Year: 2010
Type: article
Abstract: To the Editor: A 32-year-old woman originally from Cambodia (living in Canada since 1993) developed symmetrical polyarthritis involving hands, wrists, and knees. Rheumatoid factor (RF) and anticyclic citrullinated peptide (CCP), antinuclear antibody (ANA), and anti-double-stranded DNA (dsDNA) were negative. A diagnosis of seronegative polyarthritis was made. Treatment was initiated with methotrexate, hydroxychloroquine, and sulfasalazine. Three years later she developed tuberculosis of the spine (Pott’s disease). She underwent surgical debridement and internal fixation of lumbar spine (T12-L1). Antituberculous drugs were initiated. She developed hepatitis secondary to isoniazid and was treated with ethambutol, pyrazinamide, and rifampin for a year, followed by pyrazinamide and rifampin maintenance therapy indefinitely. Four years after the diagnosis of seronegative arthritis, she was readmitted to our hospital with fever (39°C) and a flare of arthritis. She also presented a sterile pharyngitis, polyadenopathy, and small bilateral pleural effusions. No rash was noted during febrile episodes but she is naturally tanned. Laboratory results showed inflammatory anemia, neutrophilia, and elevated ferritin, sedimentation rate, and C-reactive protein (Table 1). Repeat RF, anti-CCP, and anti-dsDNA … Address correspondence to Dr. Durand; E-mail: madeleine.durand{at}gmail.com
Source: The Journal of Rheumatology
Authors: MADELEINE DURAND, YVES TROYANOV, PIERRE LAFLAMME, GENEVIEVE GREGOIRE
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2088525451