Case Presentation: A healthy five-year-old girl was admitted from Ophthalmology Clinic for evaluation of bilateral anterior uveitis, fatigue and weight loss. History was notable for a cat scratch to the right eye one month prior which had prompted the referral to Ophthalmology Clinic. Patient also reported fatigue, night sweats, intermittent headache, poor oral intake, and [...]

Case Presentation: A previously healthy 57-year-old man with a history of chronic sinusitis who received the Ad26.COV2.S vaccination 13 days ago without incident presented to the ED with left lower extremity swelling and pain, left medial thigh ecchymosis, transient episodes of right hand paresthesia and weakness, severe headache with transient blurry vision, and progressively worsening [...]

Background: For patients with atrial fibrillation (AF) who undergo percutaneous coronary intervention (PCI), antithrombotic therapy including oral anticoagulants (OAC) and antiplatelets are indicated. The optimal combination is not known. We investigated the efficacy and safety of different antithrombotic strategies in patients with AF undergoing PCI. Methods: PUBMED and EMBASE were searched through September 2019 for [...]

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 68-year-old woman with a past medical history of hypertension and relapsing Thrombotic Thrombocytopenic Purpura (TTP) presented with acute kidney injury. She was diagnosed nine years ago with TTP and had three subsequent relapses; the last episode was seven years ago. She had undergone treatment with steroids, rituximab, and plasmapheresis. She was incidentally [...]

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: A 77-year-old African-American male with Adult-onset Still’s disease (AOSD) was admitted at the hospital for severe thrombocytopenia. The patient had been diagnosed with AOSD four years before this hospital admission. His AOSD was well-controlled with anakinra, an interleukin-1 receptor antagonist, and low-dose prednisone. On admission, the patient did not have any neurological manifestation. [...]

Case Presentation: A 56-year-old Caucasian female with history of mechanical aortic and mitral valves on chronic warfarin therapy, atrial fibrillation, and questionable history of SLE was admitted to the intensive care unit for emergent splenectomy following a motor vehicle accident. After initially being sent home from a regional hospital, she was diagnosed five days later [...]

Case Presentation: A 62-year-old female with diabetes, hyperlipidemia, and hypertension presented after a transient episode of left-sided weakness and dysarthria that resolved by the time of arrival to the emergency department. Vital signs were stable except for a blood pressure of 167/92. Physical exam, including a comprehensive neurologic exam, was negative. Urgent stroke workup was [...]