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Need help with this case !!
17♂️
Total duration of illness= 9 months
🌡️Fever + large - medium joint inflammatory polyarthritis +enthesitis involving 💪🦵joints + transaminitis up to ~1000 ( SGOT PT similar) X 2-3 months
Need help with this case !!
17♂️
Total duration of illness= 9 months
🌡️Fever + large - medium joint inflammatory polyarthritis +enthesitis involving 💪🦵joints + transaminitis up to ~1000 ( SGOT PT similar) X 2-3 months
Slit skin smear for M leprae negative
w/u for sarcoidosis neg
HLAB27 negative, MRI pelvis normal
HbsAg anti HCV HIV & PCR for parvo/CMV/EBV neg
Mantoux, Chest xray normal
Diagnosis: ? reactive arthritis
Treated with LD steroid
w/u for sarcoidosis neg
HLAB27 negative, MRI pelvis normal
HbsAg anti HCV HIV & PCR for parvo/CMV/EBV neg
Mantoux, Chest xray normal
Diagnosis: ? reactive arthritis
Treated with LD steroid
Returned ~1 month with lat cut nerve of thigh and saphenous nerve NCV proven sensory neuropathy
Sural N biopsy normal, ANA neg, ENA, ANCA neg
Transaminitis resolving to ~100
USG A+P mild coarse liver echotexture
Triple phase CT- incidental L chronic sacrolitis- rest normal
Sural N biopsy normal, ANA neg, ENA, ANCA neg
Transaminitis resolving to ~100
USG A+P mild coarse liver echotexture
Triple phase CT- incidental L chronic sacrolitis- rest normal
Followed up two months later with Raynaud's phenomenon and digital tip ulcers
Continuing polyarthralgia needing 0.25mg/kg of steorids
No e/o GERD/skin thickening/ILD
Repeat ANA 1+FS, ENA neg
cryoglobulins & cryofibrinogen neg
ASMA LKM neg
Doppler- reduced ulnar A flow
Continuing polyarthralgia needing 0.25mg/kg of steorids
No e/o GERD/skin thickening/ILD
Repeat ANA 1+FS, ENA neg
cryoglobulins & cryofibrinogen neg
ASMA LKM neg
Doppler- reduced ulnar A flow
Last Hb 10g/dL, TLC in the range of 5000-8000/cmm N70L20M10, platelet 2.5 L
SGOT PT ~ 100-150 IU/L
Persistently high ESR and CRP
SGOT PT ~ 100-150 IU/L
Persistently high ESR and CRP
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