Dear all
First episode lasted about 4 months beginning with a septicemia-like syndrome (subacute fever, chills, sharp-edged hepatomegaly with jaundice, hypoalbuminemia, leukocytosis with neutrophilia, prolonged INR, and mild acidemia; but with generalized lymphadenopathy (cervial, mediastinal, abdominal LNs) and significant weight loss; and without azotemia and thrombocytopenia. Hence, please imply from these clues leading to Dx???
Second episode after negative results of extensive investigations including chemistry, immunology (low titer of speckle- and homogeneous-typed ANA), microbiology, pathology, and radiology; the patient developed symmetrical polysynovitis of peripheral joints which was not completely controlled by DMARDs.
These data imply to what?
?
Last episode, during OPD follow-up visits, the main syndrome included fever wuithout chills, polysynovitis, generalized lymphadenopathy, panniculitis, and skin rash.
How to imply these data???
The persistent S/S: fever but without chills, generalized lymphadenopathy, polysynovitis.
The disappeared S/S: jaundice, hepatomegaly, neutrophilia, prolonged INR, acidosis.
The new S/S: panniculitis, rash, lung cavity
How to imply these data?
Course: 2 years with 30 kg weight loss
Please imply these data??
In diabetic old woman
Questions
Infection vs autoimmune disorder vs lymphoma/solid tumor?
What is the most likely Dx?
??
Chusana
