Diagnosing Non-HFE Hereditary Hemochromatosis

A 63-year-old Caucasian female presented for evaluation of abnormal bile duct appearance on ERCP after being diagnosed with gallstone pancreatitis, duodenal ulcers and gastritis at another hospital

Helpful or Harmful? A Case Report of Nutritional Supplements Causing Drug-Induced Liver Injury

Herbal supplement-induced liver injury represents a growing concern in the body of drug-induced liver injury (DILI) literature, with recent studies in mainland China, Iceland, and the United States reporting estimated rates of herb/dietary supplement-induced liver injury (HILI) between 1.16-6.38 per 100,000 (Björnsson et al., 2013; Shen et al., 2019; Vega et al., 2017). Notably, a recent 2020 study demonstrated an increasing prevalence of hepatotoxicity secondary to herbal and dietary supplements in the US and worldwide (Zheng et al., 2020). Recognizing the hepatotoxicity of various supplements is crucial, given the increasing usage of dietary and herbal supplements and the lack of regulation of herbal supplements in the United States. HRP-AID is marketed as a twice-daily immune system booster to reduce the intensity and frequency of cold sore outbreaks. The product ingredients include 200 mg ascorbic acid, 20 mcg cholecalciferol, 20 mg a-tocopherol, 10 mg pyridoxine HCl, 50 mcg methylcobalamin, 25 mg zinc citrate, 70 mcg selenium, 250 mg L-lysine, 50 mg Astralagus extract (Astragalus membranaceus), 50 mg Echinacea (Echinacea purpurea), 50 mg garlic powder (Allium salivum), 50 mg natural caffeine (coffee arabica), 50 mg olive leaf extract Oleuropin 20% (Olea Europaea), 50 mg oregano powder (Thymus captatus), 50 mg of elderberry extract (Sambucus nigra) and 50 mg Red Panax ginseng extract (Panax ginseng). A literature review demonstrates that this is the first reported case of DILI secondary to HRP-AID supplementation

Primary Pancreatic Lymphoma Presenting as Acute Pancreatitis

Primary pancreatic lymphoma (PPL) is a rare extranodal manifestation of any histopathologic subtype of non-Hodgkin lymphoma that predominantly involves the pancreas. Fewer than 2% of extranodal malignant lymphomas and 0.5% of all pancreatic masses constitute PPL.1 Common clinical manifestations include abdominal pain, jaundice, acute pancreatitis, small bowel obstruction, and diarrhea. The clinical and radiologic findings are not pathognomonic, and the diagnosis is established only after histopathologic and cytopathologic examination with confirmatory molecular testing. Although rare, this particular neoplasm is amenable to treatment even in very advanced stages

Primary Pancreatic Lymphoma Presenting as Acute Pancreatitis.

Primary pancreatic lymphoma (PPL) is a rare extranodal manifestation of any histopathologic subtype of non-Hodgkin lymphoma that predominantly involves the pancreas. Fewer than 2% of extranodal malignant lymphomas and 0.5% of all pancreatic masses constitute PPL.1 Common clinical manifestations include abdominal pain, jaundice, acute pancreatitis, small bowel obstruction, and diarrhea. The clinical and radiologic findings are not pathognomonic, and the diagnosis is established only after histopathologic and cytopathologic examination with confirmatory molecular testing. Although rare, this particular neoplasm is amenable to treatment even in very advanced stages

Use of Naltrexone for Alcohol Use Disorder: Closing The Gap in Inpatient Initiation

Project AIM: increase the prescribing of this medication as an inpatient to ideally provide more support to patients with alcohol use disorde