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Previous Volume 361:613-617 August 6, 2009 Number 6 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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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.

A 56-year-old woman presented to the emergency room with a 4-week history of malaise. During that time, her primary physician had ordered basic laboratory studies, which were normal except for a white-cell count of 16,000 per cubic millimeter. She had taken a sulfa antibiotic, but the malaise persisted. The patient reported no dyspnea, chest pain, weight loss, nausea, abdominal pain, hematuria, myalgias, . . . [Full Text of this Article]

Commentary

Source Information

From the Division of Rheumatology (M.E.M.), Department of Medicine (L.M.T., G.D.), University of California, San Francisco; and the San Francisco Veterans Affairs Medical Center (L.M.T., G.D.) — both in San Francisco.

Address reprint requests to Dr. Margaretten at the University of California, San Francisco, Division of Rheumatology, 3333 California St., Suite 270, San Francisco, CA 94118, or at mary.margaretten@ucsf.edu.

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