Case Presentation: A 50-year-old African American female with a history of mixed connective tissue disorder with positive ANA titer, speckled pattern 1:1280, and spindle apparatus pattern 1:640, presented with worsening dyspnea, numbness, and weakness of both lower extremities. Two days prior she received the first dose of COVID-19 mRNA vaccine and later developed nausea, vomiting, diarrhea, and anorexia.   In the emergency department, patient was found to have an elevated blood pressure of […]

Case Presentation: A 70-year-old Caucasian woman with history of hypertension, hyperlipidemia, and newly diagnosed atrial fibrillation presented with persistent exertional dyspnea, fatigue, malaise, and anorexia for the past few days. She was recently discharged for community-acquired pneumonia twice at another institution without improvement of nonproductive cough, mild proximal muscle weakness, and exertional dyspnea. She was […]

Case Presentation: A 65-year-old woman with a history of early-stage breast cancer—was treated six years prior. She was subsequently admitted multiple times over the following years for pancytopenia, which was thought to be multifactorial—due to nonalcoholic steatohepatitis and auto-immune hemolytic anemia (AIHA). Therefore, she received a supportive blood transfusion, intravenous immunoglobulins, and rituximab for suspected […]

Case Presentation: A 37-year-old female with no significant past medical history presented to emergency room with complaint of palpitation, diarrhea, and heat intolerance. She was five months postpartum. She also complained of unintentional weight loss of 20lb after delivery. She denied fever, chest pain, abdominal pain, or sick contact. General examination including thyroid gland was […]

Case Presentation: A 44-year-old male patient with a history of vitiligo, presented with a chief complaint of lower extremity tingling and numbness sensation. Upon evaluation, the patient reported unintentional weight loss along with fatigue and frequent palpitation. A review of blood testing revealed an elevated TSH level, HbA1c, a low T4, Free T3, and vitamin […]

Case Presentation: The patient is a 27-year-old male with lupus anticoagulant with hypoprothrombinemia syndrome (LAHPS)/triple positive antiphospholipid syndrome (APLS) in the setting of systemic lupus erythematous (SLE) and immune thrombocytopenia (ITP) on hydroxychloroquine, mycophenolate mofetil (MMF), and prednisone for immunosuppression, who presented to the ER with worsening right upper quadrant and epigastric pain. RUQ US […]

Case Presentation: A 20-year-old female, nonsmoker, G1P0 at 25 weeks, presented to the ED with left leg swelling. Ultrasound confirmed a left femoral DVT. CBC and CMP were unremarkable. She started enoxaparin 80mg twice daily and followed with OB/GYN. Her hypercoagulable workup showed a prolonged aPTT and DRVVT, which corrected with mixing, indicating absence of […]

Case Presentation: An 80-year-old female with a history significant for breast cancer status post mastectomy with chemo/radiation therapy and phenytoin-induced liver injury in 2013 presented with nine months of weakness, weight loss, and 2-3 month history of confusion, memory loss, and widespread tremors, suspicious for focal status epilepticus. Workup revealed hyponatremia (135 mmol/L) and elevated […]

Case Presentation: A 20-year-old female with history of primary membranous nephropathy, hypertension, iron deficiency anemia, preeclampsia, and intrauterine fetal demise presented to the hospital with weakness, 2-3 days of upper respiratory symptoms, dyspnea, nausea, vomiting, and diarrhea. Labs showed normocytic anemia with hemoglobin of 3.3 g/dL worsening to 1.9 g/dL pending blood transfusion and leukocytosis […]

Case Presentation: A 59-year-old previously healthy female presented to the emergency department with progressive cognitive decline, psychomotor retardation, and both auditory and visual hallucinations of subacute onset for which she was previously admitted to inpatient care at two separate hospitals. Extensive testing during these admissions were negative for: infection, metabolic derangement, hematologic malignancy, toxins, heavy […]