Background: Thrombotic thrombocytopenic purpura (TTP) is a rare but deadly thrombotic microangiopathy (TMA) that is caused by ADAMTS13 deficiency. The PLASMIC clinical scoring system was developed and validated to determine the pretest probability of severe ADAMTS13 deficiency in cases of suspected TTP. We studied the role of the PLASMIC score in guiding use of the [...]

Case Presentation: A 67 year-old woman presented with acute cough, fever, and hypoxia. SARS-CoV2 testing was positive, and she was treated with dexamethasone and remdesivir. Over the next two days, her serum creatinine increased from 0.6 to 3.0 mg/dL, platelet count decreased from 281 to 48 k/L, and hemoglobin decreased from 13.1 to 11.3 g/dL. [...]

Case Presentation: The patient is a 27-year-old male with lupus anticoagulant with hypoprothrombinemia syndrome (LAHPS)/triple positive antiphospholipid syndrome (APLS) in the setting of systemic lupus erythematous (SLE) and immune thrombocytopenia (ITP) on hydroxychloroquine, mycophenolate mofetil (MMF), and prednisone for immunosuppression, who presented to the ER with worsening right upper quadrant and epigastric pain. RUQ US [...]

Case Presentation: We present the case of a 31 year old primigravida African American woman who presented to her post-partum follow up clinic visit two weeks after Cesarean section delivery of a preterm live infant at 29 weeks. She was found to be in hypertensive emergency (220/120 mmHg), with complaints of acute diffuse abdominal pain, [...]

Case Presentation: A 53-year-old male with a history of Goodpasture syndrome, systemic lupus, and Wegener’s granulomatosis underwent a deceased donor kidney transplant for end-stage renal disease. Two days post-surgery, the patient developed anemia and thrombocytopenia, elevated lactate dehydrogenase, and increased creatinine, prompting a preemptive diagnosis of TTP. Plasmapheresis was initiated every other day, alternating with [...]

Case Presentation: A 77-year-old female with a history of hypertension and osteoporosis presented to the emergency department with dizziness, fatigue, decreased oral intake, and weakness for a few weeks. She also reported blurry vision and paresthesias in her lower extremities. Physical examination including a neurological examination was normal. Laboratory tests revealed a severe macrocytic anemia [...]

Case Presentation: A 36-year-old male with no past medical history presented to the emergency room for medical evaluation for one week of diarrhea that became bloody four days prior to presentation. During the hospitalization, he had worsening thrombocytopenia and labs were consistent with Shiga Toxin 2 positive hemolytic uremic syndrome. He was managed with supportive [...]

Case Presentation: Young female with history of juvenile rheumatoid arthritis, not on any medications,

Case Presentation: A 65-year-old male presented with a chief complaint of dyspnea beginning 3 months ago. Additionally, he endorsed 15-pound weight loss, fatigue, and decreased appetite during this time. Members of his family noticed yellowing in his eyes. He had no known past medical history. He described his diet as balanced, consisting of meat, eggs, [...]

Case Presentation: A 44-year-old male presented to the Emergency Department after having a witnessed seizure. There were no precipitating events and previous blood tests were normal. His blood pressure (BP) on arrival was 255/154 mmHg. Labs showed a creatinine (Cr) of 2.2 mg/dL, hemoglobin 9 g/dl, platelet 553 k/uL, low-normal haptoglobin of 31 mg/dL, and [...]