Neurofibromatosis (NF) is a common autosomal dominant disorder that can be subdivided into type 1, type 2, and schwannomatosis. Patients with NF1 typically develop café-au-lait spots, scoliosis, and benign neurofibromas. In addition, NF1 predisposes to vascular complications including stenosis, arterial ectasia, and aneurysms. Here, we report the case of an otherwise healthy 32-year-old man who developed a fatal tension hemothorax due to vertebral artery aneurysm rupture. Based on the available literature, we discuss the presentation, workup, and available therapeutic approaches to this complication of neurofibromatosis.

Clenbuterol is a beta-agonist that has been abused by fitness-oriented individuals for muscle growthand weight loss. We report a case of a 46-year-old man who presented tachycardic, hypokalemic, andhyperglycemic after injecting testosterone obtained from Brazil. He developed refractory hypotensionand was started on an esmolol infusion for suspected beta-agonist toxicity. Laboratory analysisshowed a detectable clenbuterol serum concentration. Analysis of an unopened ampule containedboldenone undecylenate, clenbuterol, and vitamin E. This case illustrates a novel exposure thatcaused beta-agonist toxicity and was treated successfully with rapid-onset beta blocker.