Case 21-1965

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Abstract
Presentation of CaseA fifty-four-year-old woman was referred to the hospital because of renal disease.During the ten years before admission blanching and numbness of the fingers and toes occurred periodically on exposure to cold. Nine years before entry urticarial lesions appeared over the face and upper trunk on one occasion after the ingestion of pea soup. She remained well until seven months before admission, when tenderness and swelling developed in the proximal interphalangeal joints of the hands, the metacarpophalangeal joints and the wrists. At that time the blood pressure was normal, urinalysis revealed a few red cells, and the . . .
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