Case Presentation: A 73-year-old male with history of type 2 diabetes and one-month prior admission for acute renal failure in the setting of stage IV chronic kidney disease presented with symptomatic anemia found to have splenomegaly. A renal biopsy revealed features of membranoproliferative glomerulonephritis and necrotizing crescentic lesions with IgM kappa deposition, suspicious for cryoglobulinemic glomerulonephritis. Immunofixation [...]

Case Presentation: 54 years old man with a history of hypertension was hospitalized due to elevated BUN/creatinine of 33/4.6 mg/dL and Hb of 9.9 mg/dL (baseline 15). He endorsed dyspnea on exertion, anorexia and weight loss of 15 pounds in 6 months. One month ago, he was treated for acute bronchitis with levofloxacin and was [...]

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: A 56 year-old man with schizoaffective and antisocial personality disorders was admitted from the county jail witha 4-day history of fever, hemoptysis, severe headaches, hematuria, diffuse myalgias,and bloody diarrhea. Officers reported the patient frequently flooded his cell and ingested toilet water. A CXR revealed L>R bibasilar infiltrates, and a diagnosis of Legionellapneumonia was [...]

Case Presentation: An 86 years old male with a history of pulmonary fibrosis, HTN, CHF, RA, valve replacement presented after left eye transient visual loss and exertional dyspnea. He reported an episode of painless vision loss in the left eye, felt like a grey curtain was pulled down over his left eye and lasted about 30 seconds. He [...]

Case Presentation: Fibrillary glomerulonephritis and immunotactoid glomerulopathy are rare renal disorders, being present in 0.5 to 1.4 percent of kidney biopsies. Although they are distinct glomerulopathies, they are both nonamyloid fibrillary glomerular diseases and as such, they are Congo red negative on immunohistochemistry. Discussion: Patient is a 75 years old male with PMH of HTN, [...]

Case Presentation: A 57-year-old man presented with three weeks of palpable petechial rash, abdominal pain, polyarthralgia and edema. The rash started as “red dots” on his abdomen and spread throughout his body. On exam, he exhibited diffuse palpable purpura with blistering to his bilateral feet. Initial work up was notable for creatinine (Cr) 3.30 from [...]

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are systemic autoimmune diseases affecting small blood vessels.  The clinical signs and symptoms of ANCA vasculitis are nonspecific and may include multisystem manifestations.  As a result, many conditions mimic ANCA-associated vasculitis, making the diagnosis challenging.  We report a case of ANCA-positive vasculitis presenting as rapidly progressive glomerulonephritis that was initially [...]

Case Presentation: A 79-year-old female nonsmoker with chronic bronchiectasis on 3 liters of home oxygen presented with worsening shortness of breath. The patient’s baseline creatinine (cr) was 0.85 mg/dL, eGFR 60, and she was admitted with cr of 2.2 mg/dL. Urinalysis showed proteinuria, pyuria, hematuria with few bacteria, with new onset anemia (Hgb 7.8) on [...]

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 [...]