Case Presentation: An 83-year-old male with a past medical history of light chain MGUS, macrocytic anemia, and cytopenias, arrived at the emergency room presenting with hemorrhagic bullae on his left hand. He reported intermittent fever episodes and chronic, nonspecific joint pain. Admission labs indicated hemoglobin of 7.6, MCV of 114.1, platelet count of 109, and [...]

Case Presentation: A 70-year old-man with a history of HLA-B27-associated anterior uveitis, spondyloarthropathy, and drug- induced leukocytoclastic vasculitis on chronic prednisone and mycophenolate, presented with 3-weeks of worsening fatigue and weakness. At admission, he was afebrile, tachycardic, and had a diffuse rash. On day 2, he began spiking fevers. Labs were notable for WBC count [...]

Case Presentation: 67 year old man with a history of psoriasiform dermatitis refractory to dapsone and hydroxychloroquine, thrombotic thrombocytopenic purpura status post plasma exchange and rituximab, and a history of multiple venous thromboemboli, and a fever of unknown origin presented with progressive worsening of his skin lesions. On exam, the patient was febrile (temperature 39.3C), [...]

Case Presentation: A 76 year old male without any significant past medical history presented to the emergency department with abdominal pain, night sweats, and a fever for a week. He was found to have a mild macrocytic anemia (Hgb 9.9, MCV 105.4) with a normal B12 and folate, and elevated inflammatory markers (CRP 24, ESR [...]

Case Presentation: A 70-year-old man visited our hospital for lower extremity edema and involuntary weight loss. A routine check-up at his diabetes clinic five months earlier revealed anemia and an increased inflammatory response. His medical history included hypertension, dyslipidemia, and type 2 diabetes. Computed tomography (CT), blood cultures, gastrointestinal endoscopy, and colonoscopy findings were unremarkable; [...]

Case Presentation: A 64-year-old man presented with persistent anemia, weight loss, fatigue, fever, cough, episcleritis, chondritis, and facial pain. Initial investigations highlighted macrocytic anemia and elevated alkaline phosphate. Despite initial suspicion of a streptococcal infection and subsequent treatment with antibiotics, his condition did not improve. Further evaluation revealed cavitary nodules on chest imaging, with biopsies [...]

Case Presentation: An 82-year-old male presented to the ED with fevers and shortness of breath. Two years prior, he was started on steroid therapy and intermittent tocilizumab for possible giant cell arteritis (GCA) given his complaints of jaw claudication, headache, elevated CRP and intermittent fevers; temporal artery biopsy was not conclusive for GCA. NM PET [...]

Case Presentation: An 80-year-old man with past medical history of GERD and hypothyroidism presented to the hospital with a 3-month history of progressive dysphagia, odynophagia, painful tongue swelling, and an associated 40-pound weight loss. Initial physical exam was only notable for left sided tongue swelling that resolved after one day of dexamethasone. Labs during hospitalization [...]