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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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Question Category : Autoimmune Disorder
Regarding the previous case I asked for, we did liver biopsy in her previous admission which was normal and we also repeated bone marrow biopsy that showed erythroid hyperplasia. Also smear for LD bodies were negative. Brucella work up was negative. Her sarcoidosis work up was also normal. Her complement levels are normal. We are waiting for c-anca and p-anca reports. And once at the age of 9 yrs she was treated as JRA due to knee joint swelling. 1 episode of GTCS+ at age of 9 yrs. I had enquired about macrophage activation syndrome also in view of this case. Thanks for ur reply. Now her urine protein also is elevated. So can we put her as JRA in the past now complicated with MAS ? Hope it`l present with repeated infections. Now she is on oral steroids after iv methyl prednisolone and she is responding well we hope. KINDLY tell how else to confirm. Our bone marrow shows only erythroid hyperplasia...no evidence of hemophagocytosis. Check Out the Answer
Question Category : Autoimmune Disorder
Dear sir a 15 year old child with JRA did not responded to NSAID+steroid. With use of Methotrixate she showed a good response. For how should he continue MTX. Check Out the Answer
Question Category : Autoimmune Disorder
I have a female patient aged 2 yrs weighing 10kg.She is born to nonconsanguineous parents. She is suffering from molar rash since infancy. Her investigations report are as follows: ANA - +ve ds DNA -ve anticardiolipin ab +ve RAsso +ve RAllb -ve C3 &C4 normal Basing on the clinical and lab findings I have diagnosed her to have SLE. Further investigation do not reveal any other organ except skin involved at present. WHAT IS THE LINE OF MANAGEMENT ? What medicines are to be used? What are the doses? How long to use? Chloroquin or steroid or both? Doses and duration? Any newer developed medicines? Kindly give reply in detail. Check Out the Answer
Question Category : Autoimmune Disorder
Dear sir, There is this 8 year old boy admitted to my ward with polyarthritis for the past 5 days prior to admission and also fever for 4 days. On admission he had a severe arthritis involving bilateral ankle joint, knee joint, right elbow joint and also left metacarpophalengeal joint. CVS/RS/ABdo : normal LAb : TWC : 20.5, HB : 11g/dl, PLT : 605,000 ESR : 100 ANA : negative ASOT : negative blood C and S : no growth, Urine C/S : NG previous history of impetigo Xray of all joints were normal. Cxray : normal We treated him as Acute Rheumatic Fever (major -polyarthritis,minor :- ESR and Fever) and started him with aspirin 25 mg/kg/dose qid. But as the days passed his temperature has not settled yet but his arthritis has settled. We have stopped his aspirin as the arthritis have improved and he can walk now but his temperature still has not come to normal.his temp rises from 37 to 40 degrees and he almost always has 3-4 spikes per day. Today is day 9 of his admission and day 14 of fever with arthritis, his fever is still not settled. We have changed his antibiotic from C peniciilin to IV Ceftriaxone. What are the differential diagnosis pt consider here? Check Out the Answer
Question Category : Autoimmune Disorder
What is Mediterranean fever, what causes it and how is it cured? Check Out the Answer
Question Category : Autoimmune Disorder
12 year old female presented with generalized joint contractures including inability to open mouth fully and generalized muscle wasting which has developed over the last 3 years, prior to which she was absolutely normal. Facial appearance has a puckered look with tight skin. Her fingers and toes show features of arachnodactyl. No h/o Raynauds phenomenon. No h/o dysphagia. No abnormal perinatal events. No h/o delayed mile stones. Bowel, micturition-normal. Investigations revealed atlanto axial subluxation.CXR NORMAL.USG abdomen normal.ESR 65MM.RA FACTOR -VE.ANA+VE.No Facilities at our center to investigate further. What could be the diagnosis and how to start treatment. Check Out the Answer

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