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A correction has been published: N Engl J Med 2000;343(21):1584.

Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 343:953-961 September 28, 2000 Number 13
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Case 30-2000— A 25-Year-Old Man with Asthma, Cardiac Failure, Diarrhea, and Weakness of the Right Hand
Jonathan P. Arm, and Eugene J. Mark

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Presentation of Case

A 25-year-old man was admitted to the hospital because of asthma, cardiac failure, diarrhea, and weakness of the right hand.

He had been well until two years earlier, when asthma developed. It was managed with bronchodilator medications and intermittent pulsed doses of corticosteroids, including prednisone. Seven months before admission, treatment with montelukast sodium was begun. The wheezing worsened, and repeated doses of corticosteroids were administered. Four months before admission, laboratory tests were performed (Table 1 and Table 2). Several weeks before admission, the dose of prednisone was tapered, but information on the specific regimen was not available.

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Table 1. Hematologic . . . [Full Text of this Article]

 
Differential Diagnosis

Clinical Diagnosis

Dr. Jonathan P. Arm's Diagnosis

Pathological Discussion

Anatomical Diagnosis

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