Moderated Poster Discussions - Case Reports

Tuesday, April 14, 2026
4:45 pm - 6:15 pm

Case Report: An article that describes and interprets an individual case, often written as a detailed story. This may include unique cases that cannot be explained by known diseases or syndromes; cases that show an important variation of a disease or condition; cases that show unexpected events that may yield new or useful information; cases in which one patient has two or more unexpected diseases or disorders.

INSIGHTS INTO ASSESSMENT AND MANAGEMENT OF MYOCARDIAL INFARCTION WITH NON-OBSTRUCTIVE CORONARY ARTERIES (MINOCA) (Cardiology / Cardiovascular Disease)
Parveer Kaur BA, BE University of Washington School of Medicine
MINOCA was first introduced as a distinct clinical entity in the Journal of Internal Medicine in 2013. Current diagnostic criteria include the presence of positive cardiac biomarkers meeting universal criteria for acute myocardial infarction with nonobstructive coronary arteries (≤50% stenosis in major epicardial vessels) on angiography and lack of any alternative diagnoses.1 MINOCA has an estimated worldwide incidence of 2.9—10.2% and occurs more frequently in younger female patients (median age 61 years).2 We describe a case of a patient with multiple cardiovascular risk factors presenting with acute coronary syndrome symptomatology to emphasize assessment and management of suspected MINOCA.
 

COMPLETE PULMONARY VEIN TRANSECTION SECONDARY TO BRONCHIECTASIS (Cardiology / Cardiovascular Disease)
Ayra Ali, University of Missouri- Kansas City School of Medicine
Pulmonary vein stenosis is a complication of bronchiectasis that occurs due to the structural proximity of the pulmonary veins to the pulmonary hilum. This pathology traditionally occurs in the lung’s left lower lobe and has not been noted to cause total occlusion of the pulmonary veins. We present the case of a female with a past medical history of bronchiectasis and latent pulmonary tuberculosis who was found to have complete left superior pulmonary venous occlusion in the setting of chest pain.
 

DEVICE-RELATED THROMBUS FORMATION ON A WATCHMAN IN A PATIENT WITH CHRONIC LYMPHOCYTIC LEUKEMIA: A CASE REPORT (Cardiology / Cardiovascular Disease)
Nikhil Furtado, BS, Creighton University School of Medicine
The left atrial appendage (LAA) is a common site for thrombus formation in patients with atrial fibrillation (AF), significantly increasing the risk of stroke. While oral anticoagulants are the standard therapy for stroke prevention, they may be contraindicated in some patients due to bleeding risks. The WATCHMAN™ device offers an alternative by occluding the LAA to prevent thrombus formation. However, device-related thrombus (DRT) can occur post-implantation. Studies have reported DRT incidences ranging from approximately 3.4% to 3.7%, which are associated with increased risks of stroke and systemic embolism. This case report describes an extremely rare complication of left atrial thrombus formation despite the presence of a WATCHMAN™ device.
 

UNRECOGNIZED RHEUMATIC MITRAL STENOSIS PRESENTING WITH ATRIAL FIBRILLATION AND EMBOLIC STROKE IN A YOUNG ADULT (Cardiology / Cardiovascular Disease)
Mercedes Garman, Des Moines University
Rheumatic heart disease (RHD) affects an estimated 40 million people globally, though its incidence has markedly decreased in high-income countries. Rheumatic mitral stenosis (MS) remains a major contributor to RHD morbidity worldwide but is now infrequently encountered in the United States. RHD more commonly affects women, making severe rheumatic MS in a young male in a non-endemic region an unusual presentation. This case illustrates the progressive, unrecognized nature of rheumatic MS and its complications, including atrial fibrillation and embolic stroke, emphasizing the importance of considering RHD even in low-prevalence settings.
 

GEMELLA MORBILLORUM AS THE CAUSATIVE PATHOGEN FOR INFECTIOUS ENDOCARDITIS LEADING TO SEVERE AORTIC INSUFFICIENCY (Cardiology / Cardiovascular Disease)
Kunal Gupta, BA, Saint Luke's Health System
A rare cause of infections in humans, Gemella morbillorum, is a Gram-positive bacterium and a known commensal organism of the oropharyngeal and gastrointestinal tract. In reported infections, G. morbillorum has been identified as the causative organism for infective endocarditis and deep visceral abscesses. This case underlines the potential for severe infection even in patients with no significant past medical history.
 

SUCCESSFUL PREGNANCY FOLLOWING REDO ASCENDING AORTIC REPLACEMENT FOR RECURRENT SUPRAVALVULAR AORTIC STENOSIS IN AN ADULT WITH COMPLEX CHILDHOOD REPAIR (Cardiology / Cardiovascular Disease)
Rayaan Rauf, BA, University of Missouri Kansas City School of Medicine
Supravalvular aortic stenosis (SVAS) is a rare congenital LV outflow obstruction most often linked to elastin (ELN) mutations and increasingly recognized as a systemic elastin arteriopathy.1 Pregnancy increases plasma volume and cardiac output, which can worsen fixed obstruction. Contemporary data show that late postoperative restenosis may occur decades after initial repair, sometimes requiring redo aortic surgery in adulthood.1,3 Reports of pregnancy after redo ascending aortic replacement for recurrent SVAS are extremely limited. This case describes lifelong SVAS progression, recurrent obstruction requiring reoperation between pregnancies, and a successful pregnancy after reconstruction.
 

LATE ONSET FABRY DISEASE IN AN ELDERLY FEMALE WITH PREDOMINANT NEUROPATHY AND LIMITED CARDIAC INVOLVEMENT (Diagnosis or Treatment of a Disease Process or Clinical Syndromes)
Rayaan Rauf, BA, University of Missouri Kansas City School of Medicine
Fabry disease is an X linked lysosomal storage disorder resulting from deficiency of alpha galactosidase A and characterized by progressive glycosphingolipid accumulation in multiple organ systems. Although cardiac involvement is a well-recognized and often defining feature, particularly in male patients, clinical expression in female patients is highly variable. Women may present later in life with atypical or subtle manifestations, frequently leading to diagnostic delay. Fabry disease diagnosed in older adults remains underrecognized, and evidence guiding management decisions in this population, including the role of enzyme replacement therapy, is limited.
 

A RARE CASE OF GASTRIC SARCOIDOSIS IN A PATIENT WITH SYSTEMIC SARCOIDOSIS: A DIAGNOSTIC CHALLENGE (Gastroenterology / Clinical Nutrition)
Mohammed Abdalkarim, MD, The University of Toledo
Sarcoidosis is a chronic multisystem granulomatous disorder that most commonly involves the lungs, lymph nodes, skin, and liver. Gastrointestinal involvement is rare, occurring in fewer than 1% of cases, with the stomach representing the most frequently affected site. Clinical manifestations are often nonspecific, including epigastric pain, nausea, vomiting, and weight loss, and may mimic more common conditions such as gastritis or peptic ulcer disease. As a result, diagnosis is frequently delayed and often requires repeated endoscopic evaluations with multiple biopsies to confirm gastric involvement.
 

RENAL CELL CARCINOMA METASTASIS TO THE THUMB: A RARE PRESENTATION OF DIGITAL OSSEOUS INVOLVEMENT (Hematology and Oncology / Bone Marrow Transplant)
Mohammed Abdalkarim, MD, The University of Toledo
Renal cell carcinoma (RCC) is known for its unpredictable metastatic patterns, most commonly affecting the lungs, bones, liver, and brain. However, metastasis to the digits of the hand is exceedingly rare, accounting for < 0.1% of all osseous metastases. Digital involvement typically signifies advanced disease and carries prognostic implications. We present an unusual case of clear cell RCC with metastasis to the right thumb, occurring four years after nephrectomy, emphasizing the diagnostic and therapeutic considerations.
 

THE DIAGNOSTIC DOMINO EFFECT: HIV UNMASKING EXTRAPULMONARY TB AND CHRONIC HEPATITIS B WITH HHV-6 AND EBV (Infectious Disease / Immunization)
Hossam Abdel Aziz, MD, Insight Hospital and Medical Center Chicago
Extrapulmonary tuberculosis (TB) often presents with vague symptoms, especially in immunosuppressed individuals. Its diagnosis can be difficult due to similarities with malignancies and other systemic diseases. High clinical suspicion is crucial in patients with risk factors like HIV, chronic hepatitis, or residence in TB-endemic areas. Coinfections and advanced immunosuppression complicate management, requiring coordinated, multidisciplinary care. EBUS-guided lymph node biopsy is valuable for diagnosis, and timing of antiretroviral therapy must be carefully considered to avoid IRIS.

SYNDEMIC IN ACTION: MPOX MASQUERADING AS STI PROCTITIS DURING 2025 OUTBREAK (Infectious Disease / Immunization)
Hossam Abdel Aziz, MD, Insight Hospital and Medical Center Chicago
Mpox (formerly known as monkeypox), caused by the monkeypox virus (MPXV), has re-emerged globally in recent outbreaks, disproportionately affecting men who have sex with men (MSM) and individuals living with HIV. Transmission is often facilitated by close skin-to-skin or mucosal contact during sexual activity. Co-infection with other sexually transmitted infections (STIs) can obscure clinical presentation and delay diagnosis. We present a case of PCR-confirmed Mpox with severe proctitis in an HIV-positive patient with poor ART adherence and concurrent rectal gonorrhea and active syphilis, highlighting diagnostic complexity and barriers to antiviral access during the 2025 outbreak.
 

BEYOND OBSTRUCTION: PSEUDO-AKI AS THE SOLE PRESENTATION OF EXTRAPERITONEAL BLADDER PERFORATION AFTER CYSTOSCOPY (Nephrology)
Thaer Alhroob, MD, The University of Toledo Medical Center
Cystoscopy with ureteral stent placement is generally considered a safe, low‑risk procedure, and acute kidney injury (AKI) afterward is uncommon and typically attributed to obstruction or prerenal factors. Reabsorption of creatinine‑rich urine from a contained urinary leak can mimic intrinsic renal injury (“pseudo‑AKI”), but this phenomenon is rarely recognized in the absence of abdominal pain or hematuria. We describe an extraperitoneal bladder perforation presenting solely with unexplained oliguria and biochemical AKI after cystoscopy, highlighting the importance of early imaging for urinary leak when obstruction is excluded.
 

ACUTE KIDNEY INJURY BEYOND THE USUAL SUSPECTS: RENAL HISTOPLASMOSIS IN AN IMMUNOCOMPETENT PATIENT (Nephrology)
Anish Patel, MD, University of Illinois Chicago
This case highlights the diagnosis of chronic progressive disseminated histoplasmosis in a previously healthy 55-year-old male who presented with oropharyngeal dysphagia and acute kidney injury (AKI). Disseminated histoplasmosis with renal involvement has been reported in renal transplant patients but is not often considered in immunocompetent patients.
 

MARCHIAFAVA-BIGNAMI DISEASE IN A PATIENT WTH BRACHIAL NEURITIS: A UNIQUE NEUROLOGICAL OVERLAP (Neurology)
Elesh Dasani, University of Toledo College of Medicine and Life Sciences
Marchiafava-Bignami Disease (MBD) is a rare neurologic disorder characterized by damage and demyelination to the corpus callosum (CC). This disease was first described in 1903 in patients with heavy alcohol use. Presentations of MBD are diverse and may include seizures, headache, confusion/cognitive impairment, limb hypertonia, and speech difficulties. Treatment revolves around alcohol cessation and supplementing B vitamins. Idiopathic brachial neuritis (IBN) is a neuromuscular disorder resulting in asymmetric damage to the brachial plexus, causing upper extremity pain and weakness. Patients regain their strength, but it can take weeks to months. MBD is a rare condition that can arise as a co-occurrence with several other clinical conditions. However, there have been no reports of cooccurrence of MBD and IBN.
 

A STROKE THAT WOULD NOT SETTLE: WAXING AND WANING DEFICITS PRECEDING COMPLETE INFARCTION (Neurology)
Farwah Shah, MD, MPH, Insight Hospital and Medical Center Chicago
Stuttering stroke is characterized by recurrent, transient neurologic deficits that fluctuate over hours to days and may precede a completed infarction. These cases present diagnostic and therapeutic challenges, particularly when symptoms rapidly improve or recur, complicating decisions regarding reperfusion therapy. We present a case of a 67-year-old man with multiple transient ischemic episodes and fluctuating deficits whose course highlights the potential role of hypotension in stuttering stroke and the importance of careful reassessment, timely reperfusion therapy and adherence to guideline-based treatment thresholds.
 

AN UNDERRECOGNIZED CAUSE OF SUBDURAL HEMORRHAGE: INTRACRANIAL HYPOTENSION (Neurology)
Michael Suntrup, BS, University of Illinois Chicago College of Medicine
Intracranial hypotension, commonly caused by CSF leak, remains an underrecognized cause of subdural hemorrhage. This mechanism likely occurs due to the stretching and damage of bridging veins caused by sagging of the brain in the setting of low intracranial pressure. In patients with intracranial hypotension, subdural fluid collections occur in up to 50% of cases, and subdural hematomas occur in up to 20% of cases. CSF leak should be suspected in these cases, especially those with signs of intracranial hypotension, such as orthostatic headache.
 

LEUKOSTASIS IN A PATIENT WITH ATYPICAL CHRONIC LYMPHOCYTIC LEUKEMIA: A CASE REPORT AND LITERATURE REVIEW (Pathophysiology / Pathology)
Heidi Christian, MD, MS, University of Illinois Hospital and Health Sciences System
Chronic lymphocytic leukemia (CLL) is characterized by morphology and monoclonal B-cells > 5k/µL; often positive for LEF1, CD5, CD20, CD23, and CD200. Most have an indolent course with mild symptoms despite severe lymphocytosis. Rarely, a CLL patient develops leukostasis.
 

HISTOPATHOLOGIC FEATURES OF CHRONIC LITHIUM NEPHROPATHY IN A PATIENT WITH BIPOLAR DISORDER: A CASE REPORT (Pathophysiology / Pathology)
Juan Sigala Lozano, MD, University of Illinois Chicago
Lithium is a first line maintenance treatment regimen for bipolar disorder. It reduces relapse rates and overall mortality. However, lithium can induce dysregulation of aquaporin-2 expression which leads to loss of principal cells in the collecting duct, resulting in impaired urinary concentrating ability. Clinically, this may manifest as nephrogenic diabetes insipidus (1,2). Long-term lithium use may also result in chronic tubulointerstitial nephritis. Progressive decline in glomerular filtration rate and eventual development of chronic kidney disease (CKD)(3). Histopathologic findings include chronic tubulointerstitial fibrosis with cortical and medullary microcysts or tubular dilatation, focal and segmental glomerulosclerosis and/or global glomerulosclerosis that exceeds age-related expectations. On electron microscopy, variable degrees of podocyte foot process effacement may be observed (1).
 

A RARE CASE OF PULMONARY CEMENT EMBOLISM FOLLOWING KYPHOPLASTY WITH RECURRENT CARDIOPULMONARY SYMPTOMS (Pulmonary / Critical Care)
Nikhil Furtado, BS, Creighton University School of Medicine
Kyphoplasty and vertebroplasty are minimally invasive procedures used to treat vertebral compression fractures by injecting polymethylmethacrylate (PMMA) cement into the vertebral body. A rare but recognized complication is pulmonary cement embolism (PCE), which occurs when PMMA inadvertently enters the vertebral venous plexus and migrates to the pulmonary arteries. Risk factors include low-viscosity cement, high injection volume, and venous breaches. Reported incidence rates of PCE vary from 2% to 26%, largely depending on imaging modality and clinical awareness, though most cases are asymptomatic. This rare complication remains underrecognized, and further reporting is essential to improve awareness, prevention, and management.
 

WHEN MI-2 MEETS NXP2: A RARE DUAL-SEROPOSITIVE DERMATOMYOSITIS WITH OVERLAPPING CLINICAL EXPRESSION (Rheumatology)
Amani Masoud, DO, Franciscan Health Olympia Fields
Dermatomyositis (DM) is an inflammatory myopathy that classically presents with proximal muscle weakness, cutaneous findings, and myositis-specific autoantibodies that define clinical features. Anti-Mi-2 antibodies are typically associated with prominent cutaneous findings and good response to corticosteroids, whereas anti-NXP2 antibodies in adults are linked to severe muscle involvement, dysphagia, edema, and increased malignancy risk¹Ë’². These antibodies are generally considered mutually exclusive. We describe a rare case of DM with dual anti-Mi-2 and anti-NXP2 positivity and overlapping clinical features.
 

BEYOND SEPSIS AND UREMIA:SUSPECTED CNS VASCULITIS IN ANCA DISEASE (Rheumatology)
Mavra Qaiser, MD, Insight Chicago Hospital and Medical Center
Anti-neutrophil cytoplasmic antibody (ANCA)—associated vasculitis (AAV) most commonly affects the kidneys and lungs, while central nervous system (CNS) involvement is rare and diagnostically challenging. Evaluation is particularly difficult in critically ill patients with concurrent infection and metabolic derangements, when invasive testing may be unsafe or low yield. This case highlights the complexity of suspected CNS vasculitis in myeloperoxidase (MPO)-ANCA disease and underscores the importance of clinical context and cautious interpretation of treatment response.
 

INTRA-CRANIAL GIANT CELL ARTERITIS PRESENTING AS MULTIFOCAL ISCHEMIC STROKE (Rheumatology)
Deion Cheng, University of Illinois Chicago College of Medicine
Giant cell arteritis (GCA) is a chronic granulomatous inflammatory disease affecting medium to large caliber arteries. It is the most common primary vasculitis, with a lifetime risk of 0.5-1%, and primarily affects patients over age 50. Classically, GCA involves extracranial vessels, notably branches of the external carotid artery (temporal and occipital arteries), the ophthalmic artery, vertebral arteries, distal subclavian and axillary arteries, and the thoracic aorta. Although intra-cranial GCA (IC-GCA) is rare, occurring in 3-7% of cases, it is associated with significant neurologic complications and increased mortality. We report a case of IC-GCA presenting with multifocal cerebral infarctions.
 

COMPLICATION OF HORNERS SYNDROME POST THYROID LOBECTOMY (Surgery)
Vineeth Atluru, University of Toledo College of Medicine and Life Sciences
Thyroidectomies are frequently performed for both benign and malignant thyroid disorders. (1) Whole or partial resections (such as thyroid lobectomy) are performed depending on risk factors such as thyroid size, location, and malignancy risks. (1) Despite its overall safety profile, complications, including hypoparathyroidism, nerve injury, and postoperative bleeding, may arise due to the intricate anatomy of the cervical region. (1) Horner’s syndrome, characterized by the triad of ptosis, miosis, and anhidrosis, is a rare complication resulting from injury to the cervical sympathetic trunk. (1) While most reported cases of postoperative Horner’s syndrome occur after total thyroidectomies, its occurrence following partial thyroidectomy is uncommon. Post-rapid weight loss changes may further influence cervical tissue vulnerability. We present a case of post-thyroid lobectomy Horner’s syndrome to emphasize its pathophysiology, diagnostic considerations, and implications for surgical practice.
 

A PERFORATED PLOT: VALENTINO'S SYNDROME STEALS THE SHOW FROM APPENDICITIS (Surgery)
Farwah Shah, MD, MPH, Insight Hospital and Medical Center Chicago
Valentino’s syndrome is a rare condition in which perforation of a gastric or duodenal ulcer results in right lower quadrant peritonitis due to the gravitational tracking of gastric contents along the right paracolic gutter. This atypical presentation closely mimics acute appendicitis and may lead to diagnostic uncertainty, particularly in patients with normal laboratory findings and inconclusive imaging. Despite advances in cross-sectional imaging, the site of perforation may not be readily identified preoperatively, increasing the risk of delayed intervention. Awareness of Valentino’s syndrome is essential to ensure timely surgical exploration and appropriate management in patients presenting with right lower quadrant abdominal pain and pneumoperitoneum.
 

MANAGEMENT OF A 4.2-CM HEPATIC ARTERY ANEURYSM ARISING FROM A REPLACED COMMON HEPATIC ARTERY WITH CONCOMITANT CELIAC OCCLUSION (Surgery)
Kathryn Tsai, BS, Carle Illinois College of Medicine
Hepatic artery aneurysms (HAAs) are rare visceral arterial aneurysms, comprising approximately 1% of all arterial aneurysms, most commonly affecting men aged 50-55 years. They carry substantial risk, including rupture, hepatic ischemia, and biliary complications such as obstructive jaundice and hemobilia, with mortality rates approaching 21% if untreated. Management is guided by aneurysm size and anatomy, with 2.0 cm traditionally serving as the threshold for intervention. We present a case of an enlarging 4.2-cm HAA in the setting of a Michels Type IX variant, in which the common hepatic artery is replaced and arises from the superior mesenteric artery (SMA), compounded by complete celiac artery occlusion. This anatomy creates a unique challenge for preserving visceral and hepatic perfusion.
 

BILATERAL CORNEAL EPITHELIAL DEFECTS FOLLOWING A SINGLE DOSE OF DUPILUMAB IN A PEDIATRIC PATIENT (Immunology / Allergy)
RISHI SHARMA, MEng, University of Chicago
Dupilumab, a monoclonal antibody targeting type 2 inflammatory pathways by inhibiting IL-4 and IL-13, is used for eosinophilic esophagitis (EoE), atopic dermatitis (AD), and an increasing number of other inflammatory conditions. While mild Dupilumab-Associated Ocular Surface Diseases (DAOSD), such as follicular conjunctivitis or superficial keratitis, are side effects reported in AD clinical trials, the pediatric phenotype remains poorly characterized. Moreover, early clinical trial data reported a 0% incidence of conjunctivitis in patients treated for EoE. However, emerging evidence suggests that children may be predisposed to more rapid and aggressive ocular toxicity. Here, we present a sentinel pediatric case where a single loading dose triggered rapid, bilateral corneal epithelial defects, resulting in acutely decreased vision.