WSI23-111-Case-3

WSI23-111-Case-3

Case #3 - The patient is a 68-year-old female with past medical history significant for chronic myelogenous leukemia currently on Gleevec. She additionally has a left lung nodule, left adrenal nodule undergoing surveillance and a newly discovered liver mass, all without a pathology diagnosis. She has a history of gastrointestinal bleeds due to arteriovenous malformation. She has paroxysmal atrial fibrillation and is reportedly receiving Eliquis. She has chronic obstructive pulmonary disease requiring supplemental oxygen and heart failure with preserved ejection fraction of 64%. Relevant laboratory results: Creatinine 5.92 mg/dL (reference interval 0.6-1.50 mg/dL), calcium 8.6 mg/dL (reference interval 8.5-10.5 mg/dL), phosphate 4.9 mg/dL (reference interval 2.6-4.5 mg/dL). PTH was not determined. She presents with large edematous bullae over the left and right lower lateral shins, along with bilateral large surrounding purpuric plaques with areas of duskiness (see clinical photograph #3 below). A punch biopsy is performed.

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December 31, 1969 7:00:00 PM