| Rheumatology Case 7 | |
|---|---|
A 58 year-old woman with a history of Sjögren’s syndrome
(SS) for the last 10 years presented to Rheumatology Clinic with
a skin rash involving the lower extremities. Clinical examination
revealed bilateral parotid gland enlargement and palpable purpura
over the extensor surfaces of the lower extremities. Antinuclear
antibodies (ANA) were 1/1280 with a fine speckled pattern, IgM
rheumatoid factor (RF) was 1/320 and antibodies to Ro (SSA) and
La (SSB) were also positive. The differential diagnosis for the
palpable purpura in this patient comprises:1. Hypergammaglobulinemic purpura 2. Idiopathic thrombocytopenic purpura 3. Waldenström macroglobulinemia 4. T-cell lymphoma
|