Also known as: Small cell lung cancer
Naomi, a 39-year-old pregnant woman, presents with altered mental status and organ failure. The team discovers a small-cell lung cancer causing paraneoplastic syndromes affecting her brain, liver, and kidneys. She faces a life-threatening decision between treating her cancer immediately or carrying her baby to term.
Naomi's lung cancer triggers antibodies that attack her brain, liver, kidneys, and peripheral nerves, causing the initial constellation of symptoms including altered mental status, organ failure, muscle weakness, and eyelid drooping.
A paraneoplastic manifestation of Naomi's lung cancer affecting the nerves controlling her eyelids and causing muscle weakness, leading to choking episodes and ptosis.
Also known as: Blood clot in lung
Naomi develops a pulmonary embolism, a blood clot in her lungs (common with lung cancer), causing respiratory distress. Treatment with clot removal leads to fatal hemorrhaging.
Also known as: Early labor
Naomi experiences preterm labor at 28 weeks gestation, which is initially stabilized with medication. Later, an emergency C-section is performed to save the baby when Naomi suffers fatal complications.
Also known as: Poor weight gain
Baby Olive drops from the 25th to 3rd weight percentile due to an inadequate vegan diet. Initially thought to be child abuse, it's later revealed to be DiGeorge syndrome affecting her ability to gain weight.
Also known as: Lung infection
Baby Olive develops pneumonia, likely secondary to immunodeficiency from DiGeorge syndrome. Treated successfully with antibiotics and IV feeding.
The underlying cause of Olive's failure to thrive is DiGeorge syndrome, a genetic condition causing her thymus gland to wither, resulting in immunodeficiency and inability to gain weight properly.