Case Presentation: A 73-year-old male with history of type 2 diabetes and one-month prior admission for acute renal failure in the setting of stage IV chronic kidney disease presented with symptomatic anemia found to have splenomegaly. A renal biopsy revealed features of membranoproliferative glomerulonephritis and necrotizing crescentic lesions with IgM kappa deposition, suspicious for cryoglobulinemic glomerulonephritis. Immunofixation [...]

Case Presentation: 54 years old man with a history of hypertension was hospitalized due to elevated BUN/creatinine of 33/4.6 mg/dL and Hb of 9.9 mg/dL (baseline 15). He endorsed dyspnea on exertion, anorexia and weight loss of 15 pounds in 6 months. One month ago, he was treated for acute bronchitis with levofloxacin and was [...]

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 79-year-old woman with a past medical history of uncontrolled hypertension, migraine, and chronic kidney disease stage 3 presented with one week of poor oral intake, nausea, vomiting, vague abdominal pain, and chronic nonproductive cough. Physical exam revealed poor skin turgor, and lungs with crackles bilaterally. Laboratory studies showed Creatinine of 5.31 mg/dl [...]

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: 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: A 58-year-old woman with multiple sclerosis, neurogenic bladder with indwelling catheter, and recurrent nephrolithiasis presented with worsening malaise and dizziness. Vitals signs were stable and physical exam was remarkable for baseline lower extremity weakness. Blood work identified leukocytosis (14.2 x 109/liter) and severe anemia (6.6 grams/deciliter). Urinalysis showed pyuria and calcium oxalate crystals.CT [...]

Case Presentation: Xanthogranulomatous Pyelonephritis (XGP) is an uncommon sequelae of chronic renal inflammation whose process may invade local structures.  We present a rare case of an invasive Xanthogranulomatous Pyelonephritis (XGP) extending into the thoracic cavity in a 48 year-old female presenting with chronic productive cough. This previously healthy patient presented with dyspnea, productive cough, and [...]

Case Presentation: A 43 year-old-woman with no known medical history presented with two months intermittent fever, cough, pleurisy, hematuria, and weight loss. On exam she had diffuse crackles and lower extremity edema. The patient was intubated for respiratory distress. Laboratory workup revealed acute anemia and urinalysis consistent with nephritic syndrome. Chest x-ray showed bilateral diffuse [...]

Case Presentation: A 31-year-old woman, G2P1A0, 32 weeks pregnant, with a history of systemic lupus erythematosus (SLE), presented with a gradual onset of worsening abdominal wall, genitalia, and bilateral lower extremity swelling. Upon admission, the workup revealed nephrotic-range proteinuria, normal renal function, and elevated anti-dsDNA. A lower extremity ultrasound showed no evidence of deep vein [...]