Osteoarthritis has a significant impact on quality of life, only partly ameliorated by anti-arthritic drugs, as assessed by the WOMAC scale in this study population. Further, a study with larger sample size is needed to further support our findings.
Dermatomyositis is a rare autoimmune inflammatory myopathy with proximal muscle weakness and skin affection. Only 4 cases of HIV that subsequently developed dermatomyositis have been reported. This is the first case of dermatomyositis being the initial presentation of an acute seroconversion illness. We highlight the pathophysiology of dermatomyositis in HIV infection along with the complex issues of treatment in such cases. We report a case of a 50-year-old woman who presented with a 2 months' history of proximal muscle weakness with classic signs of dermatomyositis and consistent electromyographic and muscle biopsy. HIV (by enzyme-linked immunosorbent assay) was initially nonreactive, indeterminate at 4 weeks, and positive at 8 weeks. It was further confirmed by Western blot and polymerase chain reaction. She was treated with prednisolone and antiretroviral therapy. A high degree of suspicion is required to diagnose HIV seroconversion when an individual presents with dermatomyositis. A fine balance of immunosuppressants and antiretroviral therapy needs to be maintained in the treatment of such cases.
Although eosinophilia is a recognised associated feature of Hodgkin’s Lymphoma, hypereosinophilia is seldom the presenting feature in the patient. Here, the authors report an unusual case of a 21-year-old male patient who presented to the General Medicine outpatient department of the hospital with a history of multiple episodes of left-sided pleural effusion in addition to mediastinal and cervical lymphadenopathy. Baseline investigations revealed hypereosinophilia which was persistent despite Diethylcarbamazine (DEC) and steroid therapy. Computer Tomography (CT) guided biopsy of an anterior mediastinal mass, likely to be thymus, led to the diagnosis of Hodgkin's Lymphoma. The patient was transferred to the Haematology department where he was started on Adriamycin, Bleomycin, Vinblastine and Dacarbazine (ABVD) chemotherapy regimen. Despite the fact that blood eosinophilia is an associated finding, it is rare for a patient to present with it. The authors also discuss the discrepancies related to the credibility of eosinophilia as a prognostic marker for Hodgkin’s disease.
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