Background: Individuals with autoantibodies against melanoma differentiation-associated protein 5 (MDA-5) are reported to have a significant risk of developing rapidly progressive and fatal interstitial lung disease (ILD) in clinically amyopathic dermatomyositis patients (CADM). Previous cohort studies of dermatomyositis patients who have been systematically evaluated for the presence of anti-MDA5 antibodies and associated clinical features and [...]

Case Presentation: A 36-year-old female with a history of morbid obesity and hypertension presented with three weeks of progressive dyspnea and productive cough. She was previously diagnosed with community-acquired pneumonia and completed two five-day courses of azithromycin, without improvement in her symptoms. She denied smoking but reported increased smoke inhalation due to local forest fires. [...]

Case Presentation: A 78-year-old female with a history of CAD, hypertension, and asthma presented to the ED with fatigue, abdominal pain, diarrhea, and decreased urine output for three days. She recently returned from Southern France where she had overexerted herself in the heat. She was ill-appearing. Vital signs and exam were normal. Significant labs/imaging: Na [...]

Case Presentation: A 50-year-old male with history of gastric lap band, obstructive sleep apnea, hypertension, and type 2 diabetes presented with two months of worsening shortness of breath. He denied cough, fever, myalgias, diarrhea, loss of sense of taste or smell, or pleuritic chest pain. He had no history of asthma, COPD, or tobacco use. [...]

Case Presentation: A 68-year-old man with hypertension and osteoarthritis presented with fever, cough, dyspnea, and weight loss for 2 months. Prior to admission, he had received antibiotics for community-acquired pneumonia without improvement. Physical exam showed multiple ulcers at the base and sides of tongue, bilateral palmar erythematous papules with ulceration and scaling, bilateral erythematous plaques [...]

Case Presentation: Introduction: Hydralazine is an adjunctive antihypertensive medication that is associated with antineutrophil cytoplasmic antibody (ANCA) – associated vasculitis. Kidney involvement usually comprises a pauci-immune, necrotizing glomerulonephritis with crescents. We describe a rare case of hydralazine induced ANCA positive vasculitis with acute tubulointerstitial nephritis and without glomerular involvement. Case Report: A 74 year old [...]

Case Presentation: A 72-year-old female with rheumatoid arthritis, ILD, hypertension, hypothyroidism, iron deficiency anemia, and monoclonal paraproteinemia presented with 3-day history of progressive dyspnea and productive cough and was admitted for acute hypoxic respiratory failure initially requiring 3 L/minute oxygen via nasal cannula (NC). The remaining vital signs were stable. Exam revealed rales at right [...]

Case Presentation: A 34 year old male with a history of CVID subclass 2 and 4, with low IgG level, absent IgA, liver nodular regenerative hyperplasia with portal hypertension, and immune thrombocytopenic purpura status post splenectomy presented with a month of nonproductive cough, mild episodes of hemoptysis, and shortness of breath. Physical exam revealed peripheral [...]

Case Presentation: A 44 year-old Hispanic female with a past medical history of hypothyroidism presented from her endocrinologist with a diffuse, maculopapular rash, including the face, hands, wrists, torso, arms and legs. The rash had been intermittent for the past six years, painful, pruritic, and exacerbated by sunlight. She also complained of joint pain and [...]

Case Presentation: This patient is a 74-year old male with CAD, HFpEF, HTN, Type 2 DM, CKD3, and obesity admitted for sepsis secondary to bilateral lower extremity purulent cellulitis, complicated by acute decompensated heart failure. He was started on cefepime 2 g twice daily and on vancomycin (vanco), dosed daily by level. After receiving only two doses of vanco 1g, the patient was found to have persistently elevated [...]