Furthur course of Management ???

45 yr Female with chest pain on/off 3 months associated with cough . Generalized body pains +, Joint pains + Her chest x ray and CECT chest done. Autoimmune profile done. Reports attached. @Sandeep Ghodekar

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Positive ANA and raised RA factor. Adv ANA blot.. ,anti CCP. Consider rheumatoid and non rheumatoid arthritis etiologies like autoimmune diseases, such as systemic lupus erythematosus , scleroderma, Sjögren's syndrome, and vasculitis. ... Liver diseases, such as cirrhosis and hepatitis. Scl70 and ds DNA is normal. Bil basal sub pleural tags and fissural effusion seen. Is possible pleural biopsy or fluid analysis if any.
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Go for ANA full profile Pleural biopsy and pleural fluid analysis Everything should be correlated
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A case of RA and to investigate accordingly to establish the DX.
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Autoimmune disorder Rheumatoid arthritis Start methylprednisolone with 40mg then tapper it .... Tab methotreaxate 5mg once a week Watch for leucopenia ...sgpt level
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