Case Presentation: A 72-year-old female never-smoker was admitted for progressive dyspnea, pleuritic chest pain, and non-productive cough after failing outpatient treatment for presumed community-acquired pneumonia based on chest x-ray findings. On arrival, she was afebrile, hemodynamically stable, and breathing comfortably on room air. Physical exam revealed pulmonary crackles and a clean-based ulcer on the lateral [...]

Case Presentation: A 79-year-old woman with a past medical history of uncontrolled hypertension, migraine, and chronic kidney disease stage 3 presented with one week of poor oral intake, nausea, vomiting, vague abdominal pain, and chronic nonproductive cough. Physical exam revealed poor skin turgor, and lungs with crackles bilaterally. Laboratory studies showed Creatinine of 5.31 mg/dl [...]

Case Presentation: Introduction: Hydralazine is an adjunctive antihypertensive medication that is associated with antineutrophil cytoplasmic antibody (ANCA) – associated vasculitis. Kidney involvement usually comprises a pauci-immune, necrotizing glomerulonephritis with crescents. We describe a rare case of hydralazine induced ANCA positive vasculitis with acute tubulointerstitial nephritis and without glomerular involvement. Case Report: A 74 year old [...]

Case Presentation: A 65 year-old female with past medical history of type 1 diabetes mellitus, renal transplant, breast cancer, sarcoidosis, and hypothyroidism presented with acute onset of severe pain, numbness, and weakness of bilateral upper and lower extremities. The patient developed rapidly progressive fatigue and weakness over three days following acute bronchitis six weeks prior. [...]

Case Presentation: A 59 year-old female with past medical history of Hashimoto’s thyrotoxicosis was admitted because of fatigue, myalgia, acute renal injury with hematuria and proteinuria, positive p-ANCA, positive stool guaiac test, and elevated inflammatory markers. She also had a head CT and MRI done for a new onset of left foot numbness and both [...]

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 [...]

Case Presentation: An 80-year-old man with recently-diagnosed pulmonary fibrosis presented to the hospital with ascending bilateral lower extremity pain and weakness. His symptoms began in both feet and calves, and progressed proximally toward his thighs over the past 6 weeks. During this timeframe, his symptoms evolved from being able to ambulate for miles and climb [...]

Case Presentation: A 48-year-old Columbian woman presented with 5 weeks of malaise, epistaxis, and hemoptysis. Physical exam was relevant for fever, conjunctival injection, hoarseness, coarse breath sounds, tachycardia, mononeuritis, trace lower extremity edema, and no stigmata of thrombotic microangiopathy (TMA). Labs were significant for a creatinine of 2.8, leukocytosis, thrombocytosis of 992×103, and microscopic hematuria. [...]

Case Presentation: 49-year-old male patient with history of hypertension was sent by his nephrologist to the ER for unexplained worsening renal function and likely renal biopsy. Vital signs were stable, exam was unremarkable, however BUN was 85 mg/dL with creatinine of 10.1 mg/dL (baseline of 1.5 mg/dL). 24-hour urine protein excretion was 5.2 grams. The [...]

Case Presentation: A 50-year-old male with a history of smoking and current vape use presented with bilateral flank pain, chills, and dysuria. Two days earlier, he had been seen at an urgent care center, where urinalysis showed hematuria without infection, and a CT scan of the abdomen and pelvis was unremarkable. He was also diagnosed [...]