Case Presentation: A 32 year old Caucasian female with a fourteen year history of relapsing-remitting MS was admitted to the hospital for evaluation of severe headache, fatigue and dizziness. On physical exam she was tachycardic and very pale. Pertinent labs were as follows: hemoglobin (Hb) 4.1 mg/dL (baseline Hb 10.5 mg/dL), red cell distribution width [...]

Case Presentation: A 37-year-old female veterinarian with past medical history of migraines was diagnosed with multiple sclerosis (MS) in December 2015. In April 2016, she was admitted with 3weeks of progressive dysphagia and 20lb weight loss. Although MRI of the brain and cervical spine obtained during admission showed no new lesions, her symptoms were initially [...]

Case Presentation: Teriflunomide is a pyrimidine synthesis inhibitor used in management of Relapsing Remitting Multiple Sclerosis (RRMS). Leflunomide is the active agent which has been used in rheumatoid arthritis. Chronic diarrhea has been associated with both of these. However, there is no evidence in literature to suggest clostridium difficile (C.Diff) diarrhea associated with these agents. [...]

Case Presentation: A 26-year-old male without prior medical history was referred by a spine surgeon to the emergency department (ED) with weakness, numbness, and discoordination of the right leg, worsening over a four month period and resulting in multiple falls. He reported three weeks of urinary and bowel urgency and incontinence. He had a family [...]

Case Presentation: A 59-year-old African-American female presented to our hospital with fatigue, exertional dyspnea and dark cola colored urine for two weeks. She was diagnosed with RRMS in 2009 and had been taking IFN-β since then with good response and no complications. Family history was significant for colon cancer in her mother, but no hematologic [...]