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Clinical Scenario for Medical Students in Adult Multiple Autoimmune Diseases

Sur M Lucia, Floca Emanuela, Lupan Iulia, Sur Genel, Samasca Gabriel
International Journal of Celiac Disease. 2022, 10(1), 20-21. DOI: 10.12691/ijcd-10-1-8
Received July 22, 2022; Revised August 24, 2022; Accepted September 05, 2022

Abstract

We continue to present Clinical Scenarios for Medical Students. Another clinical scenario is presented by associate professor Sur Genel and his team: a 62 years old female patient who presented to the family doctor for asthenia, memory disorders, paresthesia and joint pain. She was diagnosed with rheumatoid arthritis, vitiligo and pernicious anemia

1. Introduction

Rheumatoid arthritis (RA) is an autoimmune disease that causes inflammation 1. Vitiligo is an autoimmune disease that causes the destruction of melanocytes, which are responsible for skin pigmentation. Other autoimmunities are frequently associated with it 2. Pernicious anemia (PA) is also an autoimmune disease that affects the gastric mucosa and prevents the absorption of vitamin B12 3, 4.

2. Case Presentation

We report a case of a 62-year-old female patient who was known by the family doctor to have RA, which was diagnosed at the age of 30, in treatment with nonsteroidal anti-inflammatory drugs, hydroxychloroquine, methotrexate, and vitiligo, which was diagnosed at the age of 50, after she discovered depigmented spots on her eyelids and face, which then spread to her arms and especially her hands.

At the age of 62, she presented to the family doctor with asthenia, adynamia, joint pain when mobilizing, and difficulty walking. She was hospitalized and underwent investigations that supported the diagnosis of PA. Treatment with injectable vitamin B12 was instituted. The evolution of anemia was favorable.

Paraclinical examinations performed in the medical service showed the presence of megaloblastic anemia with Hb = 6.3 g/dL, erythrocyte sedimentation rate at high values and iron serum levels of 110 mcg/dL. Anti-intrinsic factor antibodies were also present, so the diagnosis was confirmed. Also, the diagnosis of RA (with a positive RF) as well as that of Vitiligo was maintained.

3. Conclusion

What is the main take home message from the present case report?

Funding

Not applicable.

Acknowledgments

Not applicable.

Conflicts of Interest

The authors declare no conflict of interest.

All authors of this paper have read and approved the final version submitted.

References

[1]  Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet 2016; 388: 2023-2038.
In article      View Article
 
[2]  Ahmed Jan DN, Vitiligo MS. StatPearls. Treasure Island (FL): StatPearls Publishing 2020.
In article      
 
[3]  Harmandar FA, Dolu S, Çekin AH. Role of pernicious anemia in patients admitted to internal medicine with vitamin b12 deficiency and oral replacement therapy as a treatment option. Clin Lab 2020; 66: 10.7754/Clin.Lab.2019.190809.
In article      View Article  PubMed
 
[4]  Chiang CP, Wu YH, Wu YC, Chang JY, Wang YP, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in 884 patients with burning mouth syndrome. J Formos Med Assoc 2020; 119: 813-20.
In article      View Article  PubMed
 

Published with license by Science and Education Publishing, Copyright © 2022 Sur M Lucia, Floca Emanuela, Lupan Iulia, Sur Genel and Samasca Gabriel

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Cite this article:

Normal Style
Sur M Lucia, Floca Emanuela, Lupan Iulia, Sur Genel, Samasca Gabriel. Clinical Scenario for Medical Students in Adult Multiple Autoimmune Diseases. International Journal of Celiac Disease. Vol. 10, No. 1, 2022, pp 20-21. http://pubs.sciepub.com/ijcd/10/1/8
MLA Style
Lucia, Sur M, et al. "Clinical Scenario for Medical Students in Adult Multiple Autoimmune Diseases." International Journal of Celiac Disease 10.1 (2022): 20-21.
APA Style
Lucia, S. M. , Emanuela, F. , Iulia, L. , Genel, S. , & Gabriel, S. (2022). Clinical Scenario for Medical Students in Adult Multiple Autoimmune Diseases. International Journal of Celiac Disease, 10(1), 20-21.
Chicago Style
Lucia, Sur M, Floca Emanuela, Lupan Iulia, Sur Genel, and Samasca Gabriel. "Clinical Scenario for Medical Students in Adult Multiple Autoimmune Diseases." International Journal of Celiac Disease 10, no. 1 (2022): 20-21.
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[1]  Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet 2016; 388: 2023-2038.
In article      View Article
 
[2]  Ahmed Jan DN, Vitiligo MS. StatPearls. Treasure Island (FL): StatPearls Publishing 2020.
In article      
 
[3]  Harmandar FA, Dolu S, Çekin AH. Role of pernicious anemia in patients admitted to internal medicine with vitamin b12 deficiency and oral replacement therapy as a treatment option. Clin Lab 2020; 66: 10.7754/Clin.Lab.2019.190809.
In article      View Article  PubMed
 
[4]  Chiang CP, Wu YH, Wu YC, Chang JY, Wang YP, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in 884 patients with burning mouth syndrome. J Formos Med Assoc 2020; 119: 813-20.
In article      View Article  PubMed