Very Rash
A 30 year old woman presents with episodic joint pain and stiffness of both hands for 1 year, which affects her activities of daily living.
There is no morning stiffness and she is well in-between episodes. She also complains of developing oral ulcers recently.
Her medical, drug and obstetric histories are unremarkable. Plain radiographs of both hands and feet are found to be normal.
There is no morning stiffness and she is well in-between episodes. She also complains of developing oral ulcers recently.
Her medical, drug and obstetric histories are unremarkable. Plain radiographs of both hands and feet are found to be normal.
Select Relevant Investigations
Autoantibody Screen
Performed
ANA titer: 1:80 (normal <1:40)
Anti-dsDNA antibodies: positive
Anti-Ro Antibodies: Negative
Anti-La Antibodies: Negative
Rheumatoid Factor: Negative
Anti-CPA: Negative
Anti-dsDNA antibodies: positive
Anti-Ro Antibodies: Negative
Anti-La Antibodies: Negative
Rheumatoid Factor: Negative
Anti-CPA: Negative
Full Blood Count
Performed
WBC/DC: 3,500/mm3
N: 57%, L: 29%
Hb: 10.1 g/dL
PCV (Hematocrit): 43%
Platelets: 79,000/mm3
N: 57%, L: 29%
Hb: 10.1 g/dL
PCV (Hematocrit): 43%
Platelets: 79,000/mm3
Urinalysis and Renal Functions
Performed
Appearance: clear
Pus Cells, RBC, Cell Casts: nil/hpf
Urea: 4.5 mmol/L (2.5-6.7)
Creatinine: 0.9 mg/dl (0.8-1.4)
Pus Cells, RBC, Cell Casts: nil/hpf
Urea: 4.5 mmol/L (2.5-6.7)
Creatinine: 0.9 mg/dl (0.8-1.4)
ESR + CRP
Performed
ESR: 80 mm/1h (< 15)
CRP: 0.8 ng/ml (< 6)
CRP: 0.8 ng/ml (< 6)
Select Relevant Management
Rituximab
Sun Screen
Hydroxychloroquine
Methotrexate
