A previously fit 71 year old woman was admitted to hospital with a one month history of temporal headache, fatigue, and jaw claudication. A few days later she developed right pleuritic chest pain and a productive cough. On examination she had bilateral temporal artery thickening, though the pulses were preserved, and signs ofa right pleural effusion. Laboratory findings included a haemoglobin concentration of 9 9 g/dl, a white cell count of 15 x 109/l (86% neutrophils, 11% lymphocytes, and 3% monocytes), a platelet count of 69 x 109/1, and an erythrocyte sedimentation rate of 126 mm in the first hour. Tests for antinuclear antibodies and rheumatoid factor gave negative results. The chest radiographs showed loss of the costophrenic angle and thickening of the oblique fissure on the right. Abdominal ultrasound examination showed no abnormality. Thoracocentesis yielded serous fluid that showed no specific features on microbiological or cytological examination. The pleural fluid white cell count was 3-2 x 109/1 (45% neutrophils, 5% lymphocytes, 8% hystiocytes, and 42% mesothelial cells); tests for antinuclear antibodies and rheumatoid factor gave negative results. Other laboratory data are shown in the table. A temporal artery biopsy specimen showed histological changes compatible with giant cell arteritis.Treatment with prednisone (1 mg/kg a day) was started and caused rapid symptomatic and radiological improvement. She was still taking prednisone (10 mg/day) and was symptom free when last seen 18 months later.

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1. Gostaria de ler muito livros de História. Não só sobre acontecimentos históricos, mas sobre a evolução de costumes e de comportamentos. A evolução dos conceitos (ódio, sinceridade, eternidade, medo). Gostaria de ler mais Filosofia e Psicologia de maneira geral. Gostaria de ler algumas obras de ficção que ainda não consegui ("O Homem sem Qualidades", do Musil, por exemplo, ou mais Robert Walser). Gostaria de ler pelo menos os romances novos que vierem a ser lançados por autores contemporâneos de outros países que têm a ver com meu universo, ou ao menos com aquilo que acredito ser o meu universo ficcional: