05-09-2012, 10:54 AM
A 53-year-old woman comes to the office with two weeks of pain in her wrists, tiredness, and diffuse aches all over her body. The discomfort lasts all day long. She is a secretary but has been unable to do her work for the last couple of days because typing has become too painful. She can't wear her watch anymore because of swelling in both her wrists. Her medical history is significant for chronic hepatitis C, for which she had been started on interferon-alpha and ribavirin seven months ago. She also had atrial fibrillation converted to sinus for which she is taking amiodarone. Physical examination reveals tender, swollen joints of both wrists and slightly diminished flexion. Blood tests show a white count of 7,500/mm3, hematocrit of 33%, and 95,000/mm3 platelets with slightly elevated transaminases. The antihistone antibody and ANA are positive. Which of the following is the most likely cause of her problem?
(A) Amiodarone
(B) Interferon
© Rheumatoid arthritis
(D) Systemic lupus erythematosus
(E) Hepatitis C
(A) Amiodarone
(B) Interferon
© Rheumatoid arthritis
(D) Systemic lupus erythematosus
(E) Hepatitis C