Case Presentation: A 68 year­-old man with prior Agent Orange exposure in Vietnam presents with 6 months of progressive orthostatic hypotension (OH), syncope, 60 lb weight loss, and lower extremity weakness, parasthesias, and allodynia.Prior workup found mildly elevated troponin and BNP, but a normal stress test. Midodrine had no improvement in OH, and BP on […]

Case Presentation: A 82 year old Caucasian male with history of long standing well controlled diabetes mellitus type 2 since 2010, gastroparesis, and GERD presented to the ED with 2 episodes of “dark, tarry” stools for 1 day onset with resolution. On review of systems, the patient endorsed 32 pound weight loss over 6 months, […]

Case Presentation: A 64 year-old woman with no significant past medical history presented with nausea, vomiting, 50 lb. weight loss and generalized weakness for the past 6 months. Her primary care physician had prescribed treatment for possible reflux; symptoms did not improve. Three months prior, the patient was admitted to a community hospital where CT […]

Case Presentation: Patient is a 76 year-old male with a significant background of ischemic heart disease with reduced ejection fraction, pyloric and duodenal ulcers, and chronic kidney disease attributed to chronic glomerulonephritis (not biopsy-proven). He presented with hematemesis and melena. Esophagogastroduodenoscopy revealed multiple gastric ulcers that were negative for Helicobacter pylori. Histology from the gastric […]

Case Presentation: A 65 year-old man with a past medical history of CAD s/p CABG, ischemic cardiomyopathy with EF 35%, bicuspid aortic valve stenosis s/p aortic valve replacement, and asbestosis presented to the ER for evaluation of anterior neck swelling, dyspnea on exertion, dysphagia, and a 30 lb unintentional weight loss over 5 months. On […]

Case Presentation: WF, an 88-year-old man with advanced, wild-type transthyretin-associated (ATTR) cardiac amyloidosis (on tafamidis) complicated by distal conduction disease and heart failure with preserved ejection fraction, presented with syncope and was admitted to the cardiac critical care unit for symptomatic, bradycardic atrial fibrillation. A continuous dopamine infusion was started with resolution of symptoms and […]

Case Presentation: A 53-year-old woman with a history of irritable bowel syndrome-diarrhea (IBS-D), chronic pain syndrome and years of nonspecific symptoms including chronic diarrhea and neuropathy, presented with bilateral lower extremity edema. Multiple outpatient visits and studies demonstrated nonspecific autoimmune condition with questionable monoclonal gammopathy of undetermined significance (MGUS) as well as a presumed diagnosis […]

Case Presentation: Cardiac amyloidosis- a multiorgan disease, which carries a grave prognosis due to its rarity and nonspecific presentation. We report a case of systemic AL amyloidosis with predominant cardiac and renal involvement associated with multiple myeloma.• A 60-year-old male presented with progressively worsening anasarca including 3+ pitting edema in all extremities, and 80 lbs. […]