Case Presentation: A 59-year-old male with chronic renal insufficiency due to IgG4-related disease (on chronic steroid therapy) and autoimmune pancreatitis presented to the ER with lightheadedness and numbness of bilateral upper extremities after masturbation. He experienced urinary incontinence, but no loss of consciousness. EMS found him hypotensive and bradycardic (BP 84/50, HR 30s) and administered [...]