Case Presentation: A 65 year old male with no significant medical history presented to an outside facility complaining of fatigue, weakness, nausea and vomiting. He had moderate alcohol history and significant weight loss over the past 6 months. Initial lab workup was notable for elevated liver transaminases with a hepatocellular pattern, Maddrey score of 53.6 [...]

Case Presentation: A 28 year old man presented to the ED with hypotension and tachycardia. Laboratory evaluation showed hyponatremia, hyperkalemia, hematocrit of 47.4, cortisol level<0.5, ACTH elevated at 886, TSH 11.91, Free T4 1.0 and negative anti TPO antibody. On admission, the patient had orthostatic hypotension and ashen grey skin tone. Cosyntropin stimulation test resulted [...]

Case Presentation: We present a 96-year-old male who presented to the emergency department with syncope and worsening fatigue. He noted yellowing of his eyes and skin, clay colored stools and dark urine. He had a remote cholecystectomy but no prior liver disease and denied alcohol use.Physical exam revealed prominent jaundice and scleral icterus with a [...]