Case Presentation: A five-year-old boy with autism presented to the hospital with two-months of fatigue, lower extremity pain, and a petechial rash. Review of systems was notable for a two-kilogram weight loss, intermittent gingival bleeding and refusal to walk for one week. On admission he was afebrile with a heart rate of 160 beats per [...]

Case Presentation: A 78 year old female with Type 2 diabetes, HTN, vitiligo, sacral decubitus ulcers, CHF, and atrial fibrillation presented with fevers and two weeks of malaise, dizziness, progressive somnolence, and altered mental status. Per her husband, she also had some episodes of sweating but had not complained of any headaches or palpitations. At [...]

Case Presentation: A Caucasian man in his 60s presented to the ED with a 6-week history of extensive bruising, worse in both legs and buttocks, along with shortness of breath on minimal exertion. He stated he had a chronic wound on his right leg (Figure 1). He was not taking any regular medications. Days later [...]

Case Presentation: We present a 22 y.o. female with a history significant for nephrolithiasis and a hormonal Intra Uterine contraceptive Device, who was admitted to the medicine Service for 6-7 days of odynophagia and dysphagia. She was being worked up along the lines of foreign body impaction and esophageal abrasion. Gastroenterology was consulted and had [...]

Case Presentation: A 54-year-old man with metastatic melanoma presented to the hospital in acute renal failure. Nine months prior, he was diagnosed with metastatic melanoma and offered immunotherapy. He declined in favor of naturopathic treatment, including high-dose intravenous vitamin C. At his naturopathic clinic, he was found to be hyperkalemic and was referred to our [...]

Case Presentation: A 7-year-old boy with autism spectrum disorder, restricted diet, developmental delay, and iron deficiency anemia presented to the emergency department with decreased oral intake, gingivitis, and progressive refusal to walk over several weeks.Family noticed red and swollen gums one month prior to presentation. He then developed acute refusal to walk one week prior [...]

Case Presentation: A 35-year-old woman with a history of congenital renal dysplasia complicated by end stage renal disease (ESRD) on hemodialysis, chronic macrocytic anemia, and malnutrition with folate, vitamins B12 and A deficiencies, presented with fatigue, dyspnea, and new rash. One week prior to presentation, the patient started experiencing progressive dyspnea on exertion. At her [...]

Case Presentation: A 56-year-old woman with a history of Parkinson’s disease and seizures presented with a month of dyspnea and associated easy bruising. She had previously presented to the emergency room two weeks before her current presentation with swelling of her right lower extremity and bruising. Workup at this time included a lower extremity doppler [...]

Background: Most primates, including humans, belonging to the suborder Haplorrhine lack the innate ability to synthesize ascorbic acid (Vitamin C) and hence exclusively depend on dietary intake (generally plant-based diets) to prevent deficiency. Modern humans’ trend of consuming ultra-processed foods that lack crucial micronutrients places us at risk for developing micronutrient deficiencies. Currently, there is [...]

Case Presentation: A 47-year-old female with history of gastric bypass complicated by dumping syndrome, opioid use disorder on methadone, alcohol use disorder, migraines, and seizures presented with 3 weeks of painful bilateral lower extremity swelling, and 2 months of poor oral intake with persistent diarrhea. Her exam was also notable for tooth fragility, course hair, [...]