Case 6-1978

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Abstract
Presentation of CaseA 56-year-old woman was admitted to the hospital because of the nephrotic syndrome.She was well until 10 years earlier, when a respiratory-tract infection developed. The cold agglutinins were positive in a titer of 1:16. One year later she began to have joint pains, with stiffness of the shoulders, hips and back. Six years before admission the erythrocyte sedimentation rate was 43 mm per hour. Three years before entry a psoriasiform rash developed. One year later a violaceous rash was observed over the anterior aspects of the shins. The joint pains improved but recurred during the next . . .
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