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Rheumatology Advance Access originally published online on January 31, 2006
Rheumatology 2006 45(4):386-391; doi:10.1093/rheumatology/kei105
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

GRAND ROUND

Rheumatoid arthritis, Pyrexia of Unknown Origin (PUO) and pancytopenia

K. Chakravarty, (Presenter)1, A. Kuttikat2, I. Saeed3 and R. Thompson, (Discussant)4

1 Professor of Rheumatology & Consultant, Rheumatologist, Haroldwood Hospital, Romford, UK, 2 Clinical Fellow in Rheumatology, Haroldwood Hospital, Romford, UK, 3 Consultant Histopathologist, Haroldwood Hospital, Romford, UK and 4 Consultant Rheumatologist and Clinical Director of Rheumatology and Rehabilitation, University Hospital Aintree.

Correspondence to: K. Chakravarty, Harold Wood Hospital, Gubbins Lane, Romford, Essex RM3 OBE, UK. E-mail: kuntal.chakravarty@bhrhospitals.nhs.uk

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


   Case report
 
A 61-yr-old previously fit lorry driver was referred by his general practitioner in October 1999 to an orthopaedic clinic with a 6-month history of painful hands, shoulders and feet. His general practitioner had treated him with ibuprofen without much improvement. He admitted to a recent history of loss of appetite with loss of two stones (12.7 kg) in weight. His joint pains had been increasing in severity with visible swelling of his fingers and knees. He had no relevant family history. He was an ex-smoker and drank little alcohol.

Physical examination revealed a healthy-looking man with signs of synovitis in the symptomatic joints. The orthopaedic surgeon referred him to the rheumatologist (K.C.). The preliminary blood tests showed haemoglobin of 10.4 g/dl with normal haematocrit, leucocyte and platelet counts and normal serum vitamin B12 and red-cell folate levels. His serum ferritin was 468 µg/l (normal range 18–400 µg/l). He also had . . . [Full Text of this Article]


   Progress 1: February to May 2000
 

   Progress 2: June to September 2000
 

   Progress 3: January to April 2001
 

   Progress 4
 

   Progress 5
 

   Limited post-mortem
 

   Conclusion
 

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