Case Presentation: A 44-year-old female with a history of an overlap syndrome of systemic lupus erythematosus and rheumatoid arthritis, fibromyalgia, and psychogenic nonepileptic seizures was in her usual state of health until 1 year ago when she developed progressively worsening dysphagia. A few months prior to presentation, she developed weakness in her proximal lower extremities [...]

Case Presentation: A 71-year-old woman with a past medical history of hypertension presented for right sided flank pain and post-menopausal bleeding. The initial CT abdomen and pelvis demonstrated bilateral pleural effusions, diffuse lymphadenopathy, and right sided ureteropelvic junction (UPJ) stenosis with hydronephrosis. She underwent lymph node fine needle aspiration (FNA) and then transferred to our [...]

Case Presentation: 26-year-old man diagnosed with T-cell acute lymphoblastic leukemia (T-ALL) with CNS involvement in July 2022 completed one cycle of hyperCVAD B and subsequently received maintenance therapy with POMP (prednisone, vincristine, methotrexate, and mercaptopurine) starting in 2023, along with intrathecal chemotherapy. The patient achieved complete remission, with serial MRIs, PET scans, and bone marrow [...]

Case Presentation: A 39-year-old male presented with persistent abdominal pain and was found to have a large, left-sided renal mass measuring 15 x 11 x 23 cm. Initial biopsy results were inconclusive, demonstrating nonspecific necrosis and inflammation. Two weeks later the patient developed worsening abdominal distention and acute kidney injury. He was found to have [...]

Case Presentation: A 68-year-old male with hypertension and benign prostatic hyperplasia presented with progressive abdominal distension and pain. He denied fever, weight loss, gastrointestinal bleeding, or any history of gastrointestinal diseases. Physical examination revealed a distended, non-tender abdomen with normal bowel sounds.Laboratory tests showed elevated lactate dehydrogenase (LDH) at 750 U/L, hyperuricemia at 9.0 mg/dL, [...]

Case Presentation: A 33-year-old man sought medical evaluation due to an ongoing cough which had persisted following infection with COVID-19. His chest xray (CXR) was negative at that time and he was discharged with symptomatic treatment. He presented again five months later due to persistent cough non-responsive to symptomatic treatment and underwent another CXR which [...]

Case Presentation: A 72-year-old woman with a past medical history significant for chronic obstructive pulmonary disease (COPD) and tobacco use disorder presented to the emergency department due to significant bilateral hand and lower extremity swelling and pain for the past several months. She denied respiratory symptoms, radicular pain, tingling, or weakness of her upper and [...]

Case Presentation: Hypercalcemia can have adverse effects on the body. Rarely a sign in and of itself, its presence is characteristically associated with an underlying condition. There are usual suspects to consider in the differential but when workup for those return unremarkable, it becomes a challenge to find the underlying etiology.An 80-year-old female with a [...]

Case Presentation: A 61-year-old woman with a history of RA (on methotrexate and adalimumab) and latent TB (previously treated with Rifampin in 2023), presented with a three-month history of cough and shortness of breath. Imaging revealed bilateral pleural effusions and hypodense lesions in the spleen. Thoracentesis was performed, with pleural fluid analysis revealing a lymphocytic [...]

Case Presentation: A 62 year old homeless male with no significant past medical history presents to a large tertiary referral center after being found unresponsive by police. Vital signs: 99.2 F, HR 86, RR 17, BP 160/81. Labs: Lactic acid 2.9, WBC 26.35, CRP 150.60, urine drug screen negative. CT imaging revealed evidence of ureteral [...]