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BEYOND THE USUAL SUSPECTS: NATIVE TRISCUSPID VALVE ENDOCARDITIS FROM CORYNEBACTERIUM PSEUDODIPHTHERITICUM
SHM Converge 2026
Case Presentation: A 48-year-old female with a history of cyclic vomiting syndrome, gastroparesis, postural orthostatic tachycardia syndrome (POTS), opioid dependence, and a right-sided Port-A-Cath presented with two days of generalized weakness, a witnessed seizure-like episode, and a fall. Initial trauma evaluation was unremarkable. Laboratory studies revealed leukocytosis (WBC 20.8), thrombocytosis (platelets 648), mild hyponatremia (Na [...]
COGNITIVE MANIFESTATIONS OF PERNICIOUS ANEMIA
SHM Converge 2026
Case Presentation: A 79 year old female with a past medical history of type 2 diabetes mellitus, hypertension, coronary artery disease, and prior ischemic stroke presented with a three day history of weakness and confusion. She was oriented to self and location at baseline, without a diagnosis of dementia. Initial investigation revealed an urinalysis with [...]
DELAYED IMMUNE CHECKPOINT INHIBITOR-ASSOCIATED POLYARTHRITIS MIMICKING SERONEGATIVE RHEUMATOID ARTHRITIS
SHM Converge 2026
Case Presentation: A 72-year-old male with lung adenocarcinoma in PET-confirmed remission developed rapidly progressive, symmetric inflammatory polyarthritis five months after completing immune checkpoint inhibitor (ICI) therapy with pembrolizumab. He reported diffuse joint pain, morning stiffness, fatigue, and functional decline involving multiple large and small joints. Examination revealed bilateral wrist and metacarpophalangeal synovitis, restricted wrist motion, [...]
FATAL AUTONOMIC FAILURE IN GUILLAIN-BARRÉ SYNDROME FOLLOWING IVIG-ASSOCIATED TRALI
SHM Converge 2026
Case Presentation: A 48-year-old man with alcohol use disorder presented with midsternal chest pain and progressive bilateral leg weakness following diarrhea and upper respiratory symptoms. Examination showed proximal weakness without sensory loss. Imaging and labs were unremarkable. Suspecting acute inflammatory demyelinating polyneuropathy (AIDP), IVIG was initiated after lumbar puncture; MRI spine was normal.Within 24 hours, [...]
HEPATIC HYDROTHORAX IN A PATIENT WITH MINIMAL ASCITES
SHM Converge 2026
Case Presentation: A 62-year-old with End Stage Liver Disease (ESLD) secondary to autoimmune hepatitis presented with 2 days of dyspnea and cough. In the ED, vital signs were notable for tachypnea and mild hypoxia. Labs revealed an elevated B-type natriuretic peptide of 123. Physical exam demonstrated crackles at the right lung base and bilateral lower [...]
HYPERAMMONEMIA IN A PATIENT WITH UNDIAGNOSED CELIAC DISEASE AND CARNITINE DEFICIENCY
SHM Converge 2026
Case Presentation: This is a case of a 38-year-old female with a relevant past medical history of rheumatoid arthritis who presented with nausea, vomiting, and altered mental status. She was found to have partially compensated anion gap metabolic acidosis and tonic-clonic seizures requiring intubation. Pertinent diagnostic workup revealed a significantly elevated ammonia level of 245 [...]
IMMUNE CHECKPOINT INHIBITORS: A DOUBLE-EDGED SWORD: A CASE OF MULTI-ORGAN IMMUNE-RELATED ADVERSE EVENT
SHM Converge 2026
Case Presentation: A 78-year-old man with newly diagnosed stage IV urothelial carcinoma, recently started on enfortumab vedotin and pembrolizumab, presented with several days of progressive lower-extremity weakness, difficulty rising from a seated position, and blurry vision. Days earlier, he had presented to another facility, where labs showed a troponin of 3,009 ng/L with a normal [...]
IMMUNE MEDIATED NECROTIZING MYOPATHY: A RARE STATIN-RELATED COMPLICATION
SHM Converge 2026
Case Presentation: A 65-year old woman taking a stable dose of high-intensity rosuvastatin presenting with 3 weeks of proximal extremity weakness and pain, noted to have an elevated creatinine kinase (CK) on presentation (7,459 U/L). Despite discontinuation of rosuvastatin and standard rhabdomyolysis management, CK levels failed to normalize, and patient continued noting persistent proximal muscle [...]
IMMUNODEFICIENCY EXPOSED: HOW A CASE OF DISSEMINATED NOCARDIOSIS WITH CNS INVOLVEMENT UNRAVELED A HIDDEN DIAGNOSIS
SHM Converge 2026
Case Presentation: A 41-year-old previously healthy man presented with three weeks of cough and one week of progressive headache, fever, confusion, and weakness. He is currently a construction worker who was born in Guatemala but has lived in Southern California since 2001. Initial vital signs were notable for a fever of 102.7 F, pulse 134, [...]
JEHOVAH’S WITNESSES TREATMENT CONSIDERATIONS: ALL BLOOD DERIVED PRODUCTS MAY NOT BE REJECTED
SHM Converge 2026
Case Presentation: 42-year-old Jehovah’s Witness female with history of uterine fibroids, PCOS, anxiety who initially presented to the emergency department with new small spots on her arms and legs found to have a platelet count of 2x 10E3/uL. She was diagnosed with ITP at the time she was hemodynamically stable and agreed to close follow-up [...]
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