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Acquired Generalized Lipodystrophy Following Immune Thrombocytopenia

We describe an adult male patient with acquired generalized lipodystrophy preceded by autoimmune thrombocytopenia. A 44-year-old man with adult-onset type I diabetes presented with 4 weeks of fat wasting in his face, neck, torso, and arms. He was hospitalized 9 months earlier for epistaxis and isolated thrombocytopenia with a presenting platelet count of 3 k/μL. […]

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Not so Obvious: Acute Herpes Esophagitis

  The gross examination immediately suggested infection with Candida species, but biopsy results pointed to a different culprit. A 29-year-old woman sought care in the emergency department after experiencing sharp epigastric pain over 2 days. She was initially seen at an urgent care center and empirically treated for gastritis with omeprazole. However, her pain progressively worsened and […]

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Unexpected Cause of Bleeding

To the Editor: A 46-year-old man was seen by his hepatologist for a follow-up visit after successful treatment of hepatitis C. He reported a general weakness and walking pain for 10 days due to lower limb edema and knee arthralgia. His medical history included an intravenous heroin and cocaine addiction weaned off since 2001 and […]

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Delayed Transient Cortical Blindness from Hypoxic Ischemic Encephalopathy

To the Editor: An 85-year-old woman with no significant past medical history presented after a mechanical fall complicated by multiple fractures. She received intravenous pain medications with resultant decreased level of consciousness and respiratory distress. Intubation was difficult because of bilateral mandibular fractures, and she consequently experienced 10 minutes of hypoxia before secure airway control […]

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Steroid-Refractory Autoimmune Hemolytic Anemia with Massive Splenomegaly

To the Editor: A 63-year-old woman was admitted in January 2012 with a 1-month history of general fatigue and jaundice. Physical examination revealed a pale conjunctiva, icteric sclera, and splenomegaly with no evidence of systemic lymphadenopathy. Laboratory findings revealed normocytic anemia (49 g/L) with increased reticulocyte count, decreased haptoglobin level, normal white cell count without […]

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