Systemic lupus erythematosus (SLE) is the most common form of lupus and a chronic autoimmune disorder that can affect multiple organ systems including the joints, skin, the cardiovascular system and even the central and peripheral nervous system. Although rare, these patients may present with neuropsychiatric symptoms. This patient presented initially with an SLE flare associated with sudden focal to generalized tonic-clonic seizures. Further rheumatologic workup was done which revealed that the patient also has scleroderma, an autoimmune connective tissue that causes inflammation of the skin and other key internal organs. Due to the seizure occurrence, cranial magnetic resonance imaging (MRI) was done which showed incidental mesial temporal sclerosis, which is the scarring of the medial part of the said lobe of the brain. Her overlap syndrome was managed with Hydrocortisone and she was given Valproic acid as her anti-epileptic drug with no recurrence of seizure afterwards.

Human ; Female ; Adult: 25-44 Yrs Old ; Lupus Erythematosus, Systemic ; Hippocampal Sclerosis ; Mesial Temporal Sclerosis ; Valproic Acid

Essential thrombocytosis (ET) is one of the myeloproliferative neoplasms (MPNs) which increase the probability of thrombosis and bleeding. ET is usually discovered as an incidental finding on blood workup and in rare cases, will present as vascular events such as stroke. Our patient, a 77-year-old female, a case of acute cerebral infarct presented with numbness and severe weakness of left upper and lower extremity. Serial complete blood count showed an elevated platelet count. Bone marrow aspiration studies showed increased number of enlarged megakaryocytes. She was diagnosed as a case of ET and maintained on Aspirin 80 mg per tablet once a day and Hydroxyurea 500 mg per tablet once a day.

Human ; Female ; Aged: 65-79 Yrs Old ; Aspirin ; Hydroxyurea