More articles from Symptoms to Diagnosis

  • Thyroid obstacle course: Many challenges from a single gland
    Timothy W. Bodnar, MD and Sima Saberi, MD
    Cleveland Clinic Journal of Medicine February 2025, 92 (2) 87-93; DOI: https://doi.org/10.3949/ccjm.92a.24076

    The patient presented to his primary care clinician for new irritability, anxiety, and insomnia. Laboratory testing revealed a low thyroid-stimulating hormone level.

  • Shortness of breath in a 52-year-old man with HIV and severe mitral regurgitation
    Felix Wangmang, MD, PharmD, Achilles Aiken, MD and Kuang-Yuh Chyu, MD, PhD
    Cleveland Clinic Journal of Medicine January 2025, 92 (1) 23-30; DOI: https://doi.org/10.3949/ccjm.92a.24060

    The patient presented with 3 weeks of acute on chronic dyspnea on exertion with progression to dyspnea at rest and associated orthopnea.

  • A 74-year-old woman with purple toes
    Baila R. Elkin, MD and Megan McGervey, MD
    Cleveland Clinic Journal of Medicine December 2024, 91 (12) 735-741; DOI: https://doi.org/10.3949/ccjm.91a.24064

    While the patient was undergoing treatment for livedoid vasculopathy, her toes started to become purple and she experienced persistent “stinging” pain in her feet.

  • A man with chronic limb-threatening ischemia and no revascularization options: Can we save his foot?
    A man with chronic limb-threatening ischemia and no revascularization options: Can we save his foot?
    Fachreza Aryo Damara, MD, Khaled I. Alnahhal, MD, Hassan Dehaini, MD, Georgeanne Botek, DPM, Ammar A. Saati, MD, Pulkit Chaudhury, MD and Lee Kirksey, MD, MBA
    Cleveland Clinic Journal of Medicine November 2024, 91 (11) 683-692; DOI: https://doi.org/10.3949/ccjm.91a.23077

    The patient’s right foot was edematous with extensive, dry-appearing gangrene of the big toe, and no pedal pulses were felt.

  • Abdominal pain in a patient with epistaxis, telangiectasias, and arteriovenous malformations
    Akash Mathavan, MD, Akshay Mathavan, MD, Andreas Giovanni Zori, MD, Marc Stuart Zumberg, MD, Jeb M. Justice, MD and Ali Ataya, MD
    Cleveland Clinic Journal of Medicine October 2024, 91 (10) 601-608; DOI: https://doi.org/10.3949/ccjm.91a.24042

    The pain was radiating to the back, exacerbated by eating, and accompanied by intermittent nausea and fatigue.

  • Recurrent syncope in a 62-year-old man
    Cindy Hsin-Ti Lin, MD, Michael Sheu, MD and Faiz Anwer, MD
    Cleveland Clinic Journal of Medicine August 2024, 91 (8) 473-478; DOI: https://doi.org/10.3949/ccjm.91a.24008

    The patient experienced 2 episodes of syncope over 4 weeks, had a history of recurrent carpal tunnel syndrome, and had ankle edema for the previous 18 months.

  • A hidden cause of hypokalemia
    Kanza Haq, MD, Zein Alabdin Hannouneh, MD, C. Elena Cervantes, MD and Mohamad Hanouneh, MD
    Cleveland Clinic Journal of Medicine June 2024, 91 (6) 345-351; DOI: https://doi.org/10.3949/ccjm.91a.24002

    A 21-year-old man presented with increasing fatigue and psychosis symptoms. Laboratory testing results were consistent with a metabolic disorder.

  • Simultaneous hemorrhage and venous thrombosis in a patient with systemic lupus erythematosus
    Binoy Yohannan, MD, Natalie A. Montanez, FNP-C and Miguel A. Escobar, MD
    Cleveland Clinic Journal of Medicine May 2024, 91 (5) 308-317; DOI: https://doi.org/10.3949/ccjm.91a.23059

    After undergoing hip arthroplasty, the patient had hematoma formation in the pelvis, active bleeding from the surgical site, and a prolonged activated partial thromboplastin time. Careful evaluation led to the diagnosis of an acquired bleeding disorder.

  • Severe hyponatremia: Are you monitoring the urine output?
    Elias Bassil, MD, Georges N. Nakhoul, MD, MEd, Jonathan J. Taliercio, DO, FASN and Ali Mehdi, MD, MEd, FACP, FASN
    Cleveland Clinic Journal of Medicine April 2024, 91 (4) 221-227; DOI: https://doi.org/10.3949/ccjm.91a.23052

    A 52-year-old woman presented with confusion and a 1-month history of drastically increased alcohol intake and mild nausea and anorexia, resulting in a 15-lb weight loss.

  • Hematologic complications after kidney and pancreas transplant in a patient with chronic myeloid leukemia
    Binoy Yohannan, MD, Allen Omo-Ogboi, MD, Johncy John Kachira, MBBS and Harinder Juneja, MD
    Cleveland Clinic Journal of Medicine March 2024, 91 (3) 183-190; DOI: https://doi.org/10.3949/ccjm.91a.23042

    This case highlights the complex interplay linking autoimmunity, solid-organ transplant, myeloid neoplasm, and Evans syndrome.

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