Case 2-1972

Abstract
Presentation of Case First admission. A 19-year-old woman was admitted to the hospital because of dyspnea.At the age of eight years she noticed that her fingers and toes turned white on exposure to the cold, and for several years thereafter she experienced morning stiffness of the fingers. During the three or four years before admission ulcerations developed at times in the fingertips; the ulcers were slow to heal, and there was occasional oozing of chalky material from the elbow. She also experienced exertional fatigue, which increased in severity and was accompanied by exertional dyspnea. During the two years before . . .
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