Background: Myelofibrosis is a chronic myeloproliferative neoplasm characterized by progressive bone marrow fibrosis and extramedullary hematopoiesis leading to splenomegaly. Progressive splenomegaly is common in advanced myelofibrosis, and spleen volume is a predictor of survival. The oral selective small-molecule JAK 1/2 inhibitor ruxolitinib is used for symptomatic management of intermediate-2 and high-risk myelofibrosis, and leads to [...]

Case Presentation: A 78 y/o M with PMH of papillary thyroid CA, BPH, and primary myelofibrosis of the bone marrow (has JAK2 mutation, leukocytosis and thrombocytosis, has not received therapy to date) presented with 8 day history of early satiety, fatigue, and new increasing ascites. An inItial diagnostic paracentesis showed SAAG = 1.1, total protein [...]

Case Presentation: A 76-year-old Chinese woman with history of cryptogenic cirrhosis (MELD-Na 25) presented to our hospital with 1 week of worsening jaundice, abdominal distension, and right upper quadrant pain. Cirrhosis was diagnosed by imaging on admission 2 months previously and presumed to be secondary to Hepatitis C infection due to antibody positivity. CT of [...]

Case Presentation: A 23-year-old male with past medical history significant for recovered COVID 19 pneumonia one year prior presented to the Emergency Department with a chief complaint of shortness of breath with exertion that was gradually worsening. He endorsed increased weakness, fatigue, and pallor over a similar time span. The onset was two weeks prior. [...]