Case Presentation: This patient was a 44-year-old female with a past medical history of localized scleroderma (morphea) of the breast diagnosed by punch biopsy. She presented to the emergency department with right upper quadrant pain and nausea. At that time, a CT scan showed a heterogeneous liver without a definitive underlying mass. Her workup revealed […]

Case Presentation: A 65 year old male with no significant medical history presented to an outside facility complaining of fatigue, weakness, nausea and vomiting. He had moderate alcohol history and significant weight loss over the past 6 months. Initial lab workup was notable for elevated liver transaminases with a hepatocellular pattern, Maddrey score of 53.6 […]

Case Presentation: A 68-year-old Caucasian male with a history of stage IV follicular lymphoma treated with rituximab and bendamustine presented with generalized malaise, weakness, and acute encephalopathy of two weeks.He was hypotensive and his exam showed dry mucous membranes and poor skin turgor. Laboratory examination was remarkable for: creatinine 7.6 mg/dL, AST and ALT 691 […]

Case Presentation: A 21-year-old male with end-stage renal disease for 3 years (cause unknown) presented to the hospital with a 19lb weight loss (10% of body weight) over 2 months. Exam was notable for jaundice, diffuse abdominal tenderness, and innumerable purple, papular lesions covering his body, which he had noticed for 8 months. Labs revealed […]

Case Presentation: A 22-year-old female with a history of biopsy-proven eosinophilic esophagitis, gastroparesis, multiple food allergies, and intermittent amenorrhea presented to the emergency room with weakness and lightheadedness. In the past month she experienced a 15lb weight loss, early satiety, and increasing fatigue. She was being followed outpatient by a gastroenterologist for several months of […]

Case Presentation: A 40-year-old female with adult-onset Still’s disease (AoSD) refractory to methylprednisolone and who had been recently started on anakinra 2 months prior to hospitalization was admitted with 2 weeks of fatigue, nausea, diffuse pruritis, jaundice, and intermittent fevers and rash. Exam was notable for jaundice and salmon-colored rashes on her trunk and back. […]

Case Presentation: A 40 year old female with a medical history of pancreatitis and gastroesophageal reflux initially presented with cough and viral cold symptoms. She was initially febrile to 102 F, with labs significant for WBC 3,900 (normal 4,500-11,000 WBC/uL), hemoglobin 9.1 (12.0-15.5 g/dL), and platelet count 35,000 (150,000-450,000 /uL). She quickly deteriorated with new […]

Background: Hepatitis C virus (HCV) is a leading cause for liver cirrhosis and one of the commonest indications for liver transplantation. The introduction of direct acting antiviral (DAA) medications have revolutionized the treatment for HCV. Prior to 2014, the treatment for HCV consisted of interferon and ribavirin which yielded a sustained virologic response (SVR) of […]