Case 22-2011 — A 79-Year-Old Man with a Rash, Arthritis, and Ocular Erythema  

Oleh:

Kroshinsky, Daniela ; Stone, John H. ; Nazarian, Rosalynn M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 365 no. 03 (Jul. 2011), page 252-262.
Topik: Swelling Pain In The Hands; Ocular Erythema.

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

Presentation of Case Dr. Sebastian Unizony (Rheumatology): A 79-year-old man was seen in the rheumatology clinic at this hospital because of a rash, joint swelling and pain in the hands, and ocular erythema. The patient had been in his usual health until approximately 2.5 months earlier, when pain developed in his elbows, knees, hips, and wrists shortly after he returned from a rafting trip in Montana. He took ibuprofen and naproxen, with minimal improvement. After several days, he went to the emergency department at another hospital. Doxycycline was prescribed for 3 weeks. Serologic testing for Lyme disease was reportedly negative, but he completed the antibiotic course. Nine weeks before the current evaluation, the patient returned to the other hospital with weakness and diaphoresis. On examination, the pulse was 140 beats per minute and irregular, and the systolic blood pressure was 80 mm Hg. A diagnosis of paroxysmal atrial fibrillation was made. Diltiazem and intravenous fluids were administered, and normal sinus rhythm resumed. The patient was discharged home, taking lisinopril and acetylsalicylic acid. One week after discharge, swelling of the tongue, diaphoresis, and shortness of breath developed, and an urticarial rash appeared on his arms, trunk, and hips. He was admitted to a second hospital, where a diagnosis of angioedema, possibly due to lisinopril allergy, was made. Atrial fibrillation had recurred. Lisinopril was stopped, and metoprolol tartrate was administered. Cardioversion was performed, with restoration of sinus rhythm.

Opini Anda

Klik untuk menuliskan opini Anda tentang koleksi ini!

Kembali