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Abstract Number: 325

MYELIN OLIGODENDROCYTE GLYCOPROTEIN ANTIBODY-ASSOCIATED DISORDER: A MIMICKER OF MULTIPLE SCLEROSIS

SHM Converge 2026

Case Presentation: A 47-year-old female with no significant past medical history presented to the emergency department in December with gastroparesis followed by progressive asymmetric weakness, numbness, and impaired gait associated with fall two years ago. MRI Brain was performed and unremarkable. She then developed a constant spinning sensation. She tried meclizine without benefit. The following [...]

Abstract Number: 326

REFRACTORY SUPRAVENTRICULAR TACHYCARDIA IN THE SETTING OF WOLFF-PARKINSON-WHITE SYNDROME: AN INTERESTING TALE

SHM Converge 2026

Case Presentation: 57-year-old male with a past medical history of nicotine dependence and concussion two weeks ago presented with supraventricular tachycardia (SVT) at another facility. He received Adenosine 6, 12, 12 mg and 2 L normal saline bolus, but did not convert and transferred to our facility for further management. Patient states that for the [...]

Abstract Number: 327

PACEMAKER EXTRUSION: A RARE AND CHALLENGING COMPLICATION IN CARDIAC DEVICE THERAPY

SHM Converge 2026

Case Presentation: A 65-year-old man with permanent atrial fibrillation on apixaban, non-ischemic cardiomyopathy, complete heart block post CRT-D implantation, prior mitral valve repair with annuloplasty ring, and bioprosthetic aortic valve replacement presented with new exposure of his CRT-D generator. His history included methicillin-sensitive Staphylococcus epidermidis endocarditis managed with long-term cefadroxil suppression.He noticed the exposure after [...]

Abstract Number: 328

WHEN DESTRUCTION MASKS DEFICIENCY: PERNICIOUS ANEMIA PRESENTING AS HEMOLYSIS

SHM Converge 2026

Case Presentation: A 44-year-old man with a history of hypertension presented with progressive weakness and dizziness occurring over the past few months. His physical exam was unrevealing. Initial laboratory results were significant for pancytopenia (WBC count: 2.38 K/mcL, hemoglobin: 3.40 g/dL, platelet count: 89 K/mcL) and markers of hemolysis showing a lactate dehydrogenase above 2,500 [...]

Abstract Number: 329

WHEN A CASE OF HISTOPLASMOSIS STICKS AROUND

SHM Converge 2026

Case Presentation: A 21-year-old female from the Ohio River Valley, previously healthy, presented in the winter for evaluation of a large lung mass of unknown etiology associated with cough, chest discomfort and shortness of breath. She initially presented to primary care for evaluation after 4 days of cough, dyspnea and malaise. Exposure history was notable [...]

Abstract Number: 330

A HEART-STOPPING SIDE EFFECT: CAPECITABINE-INDUCED CORONARY VASOSPASM PRESENTING AS STEMI

SHM Converge 2026

Case Presentation: A 62-year-old male with a history of colon cancer status post partial colectomy and initiation of Capecitabine two days prior presented to the emergency department with one day of severe episodic chest pain radiating to the back. The chest pain was increasing in frequency and relieved by sublingual nitroglycerin. He denied any prior [...]

Abstract Number: 331

WHEN EXPERTS DISAGREE: THE MULTIDISCIPLINARY CROSSROADS: TO OPERATE OR NOT TO OPERATE?

SHM Converge 2026

Case Presentation: A 56-year-old man with HIV, nonadherence to antiretroviral therapy, prior cryptococcal meningitis, and remote methamphetamine use presented with progressive bilateral lower-extremity weakness. MRI showed a 2.1-cm homogeneously enhancing intramedullary mass at T8–T9, raising concern for inflammatory versus malignant etiologies, particularly lymphoma. CSF and serum cryptococcal antigen were positive, while all other infectious studies—including [...]

Abstract Number: 332

TWO PILLS TOO POWERFUL: WHEN CYP2C9 GOES MISSING

SHM Converge 2026

Case Presentation: A 77-year-old female with recently diagnosed atrial fibrillation was discharged on warfarin for anticoagulation. Five days later, she returned with chest discomfort and dyspnea. Electrocardiography showed atrial fibrillation with rapid ventricular response and a new right bundle branch block. Her INR had increased markedly from 1.4 at discharge to 14.1, despite reported ingestion [...]

Abstract Number: 333

CHRONIC LYMPHOCYTIC LEUKEMIA WITH RARE PROGRESSION INVOLVING THE CENTRAL NERVOUS SYSTEM

SHM Converge 2026

Case Presentation: 63-year-old male with chronic lymphocytic leukemia (CLL) presented to the emergency department with altered mentation and difficulty ambulating for one month. He was undergoing treatment in a prospective randomized phase II trial of acalabrutinib followed by obinutuzumab or venetoclax and was currently on acalabrutinib 100 mg twice daily. The initial workup included a [...]

Abstract Number: 334

DELAYED CARDIAC SEQUELAE: CARCINOID HEART DISEASE MANIFESTING 10 YEARS POST DIAGNOSIS

SHM Converge 2026

Case Presentation: A 63-year-old male with a history of carcinoid disease presented to the hospital with abdominal distention, watery diarrhea, and anasarca. His carcinoid disease was diagnosed in 2013 s/p small bowel resection with recently identified hepatic metastasis. Exam revealed facial flushing, a grade 3 systolic murmur, abdominal distension, and pitting lower extremity edema, symptoms [...]

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