September 30th 2014
Mycosis fungoides; circumscribed erythematous lesions in a toddler; large abdominal ecchymotic mass . . . some of the challenges for you in this quiz.
Study Sheds Light on Wheat Sensitivity as an Emerging Clinical Entity
February 11th 2013Results suggest that wheat sensitivity is a true clinical entity worthy of further study, and that it is a heterogeneous condition with at least 2 distinct subtypes. How this will translate into clinical practice will be an evolving research area, but clinicians should not expect gluten avoidance to disappear as yet another food fad.
An Elderly Woman With IgA Lambda Multiple Myeloma and Kidney Disease
A 92-year-old woman presented with a 6-month history of progressively worsening fatigue, weight loss, generalized bone pain, and dyspnea on exertion. A skeletal survey found lytic lesions in the pelvis, sacrum, and calvarium (shown here).
A Young Man With Thousands of Colorectal Polyps: Anomalous and Benign? Or, Something Else?
April 2nd 2012Diagnostic colonoscopy revealed innumerable polyps carpeting the mucosa from the rectum to the cecum. Endoscopic findings and family history were most consistent with familial adenomatous polyposis.
What Cause of Persistent Diarrhea and Weight Loss?
March 21st 2012A 28-year-old woman presents with a 4-month history of diarrhea and a 15-lb weight loss. She reports starting “another new diet” a few months ago but was in good health until these symptoms began. There is no family history of GI disease and no sick contacts. She denies recent travel.
Myalgias in a 55-Year-Old Man, After a Camping Trip
March 9th 2012A 58-year-old man presents with myalgias of approximately 1 week’s duration. He had been recently treated for sinusitis and symptoms resolved. His only medications were hydrochlorothiazide for hypertension and simvastatin for hyperlipidemia. He and his wife had gone camping 1 month before this visit.
A Middle-Aged Man With Recurrent Pneumonia and Renal Failure
September 14th 2011A 56-year-old was seen in the ED after 4 days of hemoptysis and intermittent left chest pain. He also complained of exertional dyspnea and arthralgias. He had been treated for “pneumonia” twice during the past month. Histories were unremarkable.
Ulcerative Colitis in Adults: Summary of the Latest Practice Guidelines
December 8th 2010Ulcerative colitis affects about 500,000 persons in the United States and accounts for more than 30,000 hospitalizations and 1 million workdays lost each year. The exacerbations and remissions that characterize the clinical course of the disease can make its management particularly challenging. What is the optimal approach to treatment? And which agents are most effective for maintenance therapy?