CASE

29 years old MALE historically diagnosed as rheumatoid arthritis but no improvement with treatment for long time with corticosteroid. Reffered to the rheumatologist ,  patient complain: pain all over the joints ( knee, hip , and wrist )




Clinical findings are
     1. Hair loss in the scalp
     2. Photosensitivity
     3. Painless oral ulcer
     4. Erythematous skin rash in the hand and
     5. Malar rash not  seen very well.
     6. Pleuritic chest pain
No fever , no GIT manifestation,  no UT manifestations, no CNS symptoms, but long term effect of corticosteroid.

Serological test:
   1. ANA positive
    2. Anti ds  DNA positive.
Continue for the next............

Written by Rahmatullah, Student.