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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 345:981-986 September 27, 2001 Number 13
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Case 30-2001— A 22-Year-Old Man with Hyperthyroidism, Fever, Abdominal Pain, and Arthralgia
Mahboob U. Rahman, M.D., Ph.D, Chieh-Min Fan, M.D., and Hyon K. Choi, M.D.

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Presentation of Case

A 22-year-old man was admitted to the hospital because of fever, abdominal pain, diarrhea, and polyarthralgia.

The patient had been well until two years before admission, when a tremor developed and a diagnosis of Graves' disease was made. The patient declined radioiodine treatment. The administration of propranolol and methimazole lessened the tremor.

Three months before admission, a persistently low thyrotropin level led to an increase in the dose of methimazole. Soon thereafter, migratory arthralgia accompanied by swelling began in the right ankle and spread to the left ankle, knees, small joints of the hands, and both elbows, with a feeling . . . [Full Text of this Article]

Differential Diagnosis

Polyarteritis Nodosa

Drug-Induced Vasculitis

Diagnostic Procedure

Clinical Diagnosis

Dr. Mahboob U. Rahman's Diagnosis

Pathological Discussion

Anatomical Diagnosis

References




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