Case Presentation: A 31-year-old man with rheumatoid arthritis (on adalimumab, methotrexate, and prednisone) presented with a 3-day history of fatigue, severe asymmetrical weakness of the lower extremities (left > right), and painful vesicular rash spanning multiple dermatomes in the left > right lower extremities (Image 1). There was no evidence of myelopathy or meningismus on […]

Case Presentation: 83 year old female with a history of SLE, rheumatoid arthritis, B-cell lymphoma in remission, hypothyroidism presented with a 4 day history of atraumatic lower back pain, rash to left lower back, nausea, retching, few episodes of small volume, clear vomitus and fatigue. She also reported one year of 25 pound unintentional weight […]

Case Presentation: A 41-year-old man with history of depression and anxiety presented with a 6-day history of severe dysphagia, hoarseness, right ear pain, right-sided headache, and right arm pain with subjective weakness. A local ENT physician had discovered right vocal cord paralysis and referred him for further work up. In our facility basic labs were […]