A 69-year-old woman with lupus erythematosus and painful skin lesions of the feet
Article Abstract:
A 69-year-old woman with ulcers on her feet and a previous diagnosis of lupus erythematosus was found to have multiple myeloma and cryoglobulinemia. Multiple myeloma is a cancer of the bone marrow and cryoglobulinemia is the accumulation in the body of blood proteins that come out of solution at low temperatures. The patient had a history of hypertension, hair loss, rashes, three miscarriages, smoking, and narrowing of the carotid arteries. The earlier diagnosis of lupus erythematosus was doubted because of a lack of definitive symptoms. Blood tests indicated the presence of an immunoglobulin G-kappa M protein that comes out of solution at low temperatures. A bone marrow biopsy suggested that she had multiple myeloma. A skin biopsy of the foot showed collections of blood cells that blocked vessels and caused death of the surrounding tissue. The foot ulcers were successfully treated with prednisone and, after a recurrence in the winter, with melphalan.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
User Contributions:
Comment about this article or add new information about this topic:
A 57-year-old man with a bloody pericardial effusion
Article Abstract:
A 57-year-old man was admitted to a hospital with swelling in his legs and shortness of breath upon exertion. These are signs of heart failure and an echocardiogram revealed an accumulation of fluid around his heart. When the fluid was removed, his symptoms remained, leading his doctors to suspect he had constrictive heart disease. The echocardiogram also revealed a mass in his heart, which was surgically removed. Analysis of the mass revealed it to be squamous cell carcinoma. He had been treated for squamous cell cancer of the tongue. At his death, an autopsy revealed cancer in his lungs, liver and penis.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1997
User Contributions:
Comment about this article or add new information about this topic:
A 42-year-old woman with a pulmonic-valve mass
Article Abstract:
A 42-year-old woman was admitted to a hospital after a cardiac ultrasound revealed a mass on her pulmonary valve. She received the ultrasound as part of a workup for her symptoms of fatigue, shortness of breath upon exertion and heart murmur. Her physicians suspected infectious endocarditis, which is an infection of the heart valves. However, her blood cultures were negative for any infectious organism. A cardiac tumor was the most likely diagnosis, and surgical removal of the mass revealed that it was a papillary fibroelastoma.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1997
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Case 39-2006: A 24-yera-old woman with systemic lupus erythematosus, seizures, and right arm weakness. Case 29-2006: A 43-year-old woman with painful nodules on the fingertips, shortness of breath and fatigue
- Abstracts: A 57-year-old man with chronic lymphedema and enlarging purple cutaneous nodules of the leg. Case 31-2004: A four-year-old boy with Hypoxemia
- Abstracts: A 71-year-old man with masses in the pancreas, presacral region, and left kidney. A 69-year-old woman with severe, persistent congestive heart failure after treatment for bacteremia
- Abstracts: HLA class II antigens associated with systemic lupus erythematosus in black South Africans. Response to methotrexate in early rheumatoid arthritis is associated with a decrease of T cell derived tumour necrosis factor alpha, increase of interleukin 10, and predicted by the initial concentration of interleukin 4
- Abstracts: The Jones criteria for guidance in the diagnosis of rheumatic fever: another perspective. Lyme disease and facial nerve palsy: more questions than answers