A 90-year-old male with a past medical history of hypertension, chronic kidney disease stage II, and hyperlipidemia presented with complaints of intermittent hematuria. He had no prior history of hematuria or mucosal bleeds and denied having any trauma. His activated partial thromboplastin time (aPTT) was found to be mildly prolonged at 48.4 seconds and his factor VIII level was found to be very low at less than 3%.

A 33-year-old male with a past medical history of hypertension, migraine, depression, and alcohol abuse presented with complaints of nausea, vomiting, and abdominal pain. He was found to have an elevated lipase and ethanol level. CT scan of the abdomen was done which showed peripancreatic fat stranding around the pancreatic head consistent with mild acute uncomplicated pancreatitis. CT scan of the abdomen also revealed multiple clustered nodes in the central mesentery with fatty haziness and ground-glass appearance of the mesenteric fat, representing mesenteric panniculitis.

Mehta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Carboplatin is an alkylating anti-neoplastic drug used in various cancers especially ovarian cancer, germ cell tumors, endometrial cancer besides others. We present a case of acute autoimmune hemolytic anemia during Carboplatin infusion in a patient previously exposed to the drug, resulting in the death of the patient. Published reports of Carboplatin induced autoimmune hemolytic anemia suggest these are usually nonfatal and improve after discontinuation of the drug. Fatal autoimmune hemolysis from Carboplatin has not been reported to the best of our knowledge. A 77-year-old Caucasian lady with history of endometrial adenocarcinoma was receiving treatment with a combination of Carboplatin and Paclitaxel for recurrent adenocarcinoma presenting as a pelvic mass. She tolerated similar chemotherapy previously, except for mild side effects. During her fifth cycle of chemotherapy with Carboplatin, she suddenly collapsed in the infusion center. Despite aggressive treatment, she expired within seven hours. A direct Coomb’s test was found to be positive. Carboplatin dependent antibody was also detected. She was felt to have had a Carboplatin-induced fatal hemolytic anemia. Acute autoimmune hemolytic anemia with Carboplatin is rare but could be a devastating complication. A sudden drop in hemoglobin during Carboplatin infusion should alert clinicians of this extremely fatal possibility.

An 84-year-old male, with a large gouty tophus over the left elbow for 20 years, developed a new left elbow area mass about three months ago and presented to the emergency department (ED) with complaints of bleeding from that left elbow area mass after a small blunt injury. Initially diagnosed as olecranon bursitis, it had the worsening size and atypical growth associated with persistent leukocytosis. After being evaluated by multiple specialties, including infectious diseases, orthopedic surgery, and rheumatology, it was decided to do a biopsy, which resulted in the diagnosis of histiocytic sarcoma.