Case Presentation: A 67-year-old woman with a history of cocaine use presented with six weeks of progressive bilateral upper and lower extremity weakness, burning pain, and difficulty ambulating. Exam was significant for low grade fever and decreased sensation to pinprick in a stocking-glove distribution in all extremities. Muscle strength was reduced in the distal upper [...]

Case Presentation: A 33 year old female with reported history of recurrent ‘ear infections’ presented with acute ischemia of bilateral digits of her hands and feet after one month of bilateral hand and foot paraesthesia. Labs on admission showed white blood cell count 11.08 K/uL, hemoglobin 12.5 g/dL, platelet count 622 K/uL, ESR 107 mm/hr, [...]

Case Presentation: A 76-year-old woman presented with right flank pain and intermittent painless hematuria. Exam was unremarkable. Labs revealed a Cr of 2.35 mg/dL (0.50 – 1.20 mg/dL), BUN 54mg/dL (6.0 – 23.0 mg/dL), and urinalysis with 229 RBCs and >300 protein, but no casts. CT showed bilateral renal nephrolithiasis without hydronephrosis and a distended [...]

Case Presentation: A 50-year-old male with a history of smoking and current vape use presented with bilateral flank pain, chills, and dysuria. Two days earlier, he had been seen at an urgent care center, where urinalysis showed hematuria without infection, and a CT scan of the abdomen and pelvis was unremarkable. He was also diagnosed [...]

Case Presentation: Microscopic polyangiitis (MPA) is a rare form of small-vessel vasculitis strongly associated with antineutrophil cytoplasmic antibodies (ANCA), particularly myeloperoxidase (MPO-ANCA). While the kidneys are the most commonly affected organ, MPA can also present with pulmonary involvement, manifesting as interstitial lung disease (ILD). This presentation is particularly challenging to diagnose in older adults, as [...]