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Abstract Number: 293
THE GREAT PRETENDER: VITAMIN B12 DEFICIENCY-RELATED PSEUDO-THROMBOTIC MICROANGIOPATHY
SHM Converge 2026
Case Presentation: A 40-year-old woman with a lifelong vegetarian diet presented to the emergency department (ED) with six weeks of progressive fatigue, exertional dyspnea, and anorexia. On arrival, she was tachycardic to 115 beats/minute but normotensive and well-appearing. Laboratory studies revealed severe macrocytic anemia (Hgb 5.5 g/dL, MCV 121.1 fL), thrombocytopenia (platelets 79×10⁹/L), indirect hyperbilirubinemia [...]
Abstract Number: 294
TRAVELER WITH AN AMOEBIC LIVER ABSCESS: DIAGNOSTIC DELAY
SHM Converge 2026
Case Presentation: A 57-year-old man with a history of an intra-abdominal abscess (2012), appendectomy, and prior orthopedic surgeries presented with 8 days of profound fatigue, fevers (Tmax 104°F), malaise, and progressive left-sided abdominal pain. He is a triathlete with baseline physiologic bradycardia but was noted to have a persistently higher heart rate (80–90s) and dyspnea [...]
Abstract Number: 295
A CHALLENGING CASE OF FATAL ADULT-ONSET STILL’S DISEASE
SHM Converge 2026
Case Presentation: Purpose: -To highlight differentiating AOSD from sepsis and systemic inflammatory response syndromes (SIRS) in elderly patients with confounding, complex, comorbidities. -To remind clinicians that when appropriate anticoagulation is initiated for two new unrelated comorbidities, retroperitoneal hemorrhage may be massive and lead to fatal shock.Case description: An elderly female presented with high-grade quotidian fevers [...]
Abstract Number: 296
RAPIDLY PROGRESSIVE PEMPHIGUS VEGETANS WITH POLYMICROBIAL SUPERINFECTION IN A YOUNG MAN
SHM Converge 2026
Case Presentation: Case PresentationA 27-year-old man with eczema and polysubstance use disorder presented with a two-month history of a progressively worsening rash. The eruption began as pruritic raised lesions on the scalp while living in Connecticut and gradually extended to the peri-auricular region, neck, chest, abdomen, and right axilla. A brief course of oral antibiotics [...]
Abstract Number: 297
THERAPEUTIC CUL-DE-SAC: REFRACTORY CANCER-ASSOCIATED THROMBOSIS COMPLICATED BY HEPARIN-INDUCED THROMBOCYTOPENIA IN ADVANCED PANCREATIC CANCER
SHM Converge 2026
Case Presentation: A 67-year-old female with a history of hypertension, dyslipidemia, and type 2 diabetes mellitus presented with pleuritic chest pain, palpitations, and dyspnea. She reported a 24-lb intentional weight loss, but no cough, hemoptysis, trauma, fever, or travel. She denied tobacco use. An electrocardiogram showed sinus tachycardia; physical examination was otherwise unremarkable. Labs were [...]
Abstract Number: 298
TIROFIBAN-INDUCED ACUTE SEVERE THROMBOCYTOPENIA IN PATIENT UNDERGOING LEFT HEART CATHETERIZATION: REPORTING A RARE ADVERSE EFFECT
SHM Converge 2026
Case Presentation: We present a case of a 50-year-old male with a history of lateral and inferior wall myocardial infarctions (MI), who was admitted with complaints of shortness of breath and chest pain that had progressively worsened over the past three days. MI was suspected, but the EKG showed no acute changes, and serial troponins [...]
Abstract Number: 299
THE LYMPH NODE THAT SPOKE FIRST: UNRAVELING A CASE OF PRIMARY-UNKNOWN MERKEL CELL CARCINOMA
SHM Converge 2026
Case Presentation: A 59-year-old woman with a 25-pack-year smoking history sought care after noticing a rapidly enlarging, painful, golf-ball-sized lump in her left groin. CT abdomen/pelvis showed isolated left inguinal lymphadenopathy. Ultrasound-guided biopsy revealed a poorly differentiated neuroendocrine carcinoma with a Ki-67 proliferation index near 90%. Immunohistochemistry showed AE1/3 positivity, CK20 positivity, synaptophysin positivity, chromogranin [...]
Abstract Number: 300
A 21-YEAR-OLD WITH MALIGNANT HYPERTENSION AND INTRACRANIAL HEMORRHEAGE: A HIDDEN PHEOCHROMOCYTOMA
SHM Converge 2026
Case Presentation: n A 21-year-old woman with no significant medical history presented multiple times to the emergency department with severe headaches and markedly elevated blood pressures. Her initial episode involved a sudden 10/10 throbbing headache, nausea, and photophobia and was treated as migraine. A head CT subsequently revealed an intraparenchymal hemorrhage with thin subdural and [...]
Abstract Number: 301
DIAGNOSTIC UNCERTAINTY IN SUSPECTED NORMAL PRESSURE HYDROCEPHALUS COMPLICATED BY ALCOHOL USE AND AMA DEPARTURE
SHM Converge 2026
Case Presentation: A 50-year-old female with alcohol use disorder, asthma/chronic obstructive pulmonary disease (COPD), hypertension, and recurrent alcohol-related falls presented with generalized weakness, fatigue, and a recent fall striking her head. She denied neck pain but reported progressive imbalance and tiredness. The patient admitted to binge drinking for several days before presentation and stated that [...]
Abstract Number: 302
COLD AGGLUTININ DISEASE TRIGGERED BY IGA KAPPA GAMMOPATHY: A FIRST-IN-LITERATURE CASE REPORT
SHM Converge 2026
Case Presentation: A 45-year-old female presented with a complaint of painless jaundice worsening over 3-4 days, with chest heaviness, palpitations, and extreme fatigue. She also complained of intermittent numbness in all extremities over the past week. Her past medical history was significant for COPD, cigarette smoking, and chronic bilateral lower extremity swelling on diuretics. She [...]
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