Case Presentation: A 68-year-old white male with a history of Factor V Leiden, deep vein thromboses (DVT), pulmonary embolism (PE), atrial fibrillation, and hyperthyroidism on warfarin therapy for 12 years presented to the emergency department (ED) with acutely worsening, bilateral, black, necrotic ulcerations of his lower extremities with associated edema, purpura, and progressive sloughing of [...]

Case Presentation: We describe a rare case of a nephrotic syndrome (NS) as a complication of secondary syphilis (SS), which resolved with appropriate treatment of the infection. This is a 54 year-old male with no pertinent medical history, who presented to clinic with bilateral palmar rash. He was diagnosed of secondary syphilis with positive Venereal [...]

Case Presentation: We describe a patient with relapsing polychondritis (RPC) who developed a complete heart block, mitral valve insufficiency and aortic root dilation. A 72-year-old man with a history of RPC presented with fatigue, lightheadedness and syncope, which was secondary to the new onset complete heart block (CHB). Further investigation showed an elevated C-reactive protein [...]

Case Presentation: Xanthogranulomatous Pyelonephritis (XGP) is an uncommon sequelae of chronic renal inflammation whose process may invade local structures.  We present a rare case of an invasive Xanthogranulomatous Pyelonephritis (XGP) extending into the thoracic cavity in a 48 year-old female presenting with chronic productive cough. This previously healthy patient presented with dyspnea, productive cough, and [...]

Case Presentation: This is a case of a 30 year-old female presented in acute heart failure secondary to left ventricular noncompaction cardiomyopathy (LVNC) found to have a novel sodium channel mutation. Patient with no significant medical history presented with shortness of breath and dyspnea, chest radiograph consistent with bilateral large pleural effusions, cardiomegaly, and pulmonary [...]

Case Presentation: A 68-year-old man with a history of atrial flutter and recurrent gastrointestinal (GI) bleeds (GIBs) with no clear etiology identified presented for planned direct current synchronized cardioversion.  Patient had failed multiple rate and rhythm control regimens as well as radiofrequency ablations.  He was placed on unfractionated heparin prior to cardioversion but developed recurrent [...]

Case Presentation: A 45 year old female with history of psoriatic arthritis and renal transplant from a living unrelated donor (performed in the Philippines in 2014) presented with symptoms of fever, fatigue, weakness, tremors, epigastric pain, and loose stools. At the time of presentation, she had recently completed three cycles of plasmapharesis/IVIG and one cycle [...]

Case Presentation: 16 year old girl presenting with one week of swelling over left leg was found to have DVT involving proximal femoral and iliac systems. Despite treatment with warfarin over next 6 months, there was only partial improvement in symptoms and doppler assessed recanalization. Given the poor response to anticoagulation and young age, MTS [...]

Case Presentation: 81 y/o African-American woman with PMH of NICM with LVEF of 35-40% and CKD stage 3 presented to ED with complaints of cough, increased lower extremity swelling, and progressive DOE. She endorsed noncompliance with her diet, indulging in fried chicken but compliance with her medications. During her last admission, she was noted to [...]

Case Presentation: A 73 year-old woman presented with lethargy and decreased responsiveness for one day.  She did not respond to her name or noxious stimuli and did not follow commands.  She would spontaneously repeat the phrase “I see the light” but was otherwise non-verbal.  Waxy rigidity was noted on passive extension and flexion of her [...]