Case Presentation: A 34-year-old female with a history of hypertension, hyperlipidemia, and SLE presented with acute substernal tightness associated with nausea and vomiting. She denied fever, chills, diaphoresis, or palpitations. Her EKG showed sinus rhythm with new T wave inversions in anterior leads. Troponin elevation was noted with a peak of 4.48. Echocardiogram showed normal […]

Case Presentation: 45 year old female with history of pulmonary embolism seven years ago not on anticoagulation presented with chest pain of 4 weeks. Chest pain was sharp, retrosternal, radiating to left upper extremity, neck & back. Chest pain was also positional, worse laying flat but improved on sitting up. It started 48-72 hours of […]

Case Presentation: Lupus nephritis (LN) is a clinical manifestation of SLE that can be histologically categorized from class I-VI. One form of LN that is not included in the classification is lupus podocytopathy (LP). LP is a somewhat rare manifestation of SLE associated nephrotic syndrome that mimics minimal change disease (MCD) and is diagnosed via […]

Case Presentation: An 80-year-old woman with a history of hypertension, pre-diabetes, chronic kidney disease (stage 3b), and remote ischemic stroke without residual deficits presented to the emergency department complaining of several hours of epigastric discomfort and malaise. An EKG revealed >1 mm ST segment elevation in leads V4-6 (Fig. 1). The troponin I was elevated […]

Case Presentation: A 32 year old South Asian man with a history of hyperlipidemia presented to the emergency department (ED) for severe, crushing, mid-sternal chest pain associated with nausea and diaphoresis that awoke him from sleep. In the ED, he was found to have a troponin elevation to 1.159 ng/ml (normal < 0.055 ng/ml) and […]

Case Presentation: A 43-year-old woman presented to the emergency department for sudden-onset of right calf pain, dyspnea, and coughing of blood-tinged sputum, along with worsening of right-sided, dull, heavy, pleuritic chest pain which had otherwise been present for three weeks. She was diagnosed with  systemic lupus erythematosus four days prior to presentation. On physical exam, pulse rate was 114/min […]

Case Presentation: The patient is a 52 year old female with a history of Scleroderma, Raynaud’s, and APLS who presented to the emergency department for new onset chest pressure for 1 day. On physical exam, vital signs were 99 F, 152/99, 109, and 96% on RA and no cardiac murmurs, crackles on lungs, or pitting […]

Case Presentation: A 37-year-old female with Systemic Sclerosis (SSc) presented with new-onset elevated blood pressure. She was on medium to high dose Corticosteroids (CS) a month prior to admission. Her significant vitals on admission included a heart rate of 103 and blood pressure of 193/97. Labs showed hemoglobin 9.6, sodium 130, BUN 63, creatinine (Cr) […]