Case Presentation: A 69-year-old male with CKD Stage III and psoriatic arthritis on adalimumab (40 mg every 2 weeks) and methotrexate (20mg weekly) presents to the hospital after routine labs revealed macrocytic anemia and neutropenia. The patient was treated for right hand cellulitis 10 days ago in an urgent care setting with a dose of [...]

Case Presentation: An 89 year old male presented with itchy red rash over the body since two weeks. His past medical history was significant for Rheumatoid Arthritis (RA) managed with 2.5 mg weekly oral Methotrexate and 200mg daily Hydroxychloroquine for RA. Examination revealed multiple annular purpuric lesions with central erosion on lower extremities, upper extremities [...]

Case Presentation: A 76-year-old man with seropositive RA treated with MTX 15-20mg weekly for at least four years presented to the hospital with worsening fatigue, generalized weakness, poor appetite, and dyspnea. Contrast-enhanced computed tomography of chest abdomen and pelvis (CT CAP) demonstrated numerous pulmonary nodules, centrally hypodense left retroperitoneal soft tissue masses which may represent [...]

Case Presentation: A 63 year old female with a past medical history significant for rheumatoid arthritis, COPD, hypertension, hypothyroidism who was admitted with the chief complaint of a rash. It was present for two months and was predominantly distributed on the extremities and gluteal region. It was painful and at times even pruritic. There were [...]

Case Presentation: A 48-year-old male from North Carolina with a history of rheumatoid arthritis presented to the ED with complaints of black tarry melena, nausea, vomiting, and nose bleeds. The patient was found to have stomatitis and severe pancytopenia. He eventually admitted to not understanding his methotrexate dose and stated he accidentally took three times [...]

Case Presentation: A 76-year-old white woman with a past medical history of RA, being treated with MTX, sarilumab, and folic acid supplementation, presented to the hospital for worsening pain and lethargy. Physical exam displayed dry mucous membranes, ulcerations throughout the oropharynx, and purple digits from distal interphalangeal joints to the fingernails bilaterally. Additionally, she was [...]

Case Presentation: A 80 year-old man with past medical history of frontotemporal dementia and seronegative rheumatoid arthritis (RA) presented with a maculopapular rash that started two weeks ago on his back that progressed to his chest, abdomen, neck, face, scalp, and arms. Physical exam also showed oral mucositis. For his RA, he had been on [...]

Case Presentation: A 56 year old caucasian male with extensive sarcoidosis of the lungs, heart, pancreas and liver had a surveillance 6 month CT scan of the chest+abdomen+pelvis to look for disease progression. Incidentally, he was found to have pneumatosis of the hepatic flexure of colon with surrounding pneumoperitoneum in the absence of associated inflammatory [...]

Case Presentation: A 75-year-old female presented to the emergency department with a history of multiple falls. Her physical exam was unremarkable. A computerized tomographic scan of the head and magnetic resonance imaging (MRI) with the contrast of brain showed frontoparietal mass with metastatic brain lesions. Right frontal craniotomy with tumor resection was done and biopsy [...]

Case Presentation: A 65-year-old male presented to his primary care clinic with a one-week history of right-sided facial pain radiating around his jaw with a negative dental workup. Patient had progressive neck pain and CT scan found an ill-defined soft tissue in the superior mediastinum encasing the proximal left common carotid artery, concerning for lymphoproliferative [...]