Case Presentation: This patient was a 32 year old male with one week of fevers, coughing, and shortness of breath. On examination, the patient was tachycardic with an oxygen saturation of 85%. He had increased work of breathing with accessory muscle use, but no crackles or wheezing. Complete blood count showed leukocytosis. CT angiogram showed [...]

Case Presentation: A 43 year-old-woman with no known medical history presented with two months intermittent fever, cough, pleurisy, hematuria, and weight loss. On exam she had diffuse crackles and lower extremity edema. The patient was intubated for respiratory distress. Laboratory workup revealed acute anemia and urinalysis consistent with nephritic syndrome. Chest x-ray showed bilateral diffuse [...]

Case Presentation: Our patient is a 77-year-old female with no past medical history who presented with two weeks of dyspnea on exertion, scant hemoptysis, and rhinorrhea with occasional blood. Vitals showed tachycardia, tachypnea, and hypoxia with saturations 95% on 15 L/min via heated high flow nasal cannula. Exam revealed accessory muscle use, faint bibasilar rales, [...]

Case Presentation: A 20 year old man with history of Systemic Lupus erythematous (SLE) with Lupus nephritis presented to the hospital with cough and hemoptysis for the past few days. He was found to have severe anemia (5.4 mg/dl), thrombocytopenia (52,000/mm3), elevated LDH (829), low haptoglobin (<8), hypocomplentemia (low C3 and C4), schistocytes on peripheral [...]

Case Presentation: A 75 year old male was transferred into the ICU, already intubated, requiring antibiotics and pressors. He was hypotensive, tachypnic with respiratory distress, had severe oliguric AKI with serum creatinine of 6.0, and anemia with hemoglobin below 7.0. His initial CXR and CT showed scattered bilateral pulmonary opacities. After he did not improve [...]

Case Presentation: Granulomatosis with Polyangiitis (GPA) is a rare necrotizing vasculitis characterized by chronic granulomatous inflammation and localized and systemic manifestations. It typically involves the upper airway, lungs, and kidneys, but potentially affects every organ with a highly variable clinical trajectory. Diffuse alveolar hemorrhage (DAH) is one of its least common pulmonary manifestations, characterized by [...]

Case Presentation: A 62-year-old woman presented with a three week history of worsening shortness of breath. She endorsed a dry non-productive cough of several days without fever, chills, or other symptoms. Review of systems was negative for hemoptysis. Past medical history includes HFpEF, hypertension, and chronic atrial fibrillation on apixiban. On presentation, her temperature was [...]

Case Presentation: A 68 year old White female with atrial fibrillation presented with worsening dyspnea and cough. She was previously followed for similar symptoms and a computed tomography (CT) scan of the chest done in November 2012 demonstrated minimal basilar airspace disease.  At that time an extensive workup including autoimmune serology was unrevealing and her [...]

Case Presentation: A 24-year-old African-American woman presented with nausea, flank pain, and hematuria recurring over several months. Review of symptoms and past medical history were negative. She was a current smoker. Family history was noncontributory. Physical exam was significant for bilateral flank pain. Laboratory testing, serology, and kidney biopsy led to the diagnosis of rapidly [...]

Case Presentation: An 82-year-old female with diastolic heart failure presented with one-month worsening dyspnea on exertion and a week of scant hemoptysis and fatigue. She denied tuberculosis risk factors, night sweats, fevers, or skin, joint, or urinary changes. She was fully vaccinated against COVID-19. Her medications included aspirin and hydralazine. Her past medical, surgical, and [...]