Background: The current American Society of Hematology (ASH) guideline recommends the use of thrombopoietin receptor agonists, eltrombopag or romiplostim as one of the second-line therapies for chronic immune thrombocytopenia (ITP). The efficacy and safety of those drugs have been tested in several clinical trials. However, the safety profile was not consistent throughout trials and is [...]

Case Presentation: 70 year old male veteran with Lung Adenocarcinoma, Chronic Obstructive Pulmonary Disease, and remote Mucosa Associated Lymphoid Tissue Lymphoma presents with nausea, diaphoresis, and shortness of breath following administration of intravenous Iodinated Contrast Media (ICM) obtained for a staging Computerized Tomography (CT) scan. The patient was afebrile, with sinus tachycardia at 120 beats [...]

Case Presentation: A 65-year-old woman with antiphospholipid syndrome (APLS), and history of multiple lower extremity deep vein thrombosis (DVT) and miscarriages, on warfarin presented with syncope, fall, and head-strike. She was found to have an acute subdural hematoma (SDH) in the interhemispheric fissure and a non-occlusive DVT in the left femoral vein. Initial labs showed [...]

Case Presentation: A 27 year old previous healthy male presented to the Emergency Department with 4 days of progressive fatigue and scleral icterus. These symptoms were preceded by 2 days of a nonproductive cough. Upon presentation, the patient’s labs were notable for an indirect hyperbilirubinemia of 5.9 mg/dL. Complete blood count revealed a macrocytic anemia [...]

Case Presentation: A 46-year-old male with no known past medical history presents with worsening chronic cough of one-year duration. He also reports shortness of breath and increasing fatigue during the same timeframe. On presentation, he is noted to have numerous umbilicated facial lesions that are actively bleeding. He was febrile to 103F, tachycardic to 130s, [...]

Case Presentation: A 28 year-old unvaccinated man with a history of Hodgkin’s lymphoma in remission presented with thrombocytopenia. Six weeks ago, he was exposed to COVID-19 and developed cough and rhinorrhea. He was not tested but started taking hydroxychloroquine and azithromycin. Three weeks prior to admission, he began noticing mucosal bleeding. One week prior to [...]

Case Presentation: 63-year-old female with medical history significant for idiopathic thrombocytopenia purpura (ITP), requiring splenectomy in 2013, pulmonary embolism requiring IVC filter placement due to ITP and asthma, presented with acute onset of shortness of breath. Patient had diffuse petechial rash on extremities. She was tachypneic, hypoxic and had rales on examination. Initial evaluation with [...]

Case Presentation: A 39-year-old obese man with type 2 diabetes, dyslipidemia, and hypertension presented to the ED with intermittent abdominal pain, diarrhea, nausea, and emesis 2 weeks after an illness with sore throat. He denied fever, chills, shortness of breath, epistaxis, gum bleeding, or easy bruising. Medications included losartan-hydrochlorothiazide, metformin, and tirzepatide. Vital signs showed [...]

Case Presentation: A 43-year-old African-American female with a history of multiple sclerosis complicated by paraplegia, neurogenic bladder, and seizures presented to the hospital with a syncopal episode and was found to have a hemoglobin of 2.9 (12.0 to 16.0 gm/dL) with red blood cell count RBC 0.96 (4.00 – 5.20×10^6/uL), lactate dehydrogenase 639 (