Background: Alcoholic hepatitis (AH) related admissions have been increasing, and severe AH (as defined by a discriminant function [DF] > 32) can carry a one-month mortality rate of up to 50% (Crabb et al). With rising mortality from alcoholic liver disease, early detection of alcohol use disorder to achieve cessation and prevent progression to alcoholic […]

Case Presentation: A 19-year-old, 22-week pregnant woman with no significant past medical history presented with cough, fever, myalgia, abdominal pain and diarrhea for two weeks. On admission, she was febrile to 101.2 F and tachycardic with HR of 110-120 bpm. Physical exam revealed right upper quadrant (RUQ) tenderness upon palpation and one vesicular genital lesion. […]

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 40 year old previously healthy female was incidentally found to have elevated transaminases on routine lab work. She was sent to our hospital for further evaluation. On admission, she complained of fatigue, right sided abdominal discomfort, and jaundice of a few weeks. She denied taking prescription medications but reported taking a supplement […]

Case Presentation: A 31-year-old man presented to the ED with one week of worsening cough, headaches, and abdominal pain. Initial laboratory evaluation revealed a total bilirubin level of 15.6 mg/dL, ALP 181 U/L, ALT 518 U/L, AST 829 U/L. Lipase and GGT were within normal range. Chest x-ray and abdominal ultrasound showed no abnormalities. He […]

Case Presentation: A 39-year-old male with a past medical history significant for PTSD, depression, and asthma presented to the hospital secondary to suicidal ideation. Patient was reportedly found on an overpass by the police where he was intending to jump. Medications that the patient was currently prescribed were clonazepam, prazosin, sertraline, and zolpidem; however, patient […]

Case Presentation: A 70-year-old woman was admitted to our medical center with a 2-month history of abdominal discomfort, anorexia and fatigue. Past medical history was notable for hyperlipidemia. Five weeks prior to admission, the patient presented to her primary provider with similar complaints and was found to have significantly elevated liver enzymes, as shown in […]

Case Presentation: Introduction: Mixed Cryoglobulinemia (MC) is a rare subtype of the Cryoglobulinemia disorders which are caused by precipitation of immune complexes in the serum at cold temperature. MC involves more than one immunoglobulin component, i.e. IgM, rheumatoid factor (RF) and can be classified further as Type II or III. MC has associations with both […]

Case Presentation: A 21-year-old healthy Hispanic male presented to the hospital for evaluation of fever and sore throat for 4 weeks. He had no significant past medical history and he was not on any medications. His vital signs were within normal limits. Physical exam revealed icterus and no hepatosplenomegaly. The remainder of the physical exam […]

Case Presentation: A 64-year-old man with diet-controlled type 2 diabetes mellitus and hyperlipidemia presented to an academic center with painless jaundice. He was in his usual state of health until 2 weeks prior to presentation when he noticed dark urine. He then developed jaundice 4 days before his presentation. Initial laboratory testing was notable for […]