Background Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, severe hypersensitivity reaction characterized by rash, hematologic abnormalities, and multiorgan involvement. Although DRESS is typically triggered by medications, interindividual variability suggests a role for host-related factors. This study investigated whether underlying autoimmune diseases increase susceptibility to DRESS. Methods A retrospective, propensity score–matched case-control analysis was conducted using a large multicenter database, comparing 1128 patients with DRESS to 1128 controls matched by age, sex, and race. Autoimmune comorbidities were identified through ICD-10 codes encompassing systemic and organ-specific conditions. Results Several autoimmune diseases were significantly more prevalent in patients with DRESS, including hypothyroidism (odds ratio [OR] 1.56; 95% confidence interval [CI] 1.24–1.96; P < 0.001), type 2 diabetes mellitus (OR 1.58; 95% CI 1.31–1.91; P < 0.001), rheumatoid arthritis (OR 2.17; 95% CI 1.36–3.46; P < 0.001), psoriasis (OR 2.28; 95% CI 1.28–4.06; P = 0.004), inflammatory bowel disease (OR 1.81; 95% CI 1.08–3.04; P = 0.02), and mixed connective tissue disease (OR 2.59; 95% CI 1.52–4.44; P < 0.001). Conclusion These findings highlight the importance of heightened vigilance when prescribing high-risk medications to patients with autoimmune diseases and underscore the need for prospective studies exploring genetic and immunologic mechanisms linking autoimmunity and drug hypersensitivity.

We report the case of a 20-year-old woman who presented with facial swelling and recurrent abdominal pain. Subsequent evaluation confirmed a diagnosis of type 1 hereditary angioedema due to reduced levels of C1 esterase inhibitor. Timely diagnosis and personalized management significantly enhanced her overall well-being. The case highlights the need for heightened awareness of hereditary angioedema in patients with unexplained, recurrent angioedema and abdominal pain, facilitating timely intervention and optimal long-term outcomes.

Background Cancer-associated thrombosis is a major cause of morbidity and mortality in patients with cancer and is associated with a high risk of both recurrent venous thromboembolism (VTE) and bleeding. Although extended anticoagulation reduces the risk of recurrent VTE by more than 80%, full-dose therapy may increase bleeding complications, potentially offsetting its benefit in this population. Reduced-dose direct oral anticoagulants (DOACs) have therefore been proposed as a safer long-term treatment option. Methods We conducted a systematic review and meta-analysis of randomized controlled trials comparing reduced-dose DOACs with standard-dose regimens for extended VTE treatment in cancer patients. Outcomes included recurrent VTE, major bleeding, clinically relevant nonmajor bleeding, all-cause mortality, and composite bleeding, with pooled odds ratios calculated using random-effects models. Results Five randomized trials involving 2709 patients were included. Recurrent VTE rates were comparable between reduced-dose and standard-dose DOACs. Reduced-dose therapy was associated with a significant reduction in clinically relevant nonmajor bleeding and composite bleeding. While major bleeding occurred less, the difference was not statistically significant. Conclusions Overall, reduced-dose DOACs demonstrated similar efficacy in preventing recurrent VTE while offering an improved bleeding profile, supporting their potential role in long-term management of cancer-associated thrombosis, though larger prospective studies are needed to define optimal dosing strategies.

Background Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally. The co-occurrence of COPD exacerbation and cirrhosis may compound clinical complexity and elevate adverse outcome risks. This study aimed to evaluate the impact of cirrhosis on outcomes among patients admitted with acute exacerbations of COPD. Methods Data were extracted from the Nationwide Inpatient Sample database for the period of 2019 to 2021. Patients hospitalized with acute exacerbations of COPD were identified using ICD-10 codes. The study population was stratified into patients with cirrhosis and those without. The primary outcome was in-hospital mortality. Secondary outcomes included sepsis, hepatic encephalopathy, respiratory failure, cardiac arrest, cardiac arrhythmias, pneumothorax, pulmonary embolism, acute kidney injury, and hospital length of stay. Results Among 914,498 patients hospitalized with COPD exacerbations, 4.2% had cirrhosis. Cirrhotic patients were younger and had higher in-hospital mortality, longer length of stay, and higher hospital charges compared to noncirrhotics. Cirrhosis was independently associated with increased mortality and a higher risk of sepsis, acute kidney injury, encephalopathy, shock, and prolonged hospitalization. Associations with arrhythmia and cardiac arrest were not statistically significant. Conclusion Cirrhosis is associated with higher in-hospital mortality and increased risk of complications in patients admitted for COPD exacerbations, contributing to longer hospital stays and higher healthcare costs. Clinical monitoring and tailored management are warranted in this group.

This case report details an incident of acute hypothermia following the administration of valproic acid in a patient presenting with seizures. We describe the clinical presentation, diagnostic workup, treatment plan, and potential mechanisms underlying this rare adverse effect.

Background Colonoscopy is commonly performed after acute diverticulitis to exclude colorectal cancer (CRC) or advanced adenomas, but the true yield, especially in younger adults in the computed tomography era, remains uncertain. This study evaluated the diagnostic yield of follow-up colonoscopy with attention to age and timing. Methods We conducted a retrospective cohort study within Allegheny Health Network from 2021 to 2024. Among 550 patients in an endoscopy-based dataset, 77 had documented acute diverticulitis and subsequently underwent lower endoscopic evaluation. Demographics, comorbidities, and colonoscopic outcomes were extracted from the electronic health record. Primary outcomes were detection of CRC and adenomas; advanced adenomas were identified only when explicitly noted. Secondary outcomes included colonoscopy timing and age-stratified yield. Results Among 77 patients, CRC was detected in 4 (5.2%) and adenomas in 25 (32.5%). All neoplastic lesions occurred in adults aged ≥40 years, and all CRC cases were in patients aged ≥50 years. No lesions were found in patients aged 18 to 39 years. Only 31.7% underwent colonoscopy within 8 weeks, and delayed procedures did not appear to reduce yield. Conclusions Neoplastic findings after diverticulitis were confined to adults aged ≥40 years. No advantage was observed for colonoscopy strictly within 8 weeks, supporting selective, risk-based evaluation.

Pemphigoid gestationis is a rare autoimmune blistering disorder associated with pregnancy that may present diagnostic challenges, particularly when onset occurs postpartum. We describe a woman in her 30s who developed an intensely pruritic blistering eruption 1 day after delivery. Histopathology was nondiscriminatory, but direct immunofluorescence demonstrated specific findings—including linear complement deposition along the basement membrane—confirming the diagnosis. This case highlights a practical diagnostic approach to postpartum blistering eruptions and underscores the importance of immunofluorescence studies and neonatal monitoring.