Revision 16/12/2014

50/m hx of RA, poorly controlled with MTX and strted on infliximab for 6 months. Ds inactive. E admitted x Rt sided chest pain + sob, CXR: R pleural effusion

Ddx to consider
1. TB
2 . Malignancy: primary, met
3 . PE
4. Rheumatoid effusion

Hereditary hemorrhagic telangiectasia
Osler-Weber-Randu syndrome

Curacao criteria
1. 1st degree FHx
2. Epistaxis
3. Visceral AVM: GI, liver, brain, lung
4. Supf. Telangiectasia: lips, buccal, nose, finger

Acute/subacute paraplegia
– flaccid v spastic
– flaccid > neuropathic, myopathic
   – any 1) ascending pattern? (GBS), 2) spinal shock?
– spastic > cord or above
   – important Ddx
   **  transverse myelitis
   **  MS

TM > 4D: dysimmune (allo – infection v auto – lupus etc),  dysgammaglobulinaemia, demyelination, destabilisation (ortho)


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