Stiff Person Syndrome (SPS) is a rare autoimmune disease related to the lack of inhibition of excitatory neurons in the central nervous system leading to multiple motor dysfunction and symptoms due to uncontrolled motor neuron firing. The pathophysiology of the disease is not completely understood; however, high titers of Glutamic acid decarboxylase antibodies (anti-GAD Ab) have been found in such patients, which leads to its high association with the disease. We present a case of a 52-year-old female with a 20-year history of ongoing gait and balance issues. She is diagnosed with multiple conditions, including stiff person syndrome (GAD+), spinocerebellar ataxia with epilepsy, systemic lupus erythematosus, type 1 diabetes mellitus, IgA deficiency, hypothyroidism, and pernicious anemia. She presented in our institution with a history of a recent fall from a wheelchair. We review the case presentation and association of anti-GAD antibodies with stiff person syndrome and its treatment.

Dysphagia lusoria (DL) occurs due to an aberrant right subclavian artery (ARSA) compressing the esophagus resulting in dysphagia, odynophagia, and/or reflux symptoms. It is diagnosed by barium esophagram followed by a CT scan or MRI. In this case report, there is a 44-year-old male with a chronic history of reflux and a cough that presents after a meal. The case was complicated due to the history of the patient's alcoholism with recurrent pancreatitis. A CT scan was obtained during his admission, which showed pleural effusion, atelectasis, aspiration pneumonia, and an incidental aberrant RCA. Although DL is a rare pathology, 60%-80% of patients remain asymptomatic, and patients with symptoms can be managed conservatively or surgically, depending on their severity.

No abstract

Cutaneous T-cell lymphoma (CTCL) is a dermatologically manifesting immune cell disorder. We present a case of a 76-year-old female with a past medical history of CTCL, presenting with cellulitis of the left foot. After diagnosis of CTCL, the patient was admitted multiple times for treatment of cutaneous and soft-tissue infections with methicillin-resistant Staphylococcus aureus. Her recurrent infection with S. aureus had led to treatment for sepsis and a below-knee amputation on the right during prior hospitalizations. On this admission, the patient was treated with intravenous vancomycin and cefepime as in-patient and oral linezolid as out-patient. Recent articles show that patients with CTCL have an increased tendency to harbor S. aureus, which leads to recurrent infections. Additionally, evidence suggests that S. aureus toxins aid the progression of CTCL by helping the cancer to escape immune regulation. Our patient demonstrates this unique relationship between CTCL and S. aureus, and moreover, we make a case that S. aureus infection in CTCL, as compared to that in other dermatitis, should be better managed to not exacerbate the disease.