Case Presentation: A 4-year-old presented with persistent fever, headache and vomiting. History was significant for a 5 day febrile illness 1 month earlier and a family history positive for late-onset rheumatoid arthritis in a maternal grandparent. Parents reported that 4 days following resolution of the illness, his fever (up to 104F) recurred and persisted daily [...]

Case Presentation: 90-year-old female presented with generalized weakness, nausea, vomiting, and diarrhea of 3 days duration. She also reported anorexia but denied any fever, chills, abdominal pain, chest pain, shortness of breath and cough. Vital signs were unremarkable. Physical exam was remarkable for dry oral mucous membranes, the presence of bilateral nephrostomy tubes and costovertebral [...]

Case Presentation: Statins are commonly prescribed medications that reduce cardiovascular disease. Their side effect profile consists of muscle-related adverse effects that are classified into toxic or autoimmune forms. We present a case of statin-induced necrotizing autoimmune myopathy (SINAM), a recently characterized entity within this spectrum of statin myotoxicity. While rare, it is important to recognize [...]

Case Presentation: Case 1:A 55 year-old woman with a history of myasthenia gravis presented to with symptoms of double vision. She was also complaining of palpitations, weight loss, sweating, and insomnia. She was diagnosed with myasthenic flare, and she was treated with prednisone. The patient continued to have symptoms, so she was referred to an [...]

Case Presentation: A 66-year-old female with a history of primary hypothyroidism presented to the emergency department with an episode of vertigo. The patient reported a persistent spinning sensation, nausea, vomiting, and tinnitus of the left ear without hearing loss for over 10 hours. Review of systems revealed abnormal gait and findings consistent with hypothyroidism (cold [...]

Case Presentation: 33 yo Caucasian female with a PMH of Graves’ thyrotoxicosis and recurrent acute pancreatitis was admitted for suspected pancreatitis. She presented with acute onset epigastric pain radiating to back. She denied any associated symptoms. Exam showed yellowish discoloration of skin and epigastric tenderness. Recent ultrasound was negative for cholelithiasis or gallbladder wall thickening [...]

Case Presentation: 59 year old woman with a history of recently diagnosed rheumatoid arthritis (RA) not on therapy presents with substernal non radiating chest pain and right upper quadrant pain worsening with inspiration and dyspnea on exertion (DOE) for one week. Patient also reported dysphagia, dry mouth and Raynaud’s phenomenon. Exam showed normal vital signs [...]

Case Presentation: We present a previously healthy 22-year-old female presenting with disorganized behaviors, restlessness and sub-acute decline in mental status. There was no other relevant medical, personal or familial history. However, she had stressors three days before initial change in behavior, such as infidelity with her significant other and she had tremendous anxiety and guilt [...]

Case Presentation: A 33 year-old US born woman with iron deficiency anemia presented after one episode of pre-syncope. She reported 3 weeks of progressive fatigue, shortness of breath, and pain in the chest, back, and hips. She denied abdominal pain, menstrual abnormalities, sick contacts, recent trauma, and blood disorders or malignancy in her family. She [...]