{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T04:42:16Z","timestamp":1768106536244,"version":"3.49.0"},"reference-count":23,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,18]]},"abstract":"<jats:p>Approximately 11\u2009million people living and working in the USA do so without documentation. This group represents a disenfranchised minority with adverse experiences and unique comorbidities that faces significant obstacles to receiving healthcare, including fear of deportation, language barriers, financial barriers and difficulty navigating an inconsistent and fragmented system. Healthcare is therefore often sought once symptoms have become critical, which can lead to more severe disease processes and multiple new diagnoses at presentation even in previously healthy patients. Here we present the case of a previously healthy 32-year-old undocumented immigrant who presented to a South Florida hospital with abdominal pain, diarrhoea and leg pain. He was diagnosed with both diabetes mellitus and chronic myelogenous leukaemia after a prolonged 20-day hospital stay. Culturally sensitive providers and dedicated staff play a major role in connecting patients to outpatient care after an acute illness, which most often occurs at charity clinics.<\/jats:p>","DOI":"10.1136\/bcr-2018-225004","type":"journal-article","created":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T01:56:05Z","timestamp":1539568565000},"page":"bcr-2018-225004","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["The illness experience of an undocumented immigrant in the USA"],"prefix":"10.1136","volume":"2018","author":[{"given":"Jared G","family":"Blommel","sequence":"first","affiliation":[{"name":"University of Miami\/JFK Medical Center Palm Beach Regional GME Consortium, The Miller School of Medicine at the University of Miami, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres R","family":"Chacon","sequence":"additional","affiliation":[{"name":"University of Miami\/JFK Medical Center Palm Beach Regional GME Consortium, The Miller School of Medicine at the University of Miami, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart J","family":"Bagatell","sequence":"additional","affiliation":[{"name":"University of Miami\/JFK Medical Center Palm Beach Regional GME Consortium, The Miller School of Medicine at the University of Miami, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,10,14]]},"reference":[{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2147\/RMHP.S70173","article-title":"Barriers to health care for undocumented immigrants: a literature review","volume":"8","author":"Hacker","year":"2015","journal-title":"Risk Manag Healthc Policy"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2011.06.007"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.3","unstructured":"Krogstad J , Passel J , Cohn D . 5 Facts about illegal immigration in the U.S. Washington, DC: Pew Research Center, 2017."},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.4","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.044602"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-7379.2008.00150.x"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2014.05.012"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.7","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12079"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.8","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1001\/jamainternmed.2016.8865","article-title":"The illness experience of undocumented immigrants with end-stage renal disease","volume":"177","author":"Cervantes","year":"2017","journal-title":"JAMA Intern Med"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.9","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-010-9406-9"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.10","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.049791"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.11","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s10903-013-9968-4","article-title":"Evaluating the impact of immigration policies on health status among undocumented immigrants: a systematic review","volume":"17","author":"Martinez","year":"2015","journal-title":"J Immigr Minor Health"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.12","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1177\/0886260515589568","article-title":"Adverse childhood experiences among immigrants to the United States","volume":"32","author":"Vaughn","year":"2017","journal-title":"J Interpers Violence"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.13","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/bgv035"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.14","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s10903-009-9267-2","article-title":"Expanding the universe of universal coverage: the population health argument for increasing coverage for immigrants","volume":"11","author":"Nandi","year":"2009","journal-title":"J Immigr Minor Health"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.15","first-page":"543","article-title":"Care for immigrants with end-stage renal disease in Houston: a comparison of two practices","volume":"103","author":"Sheikh-Hamad","year":"2007","journal-title":"Tex Med"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.16","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2003.11.004"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.17","unstructured":"Ilinois State Senate, 2014. 98th General Assembly; Senate Bill 741 or Comprehensive Medicaid Legislation http:\/\/ilga.gov\/legislation\/BillStatus.asp?DocNum=0741&GAID=12&DocTypeID=SB&LegID=70138&SessionID=85&SpecSess=&Session=&GA=98 (Accessed 10 Mar 2018)."},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.18","unstructured":"Chauvin P , Parizot I , Simonnot N , 2009. Access to healthcare for undocumented migrants in 11 European Countries [Internet]. Medicins du Monde European Observatory on Access to Healthcare http:\/\/www.epim.info\/wp-content\/uploads\/2011\/02\/Access-to-healthcare-for-Undocumented-Migrants-in-11-EU-countries-2009.pdf (last accessed 15 July 2018)."},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.19","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.16.179606"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.20","first-page":"377","article-title":"Review of strategies to enhance outcomes for patients with type 2 diabetes: payers' perspective","volume":"4","author":"Greenapple","year":"2011","journal-title":"Am Health Drug Benefits"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.21","first-page":"97","article-title":"Creativity is the key in discharge planning for undocumented immigrants","volume":"14","author":"Anon","year":"2006","journal-title":"Hosp Case Manag"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.22","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1353\/hpu.2010.0111","article-title":"To discharge or not to discharge: ethics of care for an undocumented immigrant","volume":"6","author":"Asch","year":"1995","journal-title":"J Health Care Poor Underserved"},{"key":"2025081108251869000_2018.oct13_1.bcr-2018-225004.23","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s10730-012-9183-z","article-title":"Where should they go? 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