Background: Heparin-induced thrombocytopenia (HIT) syndrome is an immune-mediated disorder producing thrombocytopenia and thrombosis, with or without prior exposure to heparin. Although avoidance of heparin products and non-heparin anticoagulants are used, immune-based therapies including intravenous immunoglobulin have been tried when the thrombocytopenia persists or there is breakthrough thrombosis. We sought to systematically review and analyze the […]

Case Presentation: A 75 year old woman with past medical history of hypothyroidism presented with weakness and the sensation of “large folds of skin” on the bottom of her feet. Pertinent physical exam findings included conjunctival pallor, nonspecific diffuse abdominal tenderness, and hyperpigmented macules of the dorsal finger tips and soles, which were also new […]

Case Presentation: A 59-year-old previously healthy man presented with subacute fatigue, back pain, and fevers. He developed gradual exertional intolerance in the preceding months which had progressively worsened prior to seeking medical attention. On the day of his presentation, he developed significant abdominal and atraumatic midline back pain. Vital signs at presentation were notable for […]

Case Presentation: A 32 year-old African American man with a history of Kikuchi-Fujimoto’s Disease (KFD), presented with 2 weeks of fever, cervical lymphadenopathy and cough. Laboratory tests showed pancytopenia, elevated ESR, positive double stranded DNA and ANA titer. Complement 3 and 4 levels were low. His fever persisted despite broad spectrum antibiotics. Computed tomography (CT) […]

Case Presentation: A 53-year-old gentleman with metastatic adrenocortical carcinoma with liver and lung metastases, was recently started on pazopanib, a non-specific tyrosine kinase inhibitor. He was brought to the hospital by family for increasing confusion and decreased oral intake. He was hemodynamically stable and afebrile on presentation. Initial labs were significant for low platelet count […]

Case Presentation: A 76-year-old Chinese woman with history of cryptogenic cirrhosis (MELD-Na 25) presented to our hospital with 1 week of worsening jaundice, abdominal distension, and right upper quadrant pain. Cirrhosis was diagnosed by imaging on admission 2 months previously and presumed to be secondary to Hepatitis C infection due to antibody positivity. CT of […]

Case Presentation: A healthy 38 yo woman presented to hospital with 3 weeks of fatigue. She was recently treated for a urinary tract infection but continued to feel unwell. She complained of mild LUQ abdominal pain. On review of systems she endorsed weight loss, fever and night sweats but denied chest pain, dyspnea, easy bleeding, […]

Case Presentation: A 46-year-old female presented with a 2-day history of shortness of breath, pleuritic chest pain and lower extremity swelling while taking low-molecular weight heparin (LMWH). One month prior she was diagnosed with a left lower extremity DVT after a hysterectomy. She was treated with LMWH with a planned transition to rivaroxaban. Medical history […]

Case Presentation: A 27 y.o. male with a history of pre-B cell ALL in complete remission on maintenance therapy with vincristine, 6-mercaptopurine, methotrexate, and receiving intrathecal methotrexate for CNS prophylaxis presented with a 2 week history of fevers, productive cough, night sweats, and fatigue. He had no recent exposure to children or sick contacts. Physical […]

Case Presentation: A 39-year-old construction worker with no past medical history presented to the hospital with a 2-week-history of fatigue and left upper quadrant abdominal pain associated with intermittent high fevers and chills. Patient reports his 9-year-old daughter was sick with fevers and an upper respiratory tract infection a month ago right after a camping […]