Case Presentation: A 60 -year old Caucasian female presented to the emergency department with right-sided hemiparesis and dysarthria. The patient had been admitted to an outside facility one week prior to presentation for left foot osteomyelitis. That admission was complicated by right upper extremity DVT and she had been started on apixaban. When she presented [...]

Case Presentation: The patient is a 27-year-old male with lupus anticoagulant with hypoprothrombinemia syndrome (LAHPS)/triple positive antiphospholipid syndrome (APLS) in the setting of systemic lupus erythematous (SLE) and immune thrombocytopenia (ITP) on hydroxychloroquine, mycophenolate mofetil (MMF), and prednisone for immunosuppression, who presented to the ER with worsening right upper quadrant and epigastric pain. RUQ US [...]

Case Presentation: A 21 year old male with no significant past medical or surgical history presented to the hospital with sudden onset of bilateral lower extremity paralysis and paresthesia. He was lifting heavy boxes at work when he felt severe lower back pain that eventually radiated to his legs. The pain was followed by bilateral [...]

Case Presentation: A 20-year-old female, nonsmoker, G1P0 at 25 weeks, presented to the ED with left leg swelling. Ultrasound confirmed a left femoral DVT. CBC and CMP were unremarkable. She started enoxaparin 80mg twice daily and followed with OB/GYN. Her hypercoagulable workup showed a prolonged aPTT and DRVVT, which corrected with mixing, indicating absence of [...]

Case Presentation: A 56-year-old Caucasian female with history of mechanical aortic and mitral valves on chronic warfarin therapy, atrial fibrillation, and questionable history of SLE was admitted to the intensive care unit for emergent splenectomy following a motor vehicle accident. After initially being sent home from a regional hospital, she was diagnosed five days later [...]

Case Presentation: Our patient is a 39 year old G2 P0111 female with PMH of Type 1 diabetes mellitus and Hashimoto’s thyroiditis, s/p NSVD at 34 weeks due to previous pre-eclampsia (occurring 1 month prior to admission), who complained of acute dyspnea on exertion, orthopnea, lower extremity edema, and a 1-month history of fatigue and [...]

Case Presentation: A 61-year-old male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, tobacco use disorder, Raynaud phenomenon, and provoked DVT presented from an outside hospital with abrupt onset of a purpuric lower extremity rash with discoloration and ulceration of the distal fingers and toes. At the time of the patient’s DVT several [...]

Case Presentation: A 65 year-old man with primary antiphospholipid syndrome (APS) was transferred to our hospital for management of refractory thrombocytopenia and thrombosis. His disease was diagnosed by positive lupus anticoagulant, anti-cardiolipin antibody, beta-2-glycoprotein IgM and IgG, and was well controlled with warfarin for years. His worsening APS was precipitated by traumatic subdural hematomas and [...]

Case Presentation: Twenty three year old female presented with complaints of severe headache and dizziness since past 2 weeks. Her past medical history was significant for SLE, heart failure with reduced ejection fraction and lupus pericarditis. CT head showed possible left cerebellar stroke of indeterminate age and hence was admitted for the stroke workup. Few [...]

Case Presentation: A 37 year old female with a past medical history of Hypertension, Ischemic Cardiomyopathy (EF=40-45%), Systemic Lupus Erythematosus, and Antiphospholipid Antibody Syndrome presented to the Emergency Department with complaints of pleuritic chest pain that had been persistent for two days duration which radiated down her left arm. Initial laboratory workup noted a normal [...]