Journal of Case Reports and Clinical Studies

Background: Tuberculous pericarditis is a rare manifestation of tuberculosis in developed countries and poses a significant diagnostic challenge due to its nonspecific clinical presentation. Immunocompromised individuals, particularly those receiving tumor necrosis factor-alpha (TNF-α) inhibitors, are at substantially increased risk of developing tuberculosis. Therefore, screening for tuberculosis infection and active disease is essential prior to initiating biological therapy.

Susac syndrome is a rare autoimmune endotheliopathy characterized by encephalopathy, branch retinal artery occlusion (BRAO), and sensorineural hearing loss (SNHL). Due to its diverse presentation, it is often misdiagnosed. We report a case of a 22-year-old female with progressive neurological symptoms, hearing loss, and cognitive dysfunction. Brain MRI revealed characteristic corpus callosum “snowball” lesions, and further investigations confirmed BRAO and SNHL. 

Patients with primary adrenal insufficiency require stress-dose glucocorticoids during acute illness to prevent adrenal crisis. We report twin patients with von Hippel–Lindau syndrome status post bilateral adrenalectomy who presented concurrently with symptomatic SARS-CoV-2 infection but experienced markedly different clinical courses based on adherence to stress-dose steroid recommendations.