Case Presentation: A 54-year-old female presented with abdominal pain and bloody diarrhea for three weeks associated with fever, chills, nausea and multiple bouts of vomiting. On exam, she was hemodynamically stable and had left lower quadrant abdominal tenderness. Laboratory studies were significant for a left shift with a normal white blood cell count. Her chest […]

Case Presentation: A 56-year-old man with a history of diabetes presented to the ED with confusion and generalized lymphadenopathy. Labs were significant for severe macrocytic anemia (Hemoglobin of 3.5 g/dL, MCV of 134), low reticulocyte count, leukocytosis of 72.7k/MCL (66.1k/MCL lymphocytes), thrombocytopenia of 69000/mclThe peripheral blood film was remarkable for smudge cells and macro ovalocytes. […]