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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 340:455-464 February 11, 1999 Number 6
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Case 4-1999— A 38-Year-Old Woman with Increasing Pulmonary Hypertension after Delivery
Michael J. Landzberg, Drucilla J. Roberts, and Eugene J. Mark

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Presentation of Case

A 38-year-old woman (gravida 3, para 2) was admitted to the hospital because of left-sided chest pain.

The patient, who worked as a day-care provider, had been well until seven months earlier, when headaches and pain in the neck and shoulder began. One month later she was discovered to be pregnant. A test for antinuclear antibodies was positive, at a titer of 1:5120, with a nucleolar pattern of staining. Systemic lupus erythematosus was diagnosed, and prednisone was administered. Three months before admission, severe myalgias and progressive dysphagia developed, with a weight loss of about 7 kg.

Four days before admission, . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Michael J. Landzberg's Diagnosis

Pathological Discussion

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