| Provisional Diagnosis | - | Recurrent polyarthritis 11 years, pain calf muscles on exertion 7/12 subcutaneous swellings 5/12, DOE cl-II 7/12, LBA mainly SI joints Lt. > Rt. 7/12, On Rx, from Banglore with sazo/ pregalin 75/indomethacin SR 75, Inj. Depomedrol weekly. |
|
| Final Diagnosis | - | 1. Rheumaticarthritis(no Carditis), (Polyarthritis, S/C swellings, ASO +ve, ADNB ab, ++Echo aortic valve thickening, high ESR & CRP) 2. vit.D def.state: Pt. on steroids/Kaypen 500 bd./vit. D sachets weekly x 6 wkds. And omeprazole. Pt. improving, for review on 9/1/10 CRP 9.96 Hb 12.5 Urine Nil. ASO 200. ? Auto-immune syn involving Skin/joints & heart following Gr. A streptococcal infection (No CNS involvement/ No carditis) |
|
| History and Findings | - | ||
| Investigation | - | ESR 40, CRP 15.39, RA ANA & ds DNA-ve,ASO +ve 200 u. APLA IgM & IgG-ve homocystein 8.4, (N) anti DNA seab?? 591. MRI LS spine (N) Echo aortic valve thickening, EF 60%, skin biopsy fibrocollagenous tissue. (No inflammation) OGD & colonoscopy N. ASCA-IgA & t Tg-IgA-ve, CI Esterase inh.15 ng(N), 25 (OH) vit.D.,? 11.16 NCV N.Ca/PN HLA B 27 neg |
|
| Treatment | - | ||
| Follow Up | - | ||
M.K.Gayathri,26,Female,Date - 10/12/2009
Latest from Dr.M.Bhaskaran
Login to post comments
