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Abstract Number: 356

A RARE RHEUMATOID RAMIFICATION: HYPERVISCOSITY SYNDROME

SHM Converge 2026

Case Presentation: A 31-year-old male with rheumatoid arthritis (RA), left central retinal vein occlusion (CRVO), and bilateral sensorineural hearing loss presented to the emergency department (ED) with abnormal labs. Several weeks prior, he was diagnosed with left CRVO after experiencing blurry vision. During that hospitalization, he was referred to hematology due to concern for hypercoagulable [...]

Abstract Number: 358

RECURRENT POST-TRAUMATIC INFLAMMATORY PANNICULITIS IN MGUS: A DIAGNOSTIC MIMIC OF CELLULITIS

SHM Converge 2026

Case Presentation: A 46-year-old woman with uncontrolled type 2 diabetes mellitus and monoclonal gammopathy of undetermined significance (MGUS-monoclonal IgG Kappa paraproteinemia) diagnosed 4 years ago presented with right knee pain and swelling 3 days after a minor fall. She reported 3-4 episodes of “cellulitis” after minor trauma over the past 4 years. During her prior [...]

Abstract Number: 359

A MASS THAT WAS NOT CANCER: THORACOPULMONARY ACTINOMYCOSIS MIMICKING METASTATIC PROGRESSION IN A PATIENT WITH HYPOPHARYNGEAL CARCINOMA

SHM Converge 2026

Case Presentation: A 54-year-old man with neurofibromatosis and recent tracheostomy and gastrostomy for newly diagnosed hypopharyngeal squamous cell carcinoma presented with two weeks of worsening cough, increased tracheal secretions with brown sputum and progressive shortness of breath now occurring at rest. He appeared cachectic. He was hypotensive and tachycardic. Physical examination revealed brown tracheostomy secretions, [...]

Abstract Number: 360

THROMBOTIC MICROANGIOPATHY UNVEILING ATYPICAL SLE IN A MIDDLE-AGED HISPANIC MAN

SHM Converge 2026

Case Presentation: A 48-year-old Hispanic man with no medical history presented with two weeks of bilateral extremity edema and gross hematuria. He was febrile and hypertensive with non-pitting edema of all extremities and right knee pain but no rashes or ulcers. Urinalysis showed 3+ blood and 200 mg/dL protein. Laboratory studies revealed hypoalbuminemia, normocytic anemia [...]

Abstract Number: 362

A CASE OF MPO-ANCA POSITIVE GRANULOMATOSIS WITH POLYANGIITIS PRESENTING WITH SUBGLOTTIC STENOSIS

SHM Converge 2026

Case Presentation: A 23-year-old male with history of exercise- and allergy-induced asthma, sinusitis, repaired deviated septum, intermittent hematuria and proteinuria, allergies, occasional dysphagia, and nephrolithiasis presented with sudden-onset dyspnea, throat tightness, and cough while exercising. This episode differed from prior asthma exacerbations and was unresponsive to albuterol or montelukast. He reported recent sick contacts, chills, [...]

Abstract Number: 363

THE COST OF CONFIRMATION BIAS: EHRLICHIOSIS MASKED BY DOPAMINE-AGONIST EFFECTS

SHM Converge 2026

Case Presentation: A 74-year-old man with Parkinson’s disease on carbidopa-levodopa had started pramipexole for tremor control about 3 months prior to presentation. He initially started with 3 (0.125 mg) tablets three times a day and was titrated to 8 tablets three times a day, which he had maintained for 3 weeks. He presented to the [...]

Abstract Number: 364

COLD AGGLUTININ

SHM Converge 2026

Case Presentation: A 72-year-old woman with hypothyroidism and osteoporosis presented with fevers, dysuria, and jaundice. Ten days earlier, she was treated for a urinary tract infection with ciprofloxacin. She reported intermittent fevers, persistent dysuria, and progressive yellowing of the skin over several months. On admission, she was hemodynamically stable and appeared pale, without icterus. Cardiopulmonary [...]

Abstract Number: 365

CERVICAL ESOPHAGEAL PERFORATION SECONDARY TO CONSENSUAL ORAL SEX: A CASE REPORT

SHM Converge 2026

Case Presentation: A 50-year-old female with May-Thurner Syndrome presents with three days of odynophagia following consensual “aggressive” oral sex. Barium swallow study confirmed cervical esophageal perforation; CT neck & chest found mediastinal free air. She underwent incision & drainage with pharyngoesophageal repair with Otolaryngology (ENT) and received prolonged IV antimicrobials. Course was complicated by an [...]

Abstract Number: 366

DIAGNOSTIC COMPLEXITY IN VARICELLA ZOSTER VIRUS RETINITIS: A CASE OF SUBACUTE VISION LOSS

SHM Converge 2026

Case Presentation: Varicella zoster virus (VZV) retinitis is a rapidly progressive infection of the retina, most commonly presenting as acute retinal necrosis (ARN). ARN leads to severe inflammation, retinal necrosis, retinal detachment and permanent vision loss. It can occur in both immunocompetent and immunocompromised individuals, often following herpes zoster, and demands prompt antiviral treatment to [...]

Abstract Number: 367

IMPELLA RP FLEX IN MASSIVE PULMONARY EMBOLISM WITH OBSTRUCTIVE SHOCK

SHM Converge 2026

Case Presentation: A 46-year-old man with no prior medical history, with family history of Factor V Leiden mutation in father presented with a one-week history of progressive dyspnea, fatigue, and weakness. Initial imaging at an outside facility revealed bilateral pulmonary emboli with a saddle embolus, left lower lobe infarction, and right heart strain. He was [...]

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