Neuromyelitis optica spectrum disorder is an autoimmune demyelinating disease with high relative prevalence in the East Asian population. Clinical manifestations include optic neuritis, longitudinally extensive transverse myelitis, area postrema syndrome, brainstem syndromes, and diencephalic syndromes.In this case report, we present a case of neuromyelitis optica spectrum disorder that developed 10 days after the first dose of the severe acute respiratory syndrome coronavirus 2 mRNA-1273 vaccine. The patient was a previously healthy White female, completely independent and functional at baseline. She presented with bilateral lower-extremity numbness/tingling, weakness, and urinary retention. Although her neuromyelitis optica IgG was negative, the MRI was consistent with neuromyelitis optica involving and spanning longitudinally the C6-T2 vertebrae. She was treated with IV steroids and her symptoms improved.Given the novelty of the COVID-19 vaccines and the paucity of literature regarding their adverse effects, case reports such as ours provide unique information that aids healthcare providers in accurately diagnosing and treating patients, ultimately minimizing long-term neurologic deficits.

Yamaguchi syndrome or apical hypertrophic cardiomyopathy (HCM) is a unique variant of HCM. It is characterized by localized hypertrophy involving the left ventricular apex rather than the left ventricular septum. This syndrome has been traditionally seen in the Asian population, particularly those of Japanese descent. We present an interesting case of Yamaguchi syndrome seen in a Hispanic male.A 48-year-old Hispanic male presented with epigastric tenderness and was admitted to the hospital for a non-ST-segment elevation myocardial infarction. His diagnostic catheterization revealed no significant coronary artery disease. However, his echocardiogram revealed apical hypertrophy and narrowing of the left ventricular cavity at the apex, consistent with Yamaguchi syndrome. Case reports such as ours serve to help clinicians broaden their differential diagnoses when approaching patients with acute coronary syndromelike symptoms to include diagnoses such as Yamaguchi syndrome.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel human pathogen known for its predilection on the respiratory system. Herein, we present a unique case in which a patient developed hyperhemolysis in the setting of mixed autoimmune hemolytic anemia (AIHA) secondary to SARS-CoV-2. A 33-years-old male with a past medical history of resolved immune thrombocytopenic purpura (ITP) presented to the hospital with symptoms of jaundice after being infected with SARS-CoV-2. On admission, his Hgb was 12.5 g/dL. Lab results showed indirect bilirubin of 13 mg/dL, LDH at 759 U/L, haptoglobin <10, and the percent reticulocyte count was 2.33%. A direct antiglobulin test (DAT) was also positive for C3, IgG, anti-E, in addition to both warm and cold autoantibodies. PCR was positive for COVID-19. Within two days of admission, his Hgb dropped to 5.9 g/dL. A total of seven units of packed red blood cell (pRBC) was required to achieve a Hgb of 6 g/dL in 48 hours. Patients with preexisting hematological abnormalities have a propensity to develop AIHA in the setting of the virus. The majority of the cases described in the literature were associated with warm AIHA. Our patient tested positive for both warm and cold antibodies, which may partially explain the mechanism behind hyperhemolysis in our patient.

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is increasing in prevalence due to an aging population. Although medications for rhythm and rate control remain the first-line treatment options for many patients, difficulties can include arrhythmia relapse and drug side effects. Catheter ablation or radiofrequency is an alternative treatment modality that can isolate where ectopic arrhythmic sites originate. Several previous studies have examined post-ablation complications and hospitalization rates for arrhythmia recurrence. However, many of these studies used patient data from before 2015. We examined the following data using recent records: pre-procedural patient characteristics, rates of post-procedural hospitalizations with documented recurrence of AF, and patient risk factors associated with these recurrences.

Ischemic colitis is the most common type of intestinal ischemia and is caused by an acute arterial occlusion, thrombosis, or hypoperfusion of the mesenteric vasculature. This case centers around a 39-year-old female with a past medical history significant for a 20-year history of stimulant laxative abuse, chronic constipation, bipolar disorder, and anxiety that presented with ischemic colitis following 21 days of obstipation. At the time of presentation, the patient was taking olanzapine 15 mg daily for the treatment of bipolar disorder and clonidine 0.2 mg three times daily for anxiety. Over the course of her hospitalization, the patient was found to have a high stool burden, including calcified stool, contributing to ischemic colitis. She was successfully treated with a clonidine taper, multiple enemas, and laxatives. Pharmacological agents that induce constipation have been shown to increase the risk of colonic ischemia by increasing intraluminal pressure in the colon. Atypical antipsychotics block peripheral anticholinergic and anti-serotonergic receptors, limit gastrointestinal muscle contractions, and delay intestinal transit.