Case Presentation: A 61 years old male patient not known to have any medical problem presented to the emergency department after he noticed swelling in his mouth which increased in size to involve both lips, he reported loose bowel movements in the last couple weeks and mild arthralgia. His physical examination was completely normal apart [...]

Case Presentation: Case of a 63-year-old female with medical conditions of hypertension, chronic obstructive pulmonary disease, diabetes mellitus type 2, and pulmonary embolism (2013) presented to our clinics with progressively worsening purpuric lesions since 1 month prior to evaluation. She stated that these lesions began in the lower extremities and progressed to involve her buttocks, [...]

Case Presentation: A 56 year-old woman with a history of untreated Hepatitis C, anal cancer status post chemotherapy and radiation, current IV heroin use, and MRSA tricuspid valve endocarditis presented with lethargy, jaundice, abdominal pain, oliguria, fevers and lower extremity swelling and rash. On arrival, she initially had fluid-responsive hypotension and fever up to 102. [...]

Case Presentation: An 18 year old male with Diabetes Mellitus 1 was admitted for management of painful foot ulcerations after having submerged his feet daily in 20 hour ice baths for relief of chronic foot pain. On exam, there were numerous symmetric, foul-smelling, tender, shallow ulcers with overlying crusting and purulent drainage on bilateral dorsal [...]

Case Presentation: 73 year old male with solitary kidney due to prior renal cell carcinoma and splenic marginal zone lymphoma currently treated with chlorambucil presented to the emergency department with acute kidney injury. He complained of red “kool-aid” urine and lower extremity rash. The rash was non-blanching, erythematous, papular and present on his ankles and [...]

Case Presentation: A 30 year old Hispanic female with no past medical history presented with a one week history of progressive dyspnea and lower extremity edema. Her dyspnea was present at rest, and she also reported orthopnea and nocturnal cough. She denied any associated chest pain, nausea, or diaphoresis. Upon presentation, vital signs were stable [...]

Case Presentation: Mononeuritis multiplex (MM) was first described in 1960 as a hereditable neuropathy favoring the brachial nerve. MM is now known as the painful, asymmetrical destruction of at least two separate peripheral nerves caused by an array of disorders including diabetes mellitus, systemic lupus erythematous, rheumatoid arthritis, and various vasculitides. This clinical case describes [...]

Case Presentation: Introduction: Mixed Cryoglobulinemia (MC) is a rare subtype of the Cryoglobulinemia disorders which are caused by precipitation of immune complexes in the serum at cold temperature. MC involves more than one immunoglobulin component, i.e. IgM, rheumatoid factor (RF) and can be classified further as Type II or III. MC has associations with both [...]

Case Presentation: Pulmonary renal syndrome is a condition characterized by diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis. It is often associated with vasculitides, but rarely Type I cryoglobulinemic vasculitis. When presenting in the setting of rare comorbidities, it can be confused with pneumonia and acute kidney injury. This patient was a 66-year-old male with a [...]

Case Presentation: A 54 y/o lady with a past medical history of HCV cirrhosis s/p Harvoni treated 5 years ago, IVDU now on methadone who presented to the ER with a lower extremity rash that started two days ago. They were multiple tender nonblanching, red to purple petechial and purpuric lesions on the bilateral lower [...]