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: 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 75 year old male was transferred into the ICU, already intubated, requiring antibiotics and pressors. He was hypotensive, tachypnic with respiratory distress, had severe oliguric AKI with serum creatinine of 6.0, and anemia with hemoglobin below 7.0. His initial CXR and CT showed scattered bilateral pulmonary opacities. After he did not improve [...]

Case Presentation: An 82-year-old female with diastolic heart failure presented with one-month worsening dyspnea on exertion and a week of scant hemoptysis and fatigue. She denied tuberculosis risk factors, night sweats, fevers, or skin, joint, or urinary changes. She was fully vaccinated against COVID-19. Her medications included aspirin and hydralazine. Her past medical, surgical, and [...]

Case Presentation: A 74-year-old African-American woman presented to our Emergency Department with hemoptysis and severe respiratory distress. Two weeks prior to presentation, she was admitted with persistent cough and blood streaked sputum of 1-month duration and was treated with antibiotics for a presumptive diagnosis of pnemonia after a negative bronchoscopy and bronchoalveolar lavage (BAL). Her [...]

Case Presentation: 49-year-old male patient with history of hypertension was sent by his nephrologist to the ER for unexplained worsening renal function and likely renal biopsy. Vital signs were stable, exam was unremarkable, however BUN was 85 mg/dL with creatinine of 10.1 mg/dL (baseline of 1.5 mg/dL). 24-hour urine protein excretion was 5.2 grams. The [...]

Case Presentation: Pulmonary renal syndrome is a condition characterized by diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis. It is often associated with vasculitides, but rarely Type I cryoglobulinemic vasculitis. When presenting in the setting of rare comorbidities, it can be confused with pneumonia and acute kidney injury. This patient was a 66-year-old male with a [...]

Case Presentation: A 76-year-old woman presented with right flank pain and intermittent painless hematuria. Exam was unremarkable. Labs revealed a Cr of 2.35 mg/dL (0.50 – 1.20 mg/dL), BUN 54mg/dL (6.0 – 23.0 mg/dL), and urinalysis with 229 RBCs and >300 protein, but no casts. CT showed bilateral renal nephrolithiasis without hydronephrosis and a distended [...]