavior change and diagnosed with substance induced psychosis. She returned to the hospital after two weeks of recurrent bizarre behavior at home including wandering disrobed, [...]

Case Presentation: 46-year-old male with past medical history of nicotine dependence was seen in the emergency department as code neuro with chief complaints of right arm/leg weakness and numbness which started 2 hours ago while he was playing video games. Physical exam showed right sided facial droop with power 0/5 in right upper extremity and [...]

Case Presentation: Methemoglobinemia is a hematological condition that is most commonly acquired when substances cause oxidation of iron to the ferric state (Fe3+) from the ferrous state( Fe 2+). It is a clinical diagnosis based on effective history taking and signs of hypoxemia resistant to supplemental oxygen. Here we describe a patient who had been [...]

Case Presentation: 52 years old male with no significant past medical history presented to the hospital with back pain within few days to leg tingling ascending to his nipple level with weakness and inability to walk. In the ED, he was noted to have myelopathic changes on exam from T2-3 level down with hyperreflexia in [...]

Case Presentation: A 54-year-old man with congestive heart failure, chronic kidney disease and atrial fibrillation (on digoxin 0.125 mg daily for 3 years) presented to the emergency department with fatigue, weakness, vomiting, poor oral intake and whole body “involuntary sudden movements.” Neurological exam revealed generalized symmetrical choreiform movements more pronounced in the head, upper torso [...]

Case Presentation: 54-year-old female with past medical history of bronchitis was referred for evaluation of hemoptysis and chest radiograph changes. She had 5 pack year history of cigarette smoking but quit 4 years prior. Additionally, she admitted to significant occupational exposure working as an electrician for 8 years. On physical examination, her temperature was 37.3°C, [...]

Case Presentation: Ghosal hematodiaphyseal dysplasia (GHDD) is a rare autosomal recessive disorder presenting with myelophthisic anemia and distinctive bony changes. TBXAS1 gene encodes Thromboxane A synthase. In GHDD, dysregulation of TBXAS1 occurs and this increases prostaglandin synthesis and causes direct bone marrow injury. Here we report, a 31-year-old Southeast Asian female presented with bilateral knee [...]

Case Presentation: An 81 year old woman with history of stage 3 melanoma and hypothyroidism presented with a four day history of progressive weakness and dyspnea two weeks after receiving her first dose of nivolumab. Upon arrival to her local hospital, she was noted to have significantly elevated troponin level (Troponin-I > 8,000). Due to [...]

Case Presentation: A twenty-year-old male patient with no past medical history presented to the emergency department with bilateral lower extremity weakness after working in agricultural fields which had progressed over three hours to near paralysis. When the patient was first evaluated, an ECG revealed his heart rhythm to be in asymptomatic ventricular tachycardia. He exhibited [...]

Case Presentation: A 74-year-old female patient presented to the clinic with a decade-long history of severe joint pain in her hands, escalating weakness in her arms and legs, difficulty gripping or holding objects, dysphagia, impacting daily activities. Past medical history includes sicca complex and fibromyalgia, with a family history of her sister having rheumatoid arthritis. [...]