Pericarditis Induced by Methotrexate: A Case Report and Literature Review.

Methotrexate (MTX) is a crucial part of the management of rheumatoid arthritis (RA). Although MTX is generally well tolerated, it is not exempt from adverse effects. The side effects of MTX are diverse, and pericarditis, as demonstrated in our case, is one of the rarest adverse effects. Therefore, it is crucial to rule out common causes of pericarditis, such as infections, malignancies, or other underlying conditions. However, once common causes are excluded, MTX-induced pericarditis should always be considered, and MTX should be discontinued without resumption due to potential relapse. Furthermore, the timing of MTX initiation is not significant; patients may have been on chronic MTX treatment or have recently started it. Moreover, pericarditis secondary to MTX is not exclusive to patients with rheumatological conditions but can also occur in other conditions.

Intestinal Reactive Amyloid A (AA) Amyloidosis in a Patient With Multiple Myeloma: A Case Report and Literature Review.

Amyloidosis is a rare group of disorders characterized by the extracellular deposition of misfolded protein aggregates that interfere with the function of the tissue affected. In some patients, the presenting symptom of monoclonal gammopathies, such as multiple myeloma, can be a gastrointestinal bleed with a further report of amyloidosis in gastrointestinal samples. In all the cases the pathology report is read as AL (light chain) amyloidosis. We present a case of a 57-year-old male patient with no medical history who debuted with gastrointestinal bleeding. A colonoscopy revealed a colonic ulcer with a pathologic diagnosis of amyloid A (AA) amyloidosis. Further investigation led to the finding of multiple myeloma (MM) with no evidence of systemic amyloidosis. Although there is little evidence in the literature of the association or even causative relationship between multiple myeloma and AA amyloidosis, our case highlights the importance of searching for an underlying monoclonal gammopathy like MM in a patient with a confirmed diagnosis of AA amyloidosis.

A Case Report of Cold Agglutinin Disease, Severe B12 Deficiency, and Pernicious Anemia: A Deadly Coincidence.

Anemia is the most common hematological disorder. It is commonly a manifestation of an underlying disease. Its causes are multifactorial, including but not limited to nutritional deficiencies, chronic conditions, inflammatory processes, medications, malignancy, renal dysfunction, hereditary diseases, and bone marrow disorders. We present a case of a patient exhibiting anemia related to cold agglutin disease and severe B12 deficiency secondary to pernicious anemia.