Case Presentation: A 57-year-old male with a history of renal transplant currently on immunosuppressive medication presents to the hospital with fevers and general malaise. Laboratory findings were significant for hypercalcemia (15.6 mg/dL) with suppressed parathyroid hormone (PTH) levels. Infectious investigation including urinalysis, chest x-ray, commuted tomography (CT) of the chest, abdomen, and pelvis, blood cultures, […]

Case Presentation: 69 year old female with a history of untreated hepatitis B presented with leg pain, fatigue, and a 13-pound unintended weight loss over 5 months. She had no family history of cancer and had unremarkable age-appropriate cancer screenings. On exam, she had normal vitals, bilateral paraspinal and hip tenderness and positive straight leg […]

Case Presentation: Our patient is an 83 year old female with medical history of right breast cancer treated with lumpectomy and chemo-radiation 12 years ago. She presented with complaints of generalized weakness and confusion for 5 days. On admission, labs were significant for elevated calcium level of 17.2 mg/dL, white blood cell count (WBC) of […]

Case Presentation: A 55-year-old woman with a remote history of renal transplant complicated by stage 4 chronic kidney disease (CKD) presented to the emergency room with a week history of progressive fatigue, fever, dry cough and exertional dyspnea. Outpatient medications were tacrolimus 2.5mg BID, mycophenolate mofetil 500mg BID, prednisone 5mg daily, and vitamin D 1000 […]

Case Presentation: 78 y/o M with past medical history of Diabetes Mellitus type 2, Dyslipidemia ,RCC s/p partial nephrectomy presented with altered mental status. Symptoms started with fatigue, generalized weakness, SOB, 18-20 pound weight loss, constipation ,loss of appetite and confusion that started 1 month ago. Patient appeared frail, was not oriented to time, place […]

Case Presentation: A 26-year-old male with no significant past medical history was intubated due to respiratory failure from cocaine and fentanyl overdose. Admission labs showed severe rhabdomyolysis (creatinine kinase> 22K U/L), hyperphosphatemia (>20mg/dL) and hyperkalemia (>10mmol/L) with creatinine 2.9mg/dL. ICU course was complicated by hypoalbuminemia, chronic hypocalcemia (corrected calcium-7.6-8.4 mmol/L) and chronic hyperphosphatemia (5.6-10mg/dL). He […]