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Abstract Number: 466

UNCOVERING ADVANCED INFLAMMATORY MYOSITIS VIA THENAR ATROPHY

SHM Converge 2026

Case Presentation: A 51-year-old female with history of ESRD, Type II diabetes, and stroke with mild residual right lower and upper extremity weakness presented with left upper arm pain and swelling that had been present for several weeks and worsened to the point that she was no longer able to tolerate dialysis. The patient had [...]

Abstract Number: 467

UNEXPECTED SPONTANEOUS TUMOR LYSIS SYNDROME IN RENAL CELL CARCINOMA

SHM Converge 2026

Case Presentation: A 49-year-old male with metastatic renal cell carcinoma (RCC) involving the lungs and liver, diagnosed one month prior and with no other past medical history, presented from his outpatient oncology clinic with one week of worsening oral intake, throat pain, nausea, abdominal pain, fatigue, and confusion. He had received his first dose of [...]

Abstract Number: 469

A GUT MOTILITY MYSTERY: A UNIQUE PRESENTATION OF SYSTEMIC AMYLOIDOSIS

SHM Converge 2026

Case Presentation: A 61-year-old man with a history of non-ischemic cardiomyopathy presented with recurrent abdominal pain. He was initially admitted one month prior for abdominal pain with concern for acute bowel ischemia. He underwent exploratory laparotomy which showed good perfusion but required detorsion of a portion of the jejunum. After discharge, he was soon readmitted [...]

Abstract Number: 470

A GASTRIC ENIGMA: WHEN BIOPSY TELLS A BIGGER STORY

SHM Converge 2026

Case Presentation: A 36-year-old African American male presented with 3 weeks of epigastric pain radiating to the left lower back, decreased appetite, unintentional weight loss, occasional acid reflux, and nausea with daily episodes of dark, non-bloody emesis. He reported social alcohol use but otherwise denied any other substance use, medications, or supplements. He had no [...]

Abstract Number: 471

BEYOND THE PENTAD: RARE MACROVASCULAR PRESENTATION OF THROMBOTIC THROMBOCYTOPENIC PURPURA

SHM Converge 2026

Case Presentation: A 72 year-old woman with history of thrombotic thrombocytopenic purpura (3 years ago, in remission after rituximab), hypertension, and hyperlipidemia presented as an inpatient transfer to a stroke center after presenting with left facial droop, left-sided weakness, and dysarthria with a right middle cerebral artery occlusion on CT imaging. On clinical exam, the [...]

Abstract Number: 472

NEUROPSYCHIATRIC DECLINE AS AN ATYPICAL PRESENTATION OF HEREDITARY HEMOCHROMATOSIS

SHM Converge 2026

Case Presentation: A 37-year-old male (they/them) with a history of melanoma status post resection and alcohol use presented with behavioral and cognitive changes and increased falls for one year. They developed progressive fatigue, a new tremor, slowed speech, and intermittent confusion that ultimately led to a demotion at work. In neurology clinic evaluation, the team [...]

Abstract Number: 473

A MIND OF ITS OWN: MALIGNANT TRANSFORMATION OF AN OVARIAN TERATOMA TO GLIOBLASTOMA PRESENTING AS NMDAR ENCEPHALITIS

SHM Converge 2026

Case Presentation: A 22-year-old female with no past medical history presented to an ED with insomnia, anxiety, and hallucinations. She was given antipsychotics and admitted to a behavioral health unit on a mental health hold. Two days later, she re-presented to the ED with increased agitation requiring frequent haloperidol administration. During this visit, an LP [...]

Abstract Number: 474

LYMPHADENOPATHY AND EXTENSIVE THROMBOSIS AS THE INITIAL PRESENTATION OF IDIOPATHIC RETROPERITONEAL FIBROSIS

SHM Converge 2026

Case Presentation: A previously healthy 23-year-old male training for an ultramarathon presented with acute-onset severe back pain and subacute B symptoms (fever, night sweats). CT revealed retroperitoneal lymphadenopathy, which prompted urgent transfer to an academic medical center for further evaluation. He was found to have thrombosis of the IVC and left internal, left external, and [...]

Abstract Number: 475

A GUT REACTION: UNMASKING LEFLUNOMIDE TOXICITY

SHM Converge 2026

Case Presentation: A 64-year-old woman with a history of rheumatoid arthritis (RA) on leflunomide for 4 months presented with a 2-month history of dysphagia, emesis, and epigastric pain with multiple prior outside admissions for the same. Prior upper endoscopy was notable for erythematous duodenopathy, gastritis, and normal esophagus. Biopsies showed chronic duodenitis, reactive gastropathy, and [...]

Abstract Number: 476

BROMAZOLAM WITHDRAWAL: NAVIGATING UKNOWN TERRITORY IN DESIGNER BENZODIAZEPINE DEPENDENCE

SHM Converge 2026

Case Presentation: A 39-year-old male with a history of benzodiazepine (BZD) use disorder, anxiety, and post-traumatic stress disorder presented to our academic medical center after a seizure in the setting of a self-directed bromazolam taper. He was prescribed BZDs 15 years ago for anxiety and insomnia, but he began to self-medicate with illicitly purchased bromazolam [...]

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