Isopropyl alcohol (IPA) is a common constituent of rubbing alcohol, household cleaning agents, and antiseptic agents. Ingestion of IPA usually leads to self -resolving mild symptoms in most cases but can result in severe symptoms, including central nervous system depression or hemodynamic instability. Treatment is mainly supportive, and hemodialysis is generally reserved for severe intoxication. Limited data are available on the use of hemodialysis to treat IPA intoxication. We are presenting a case of accidental ingestion of IPA in an elderly female with dementia leading to severe intoxication requiring hemodialysis at relatively non-toxic serum levels of IPA. The patient had a prompt recovery without any post -procedural or hospital -acquired complications.

Extramedullary myeloma with pulmonary and pleural involvement is rare and can present in different ways. Here we present two cases of extramedullary pulmonary disease in relapsed/refractory multiple myeloma. Background: Multiple myeloma remains an incurable disease with unmet need for new treatments for high-risk disease such as extramedullary plasmacytoma. Relapses can occur at different stages due to the heterogeneity of the disease. While relapsed/refractory disease can be challenging to treat, progression can also lead to extramedullary disease which indicates an aggressive form with poor outcomes. Pulmonary extramedullary disease can present in various ways, such as a lung mass, parenchymal infiltrates, pleural mass, or pleural effusion. Objective: Our case series highlights two different presentations of pulmonary extramedullary disease and a review of the treatment of relapsed/refractory myeloma. Our patients highlight the progression of their multiple myeloma due to the aggressive nature of their extramedullary disease. Their cases emphasize the importance of new targeted treatments to treat extramedullary disease and penta-refractory disease as there is no currently accepted standard regimen for this difficult to treat condition.

Acidosis is prevalent in patients with ARDS, yet the mechanisms involved in alveolar-capillary dysfunction during metabolic acidosis and lung injury remain poorly defined. Here, we report that carbonic anhydrase IX, a unique pH regulatory protein, promotes pulmonary edema and mortality but does not affect lung bacterial clearance during metabolic acidosis and pneumonia. Our findings suggest that carbonic anhydrase IX may serve as a therapeutic target to alleviate lung injury in patients with acidosis and ARDS.

Rheumatoid arthritis is a multisystemic inflammatory disease that can involve the respiratory system, including the pleural space. Most rheumatoid pleural effusions (PE) are incidentally found and do not require any treatment. Very rarely, however, they can become symptomatic and loculated, leading to lung entrapment or trapped lung. Surgical decortication remains the mainstay of management in such circumstances, although recent studies showed comparable efficacy of intrapleural fibrinolytics (alteplase and dornase alfa) in non-rheumatoid complicated effusions. We present a case of rheumatoid PE leading to lung entrapment successfully treated with intrapleural fibrinolytics without complications and good clinical status at six-month follow-up.