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 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 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 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 [...]

Case Presentation: A 86 year-old man with rheumatoid arthritis on methotrexate and prednisone, CAD, HTN, CKD 3 presented with bilateral lower extremity rash for 5 days. He initially had pruritus in the legs, now progressed with redness and pain. He spent most of his days in his backyard during the summertime but did not recall [...]

Case Presentation: A 32-year old female with complicated past medical history of intravenous drug use, mitral valve endocarditis status/post repair, and recent diagnosis of Immune thrombocytopenia (ITP) was transferred from another hospital for management of severe thrombocytopenia refractory to Intravenous Immunoglobulin (IVIG) and steroids. She had initially presented with intermittent high-grade fevers and fatigue without [...]

Case Presentation: A 41-year old-woman with history of Hashimoto’s thyroiditis was transferred from referring hospital (OSH) for persistent thrombocytopenia. Patient was well until one month prior to presentation, when she presented for right upper quadrant (RUQ) pain. The patient was diagnosed with gallstone cholecystitis and underwent laparoscopic cholecystectomy. At the time of her surgery, she [...]

Case Presentation: A 43-year-old African-American female with a history of multiple sclerosis complicated by paraplegia, neurogenic bladder, and seizures presented to the hospital with a syncopal episode and was found to have a hemoglobin of 2.9 (12.0 to 16.0 gm/dL) with red blood cell count RBC 0.96 (4.00 – 5.20×10^6/uL), lactate dehydrogenase 639 (

Case Presentation: A 59-year-old female with a history of type 2 diabetes, hypertension, dyslipidemia, bipolar disorder, and daily alcohol use, presented with acute onset epigastric abdominal pain radiating to the back, nausea and vomiting. Physical examination was notable only for epigastric tenderness. Pertinent labs include neutrophilic leukocytosis, elevated lipase (2353 units/L) and lactic acidosis (2.4 [...]