Case 10-1972

Abstract

Presentation of CaseA 47-year-old woman was admitted to the hospital because of fatigue.She had enjoyed vigorous health until one year previously, when she began to be fatigued easily and to experience musculoskeletal "aching" pain that principally affected the arms, thighs and calves; the pain was aggravated by physical exertion and relieved by rest, with residual soreness of the affected muscles. Concurrently, there was the onset of numbness and weakness of the hands, particularly at night, and pain in the jaw on chewing. Nine months before admission hoarseness developed. Three months later an x-ray film of the chest was . . .