Case Presentation: A Korean 55-year-old female with a history of leiomyoma and kidney stones presented to the emergency department with abdominal pain. Further work up also showed new onset anemia. A pelvic exam demonstrated a large distended fibroid protruding into the vagina. Pelvic MRI noted a large multilobulated complex mass, consistent with a uterus replaced [...]

Case Presentation: A 29 year old woman presented with a generalized tonic clonic seizure and progressively worsening ataxia over the last six months. She also had memory deficits and diplopia. Her past medical history included Li Fraumeni syndrome and an immature ovarian teratoma that was treated with a right oophorectomy and chemotherapy in 2015. Her [...]

Case Presentation: Patient is a middle-aged African-American female with a history of hypertension and hyperlipidemia, for which she had been on atorvastatin for approximately four years. She originally presented to her primary care physician for evaluation of a one month history of progressive myalgias and proximal muscle weakness. Creatine phosphokinase (CPK) level was elevated to [...]

Case Presentation: 59 year old woman with a history of recently diagnosed rheumatoid arthritis (RA) not on therapy presents with substernal non radiating chest pain and right upper quadrant pain worsening with inspiration and dyspnea on exertion (DOE) for one week. Patient also reported dysphagia, dry mouth and Raynaud’s phenomenon. Exam showed normal vital signs [...]

Case Presentation: We present a previously healthy 22-year-old female presenting with disorganized behaviors, restlessness and sub-acute decline in mental status. There was no other relevant medical, personal or familial history. However, she had stressors three days before initial change in behavior, such as infidelity with her significant other and she had tremendous anxiety and guilt [...]

Case Presentation: A 33 year-old US born woman with iron deficiency anemia presented after one episode of pre-syncope. She reported 3 weeks of progressive fatigue, shortness of breath, and pain in the chest, back, and hips. She denied abdominal pain, menstrual abnormalities, sick contacts, recent trauma, and blood disorders or malignancy in her family. She [...]

Case Presentation: A 60 year-old female with no significant past medical history was brought in as a level 2 trauma after being involved in a motor vehicle accident. The non-contrast head CT demonstrated bilateral frontal brain lesions, prompting a brain MRI which revealed a non-enhancing T2/FLAIR hyperintense lesion in the anterior frontal lobes and crossing [...]

Case Presentation: A 44-year-old woman with past medical history of anxiety, depression, and seizure disorder presented with seizure-like activity consisting of asynchronous bilateral upper and lower extremity shaking, throughout which patient was alert and responsive. Patient had a 5-year history of these episodes, with a recent increase in frequency exacerbated by stress. Prior extensive workup [...]

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 [...]

Case Presentation: A 51-year-old Caucasian male presented for evaluation of worsening lower extremity muscle weakness and associated myalgias. He received a diagnosis of NAM after three months of progressive proximal, symmetric upper and lower extremity weakness with myalgias, and an initial creatinine kinase (CK) of 13,875 IU/L. He had been on Atorvastatin 40 mg for [...]