Case Presentation: An 87-year-old woman with a history of pancreatic cancer status post distal pancreatectomy/splenectomy/partial colectomy, chronic kidney disease, hepatocellular carcinoma, and diabetes was admitted following sudden onset of new, uncontrollable bilateral upper extremity shaking and facial twitching. Symptoms started the night before and became progressively worse with dyspnea, nausea, and bilateral lower extremity tremors [...]

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: A 56-year-old man with PMH chronic kidney disease (CKD) stage II, adjustment disorder, methamphetamine (meth) abuse, last use 2 days before admission, presented with decreased urine output, “coffee-colored” urine, diffuse muscle pain, severe back pain, and fatigue for 1 day. Urine was positive for amphetamines, CPK 218,000 mcg/L, AST, and ALT were 1254 [...]