The EC approved upadacitinib for active polyarticular JIA in children 2 years and older, based on phase 1 SELECT-YOUTH efficacy and safety data.
|Articles|August 24, 2013
Young Woman With Calf Pain and Fever of Unknown Origin
She presented with such severe calf pain she could no longer walk unassisted, with a months-long history of fever of unknown origin. What does the MRI show?
Advertisement
An 18-year-old Hispanic female with no significant medical history presented to our hospital with severe, debilitating pain and weakness in both calves, intermittent fevers over the past three months, drenching night sweats, and new-onset upper extremity bilateral weakness and pain during the previous three weeks. Her fevers, which had increased from once weekly to twice daily over the past month, usually arrived in the afternoon, with associated chills, frontal headache, nausea, photophobia, phonophobia, and dizziness. She also reported decreased appetite and a 5 kg weight loss over the prior six months.
The calf pain and weakness had begun four months earlier, concurrent with an upper respiratory infection that resolved within two weeks. This episode was not associated with cough, fever, chills, or night sweats. She had no prior history of respiratory problems.
An MRI image of the right calf appears above. What do you think it shows? What other symptoms would you expect to see, and which further tests would you order?
Click here to see the
References:
REFERENCES
1. Watts R, Scott DGI. Polyarteritis nodosa and microscopic polyangiitis. In Rheumatology, 5th edn. Edited by: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH. Mosby Elselvier, Philadelphia. (2011) 1523-1534.
2. Kamimura T, Hatakeyama M, Torigoe K, et al.
3. Khellaf M, Hamidou M, Pagnoux C, et al.
4. Ahmed S, Kitchen J, Hamilton S, et al.
5. Nakamura T, Tomoda K, Yamamura Y, et al.
6. Jennette JC, Falk RJ, Bacon PA, et al.
7. Pagnoux C, Seror R, Henegar C, et al.
8. Gallien S, Mahr A, Rety F, et al.
9. Balbir-Gurman A, Nahir AM, Braun-Moscovici Y.
10. Carron P, Hoffman IE, De Rycke L, et al.
11. Garcia-Porrua C, Mate A, Duran-Marino JL, et al.
12. Hall C, Mongey AB.
13. Iwamasa K, Komori H, Niiya Y, et al.
14. Soubrier M, Bangil M, Franc S, et al.
15. Esteva-Lorenzo FJ, Ferreiro JL, Tardaguila F, et al.
16. Gardner GC, Lawrence MK.
17. Garcia F, Pedrol E, Casademont J, et al.
18. Hofman DM, Lems WF, Witkamp TB, et al.
19. Nash P, Fryer J, Webb J.
20. Ferreiro JE, Saldana MJ, Azevedo SJ.
21. Laitinen O, Haltia M, Lahdevirta J.
22. Golding DN.
24. Watts RA, Scott DGI: Epidemiology of vasculitis. In: Vasculitis, (2008) 2nd edition. Edited by: Ball GV, Bridges, SL. Oxford: Oxford University Press; 7-22.
25. Mahr A, Guillevin L, Poissonnet M, Aymé S.
Advertisement
Related to this article
Amgen reported dazodalibep met its primary endpoint in the phase 3 OASIZ-301 trial, improving ESSDAI score in moderate-to-severe systemic Sjögren's disease.
Rozanolixizumab improved FIQR score at 10 weeks but did not reach 2-sided statistical significance on its primary BPI-SF interference endpoint.
Two-year data from the open-label extension show sustained ACR and MDA response rates for the TYK2 inhibitor in active psoriatic arthritis.
Oberlin outlines what dermatologists should weigh, beyond APEX's radiographic data, when selecting a biologic for PsA.
Beeline Medicines reported positive topline data meeting primary SRI-4 endpoint at week 48 across all 3 doses in systemic lupus erythematosus.
The designation follows phase 2 IMPACT trial data showing reduced adverse pregnancy outcomes in high-risk antiphospholipid syndrome.
In a large real-world PsA cohort, higher BMI reduced the odds of minimal disease activity, especially with TNF inhibitors other than infliximab.
Advertisement
Advertisement