Background: Patients with COVID-19 have increased rates of venous thromboembolism, however, there is currently no standardized approach to anticoagulation (AC) therapy particularly with respect to the proper dose of anticoagulation (prophylactic or therapeutic). Many observational studies have shown a mortality benefit in using prophylactic AC for hospitalized patients with COVID-19. A few studies have reported [...]

Background: The risk of thrombosis and bleeding in hospitalized patients with Coronavirus disease 2019 (COVID-19) is uncertain. Early studies suggested patients with COVID-19 may develop a unique coagulopathy marked by elevated thrombotic risk which has led some institutions to recommend stronger thromboprophylaxis in these patients. Our goal was to quantify the incidence of thrombosis and [...]

Background: Given its ability to identify obscure bleeding at a rate of 0.1-0.5 mL/min, technetium-labeled red cell scans have long been considered the most sensitive radiographic test for gastrointestinal bleeding. They are routinely compared to computed tomography angiography, which detects bleeding at a minimum rate of 0.5 mL/min or greater. We conducted a clinical quality [...]

Case Presentation: A 69-year-old male with CKD Stage III and psoriatic arthritis on adalimumab (40 mg every 2 weeks) and methotrexate (20mg weekly) presents to the hospital after routine labs revealed macrocytic anemia and neutropenia. The patient was treated for right hand cellulitis 10 days ago in an urgent care setting with a dose of [...]

Case Presentation: A 72 year-old male patient with recent deceased donor renal transplant was on combined immune suppression with prednisone, tacrolimus and MMF. He Had multiple comorbidities but no previous history of IBD or autoimmune disease. He presented with normocytic anemia (hemoglobin 6.5 g/dL), weakness, anorexia and diarrhea. He was found to have ulcerated hemorrhoids [...]

Case Presentation: A 49 year old female with history of alcoholic cirrhosis presented to the ED after experiencing self-reported bright red blood per rectum that morning. Patient had history of numerous prior admissions for reported GI bleed with extensive endoscopic work-up; evidence of portal hypertensive gastropathy had been seen previously however no actively-bleeding lesions were [...]

Case Presentation: Our patient is a 66-year-old female who was admitted for shortness of breath and generalized weakness. She was severely anemic with hemoglobin of 6.5. Her EGD did not show any obvious evidence of bleeding. Colonoscopy in the past showed a large inflammatory mass consistent with ischemic colitis. Follow-up colonoscopy showed completely healed mucosa. [...]

Case Presentation: A 33-year-old female was initially admitted to the ICU for septic shock secondary to complicated Pseudomonas aeruginosa urinary tract infection and methicillin-sensitive Staphylococcus aureus bacteremia. CT of the abdomen showed fluid in the left paracolic gutter. Aspiration and culture of the fluid was positive for Staph aureus and attributed to seeding from bacteremia. [...]

Case Presentation: A 73-year-old male with chronic kidney disease stage 4 from polycystic kidney disease, diabetes, and hypertension presented 2 days after having a peritoneal dialysis catheter placed complaining of dysphagia, dyspnea, abdominal pain, and worsening lower extremity edema. He was not known to have any prior heart or lung disease. His baseline creatinine was [...]

Case Presentation: A 10-year-old female presented with her third episode of painless hematochezia. Episodes were separated by months, each lasting 3 to 5 days with passage of multiple “fist-sized” bright red clots. There were no other associated symptoms and resolution of bleeding was spontaneous. Extensive prior workup included coagulation studies, upper and lower gastrointestinal (GI) [...]