Acquired hemophilia A is a disorder of rare entity, resulting in spontaneous bleeding in individuals with no history of bleeding disorders. It is believed to be caused by spontaneous inhibition of clotting factor VIII by autoantibodies, and is usually associated with other autoimmune conditions. The hallmark of this condition is mucocutaneous bleeding leading to ecchymosis, melena, hematoma or hematuria. Our discussion revolves around the case of an elderly male with no history of anticoagulant use presenting with hematuria. Imaging showed left kidney hemorrhage, his labs were significant for a prolonged partial thromboplastin time (PTT), and subsequent tests revealed low factor VIII levels and high factor VIII inhibitor levels, which led to the diagnosis of acquired hemophilia A in the patient. He was managed with medications resulting in normalization of factor VIII levels.

No abstract

No abstract

The consumption of daily nutritional supplements has risen dramatically all over the world. Many people believe that dietary supplements, if not useful, are at least safe to fulfil small dietary gaps. Many nutritional supplements have not been approved by Federal Drug Administration due to their unregulated active ingredients, but they are available as over the counter. One of the active ingredients, exogenous triiodothyronine (T3), has been reported in dietary supplements. We present a case of sudden onset of tetraparesis. Laboratory workup showed hypokalaemia, low thyroid-stimulating hormone and thyroxine (T4) but normal T3 and thyroglobulin levels. The radioiodine uptake scan also showed reduced uptake. After aggressive serum potassium correction and stopping supplements, his condition got improved. So the suspicion of exogenous T3-induced thyrotoxic periodic paralysis was confirmed.

HighlightsMantle cell lymphoma is an extremely rare form of lymphoma associated with appendicitis.This is one of few reported cases of mantle cell lymphoma showing obstruction of appendiceal lumen.Appendicitis associated with mantle cell lymphoma in this incident is unaffected by the effect of chemotherapy treatments.