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Postgraduate Medical Journal 2003;79:540
© 2003 Fellowship of Postgraduate Medicine

SELF ASSESSMENT QUESTION

Infection

A diagnostic conundrum

R C Rakshit , J D Mackay

Blackpool Victoria Hospital, Whinney Heys Road, Blackpool FY3 8NR, UK

Correspondence to:
Correspondence to:
Dr Rakshit;
rinti1@hotmail.com

Submitted 14 August 2002
Accepted 5 March 2003

Answers on p 545.

The first 150 words of the full text of this article appear below.

A 37 year old man with learning difficulties presented to our hospital in 1999 with anorexia, 12 kg weight loss, swelling of the legs, and night sweats. On examination he had a dusky generalised pigmentation but no rash and slight hepatomegaly. He had a microcytic anaemia (haemoglobin 11.9 g/l, mean corpuscular volume 75 fl) and erythrocyte sedimentation rate 89 mm/hour. Blood biochemistry profile, serial urine samples for microscopy and culture, and chest radiography were normal. Abdominal ultrasound revealed a gross right sided hydronephrosis, but was thought to be a long standing problem caused by pelviureteric junction obstruction. There was no evidence of a pyonephrosis.

A bone marrow examination revealed non-specific reactive changes only. Lymphocyte markers were normal. Computed tomography of the chest and abdomen showed multiple enlarged lymph nodes in the mediastinum, para-aortic area, mesentery, inguinal regions, and axilla. Lymphoma was ruled out with two lymph node biopsies, the . . . [Full text of this article]


Relevant Article

A diagnostic conundrum
Postgrad. Med. J. 2003 79: 545-546. [Extract] [Full Text] [PDF]





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