Case Presentation: Hemophagocytic lymphohystiocytosis (HLH) is a rare cause of pancytopenia. Patients with sickle cell disease can present with pancytopenia and recognition of (HLH) in patients with sickle cell disease may be a lifesaving diagnosis.Case presentation:A 39-year-old female with past medical history of sickle cell anemia and moyamoya disease was admitted with sickle cell vaso-occlusive [...]

Case Presentation: A previously healthy 57-year-old man with a history of chronic sinusitis who received the Ad26.COV2.S vaccination 13 days ago without incident presented to the ED with left lower extremity swelling and pain, left medial thigh ecchymosis, transient episodes of right hand paresthesia and weakness, severe headache with transient blurry vision, and progressively worsening [...]

Background: The current American Society of Hematology (ASH) guideline recommends the use of thrombopoietin receptor agonists, eltrombopag or romiplostim as one of the second-line therapies for chronic immune thrombocytopenia (ITP). The efficacy and safety of those drugs have been tested in several clinical trials. However, the safety profile was not consistent throughout trials and is [...]

Background: Heparin-induced thrombocytopenia (HIT) syndrome is an immune-mediated disorder producing thrombocytopenia and thrombosis, with or without prior exposure to heparin. Although avoidance of heparin products and non-heparin anticoagulants are used, immune-based therapies including intravenous immunoglobulin have been tried when the thrombocytopenia persists or there is breakthrough thrombosis. We sought to systematically review and analyze the [...]

Background: Heparin-Induced Thrombocytopenia (HIT) is an antibody-mediated pro-thrombotic disorder which occurs after exposure to heparin product. Diagnosis of HIT type II is rather challenging as affected individual often has other causes of thrombocytopenia and a delayed discontinuation of heparin in HIT type II is associated with a mortality rate of 20-30%. 4Ts score is a [...]

Background: Heparin-Induced Thrombocytopenia (HIT) is a rare (0.1-1% of heparinized medical patients) but devastating (up to 10% mortality) side-effect of heparin administration[1].  In thrombocytopenic patients, the pre-test probability of HIT is estimated by the validated “4Ts Score”, which is used to risk-stratify patients into Low (0-3 points), Intermediate (4-5 points), and High (6-8 points) likelihoods [...]

Case Presentation: A 61 years old man with a history of metastatic rectal carcinoma T3 N0 M1 underwent neoadjuvant & adjuvant chemotherapy with FOLFOX along with resection of rectal tumor. One year later he had recurrent liver & sacral metastases for which he was started on FOLFIRI and bevacizumab with completion of 1 cycle of [...]

Case Presentation: A 3,400 gram male infant was born at full term to a 32 year old G1P0>1 mother with unremarkable prenatal labs. Labor was complicated by prolonged rupture of membranes, foul smelling amniotic fluid, and maternal fever of 100.5°F. The infant was delivered vaginally. After initial resuscitation, the infant was started on antibiotics due [...]

Case Presentation: A 72-year-old man with a history of Crohn’s disease and hypertension presented to the emergency department with one month of worsening fatigue, anorexia with weight loss and headaches. The patient also noted intermittent high-grade fever up to 105 degrees Fahrenheit of one week’s duration.One month before presentation, the patient had returned to NYC [...]

Case Presentation: The diagnosis of a sexually active young male who presents with fevers, night sweats, weight loss with opportunistic infections and then found to have an acquired immunodeficiency is going to be HIV except when it isn’t. We present a patient with a presumptive diagnosis of HIV but a negative comprehensive HIV laboratory testing [...]