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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Perkins, Philip Wood, Gordon Disney, Benjamin Szeto, Matthew Chak Hin |
| Description | Author Affiliation: Szeto MC ( George Elliot Hospital, Nuneaton, UK.); Disney B ( George Elliot Hospital, Nuneaton, UK.); Perkins P ( Department of Rheumatology, University Hospital Coventry and Warwickshire, Coventry, UK.); Wood G ( Department of Gastroenterology, George Elliot Hospital, Nuneaton, UK.) |
| Abstract | We describe a case of a 43-year-old man presenting to the gastroenterology outpatient department with exudative ascites. Mediastinal lymphadenopathy, pericardial effusion and pleural effusion were detected on further imaging. Further clinical examination revealed subcutaneous nodules on the left arm, which were confirmed to be rheumatoid nodules on histology. Inflammatory markers were elevated with positive serology for rheumatoid factor and anticyclic citrullinated protein antibody. Our investigations excluded tuberculosis, pancreatitis and malignancy in the patient. Following review by a rheumatologist, a diagnosis of systemic rheumatoid arthritis (RA) was made. Pleuritis and pericarditis are well recognised as extra-articular manifestation of RA. Ascites, however, is rarely recognised as a manifestation of RA. Our literature search revealed two other cases of ascites due to RA disease activity, and both patients had long-standing known RA. This case adds to the discussion on whether ascites and peritonitis should be classified as extra-articular manifestations of RA. |
| Volume Number | 2015 |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Arthritis, Rheumatoid Complications Diagnosis Ascites Etiology Rheumatoid Factor Blood Adult Anti-Inflammatory Agents, Non-Steroidal Therapeutic Use Antirheumatic Agents Drug Therapy Humans Incidental Findings Liver Function Tests Male Methotrexate Naproxen Pericardial Effusion Pleural Effusion Prednisolone Referral And Consultation Rheumatoid Nodule Treatment Outcome Case Reports Journal Article Review Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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