Case Presentation: 17 year old female with no medical history presented with malaise. Labs were WBC 3.78 with normal differential, a microcytic anemia 7.1, platelets 7, and uric acid 10.6. On admission, she was found to have epistaxis, conjunctival hemorrhage, and hemoptysis. She required escalation to high flow nasal cannula. Chest x-ray was concerning for [...]

Case Presentation: 63-year-old female with medical history significant for idiopathic thrombocytopenia purpura (ITP), requiring splenectomy in 2013, pulmonary embolism requiring IVC filter placement due to ITP and asthma, presented with acute onset of shortness of breath. Patient had diffuse petechial rash on extremities. She was tachypneic, hypoxic and had rales on examination. Initial evaluation with [...]

Case Presentation: A 59-year-old Caucasian woman with asthma and PsA, treated with monthly guselkumab injections, presented with a one-week history of progressive shortness of breath and generalized weakness. Initial laboratory findings revealed leukocytosis and lactic acidosis, and arterial blood gas (ABG) indicated respiratory acidosis. Chest X-ray showed bilateral ground-glass opacities, and echocardiography revealed preserved ejection [...]

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 [...]