A Rare Case of a Patient With Hairy Cell Leukemia Developing Blastoid Marginal Zone B-Cell Lymphoma.

There have been several case reports associating hairy cell leukemia (HCL) with non-Hodgkin's lymphoma. However, it remains unclear whether these rare phenomena represent disease transformation or the coexistence of two separate disease entities. De novo marginal zone lymphoma can be routinely seen in elderly patients; however, in a patient with a history of HCL, a transformation is more likely than de novo blastoid marginal zone lymphoma. In this report, we present a rare case of a patient with HCL developing a high-grade blastoid marginal zone B-cell lymphoma (MZBCL).

Newly Diagnosed Idiopathic Thrombocytopenia Post COVID-19 Vaccine Administration.

A few individuals are believed to have developed immune thrombocytopenia (ITP) following the administration of the coronavirus disease 2019 (COVID-19) vaccine. This phenomenon has been reported in a few case reports and also in some recent news articles. In this report, we discuss a case of a 54-year-old Caucasian female who presented to the emergency room with life-threatening thrombocytopenia in the setting of de novo ITP following COVID-19 vaccine administration. Due to the relapsing nature of ITP, it is unclear if the patient has achieved complete remission of the disease.

A Rare Case of Double Antibody-Positive Rapidly Progressive Glomerulonephritis: A Therapeutic Challenge.

Crescentic glomerulonephritis, also known as rapidly progressive glomerulonephritis, is a syndrome characterized by progressive and rapid deterioration of renal function over the course of weeks to months. Oliguria, hematuria, azotemia, and hypertension are characteristic features of this condition. Crescentic glomerulonephritis is further classified according to the staining pattern on immunofluorescence. In rare instances, a mixed pattern of injury is encountered as in the case of double antibody-positive rapidly progressive glomerulonephritis (RPGN). This case illustrates the challenge in treatment of double antibody-positive RPGN in an elderly female with no previous renal disease. The patient was found to be positive for anti-GBM antibody and MPO-ANCA. Treatment was initially targeted against MPO-ANCA as the biopsy was most consistent with this process; however, the patient failed to respond to treatment and was subsequently transitioned to oral cyclophosphamide directed against anti-GBM disease. In cases of doubly antibody-positive RPGN with anti-GBM disease and ANCA-associated vasculitis, initial treatment should focus on inducing remission of anti-GBM disease as double antibody-positive disease often presents with the aggressive morbidity and mortality seen in anti-GBM disease, and the chronic risk of relapse seen in ANCA-mediated vasculitis.

A case of immunotactoid glomerulopathy in a patient with monoclonal gammopathy of renal significance.

Monoclonal gammopathy of renal significance is a relatively new diagnosis that attributes kidney disease to damage caused by a monoclonal protein. There is growing recognition of this disease in patients previously diagnosed with monoclonal gammopathy of undetermined significance, as they increasingly develop clinically significant renal impairment requiring treatment. We outline a case of a patient presenting with worsening renal function, found to have a circulating monoclonal protein and ultimately diagnosed with a subtype of monoclonal gammopathy of renal significance referred to as immunotactoid glomerulopathy. Abbreviations: MGUS: Monoclonal gammopathy of undetermined significance; M-protein: Monoclonal protein; MM: Multiple myeloma; MGRS: Monoclonal gammopathy of renal significance; MGCS: Monoclonal gammopathy of clinical significance; CKD: Chronic kidney disease; C3 and C4: Complement 3 and complement 4, respectively; EF: Ejection fraction; CT: Computed tomography; IgG: Immunoglobulin G; GFR: Glomerular filtration rate; PET: Positron emission tomography; MRI: Magnetic Resonance Imaging.

Nitrous Oxide-Induced Vitamin B12 Deficiency Resulting in Myelopathy.

Nitrous oxide, primarily used in the medical field and in the food industry, can cause symptoms of euphoria and analgesia. Recreational use of nitrous oxide is rising, as are reports of its adverse effects, including neurologic complaints secondary to an evoked vitamin B12 deficiency. We outline a case of a patient presenting with several neurologic symptoms and found to have myelopathy secondary to vitamin B12 deficiency in the presence of prolonged recreational nitrous oxide use.