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Previous Volume 347:921-928 September 19, 2002 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

A 17-year-old boy was admitted to the hospital because of acute mitral regurgitation and pulmonary edema.

The patient had received a diagnosis of juvenile spondyloarthropathy two years earlier. He had intermittent acral arthralgia, which affected mainly the left wrist. He had used indomethacin, but it had been discontinued about 10 days before admission because of painless hematuria, and ibuprofen had been substituted. Six days before admission, vomiting developed in the evening, and the ibuprofen was discontinued. The vomiting recurred daily. On the third day of the illness, the vomitus was bile-stained and contained red mucus. No frank hematemesis or hematochezia . . . [Full Text of this Article]

Differential Diagnosis

Inflammatory Arthritides

Systemic Lupus Erythematosus

Systemic Vasculitides

            Polyarteritis Nodosa

            Rheumatic Fever

            Infective Endocarditis

Clinical Diagnosis

Dr. Bradley J. Bloom's Diagnoses

Pathological Discussion

Anatomical Diagnosis

Related Letters:

Case 29-2002: Antiphospholipid-Antibody Syndrome
Golden H. E., Steele D., Mills J. A., Kay J.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:960-961, Mar 6, 2003. Correspondence

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• Golden, H. E., Steele, D., Mills, J. A., Kay, J. (2003). Case 29-2002: Antiphospholipid-Antibody Syndrome. NEJM 348: 960-961 [Full Text]