- A 69-year-old woman was admitted to our institution with progressive dyspnea and cough productive of white sputum. Three months earlier, the patient was hospitalized elsewhere for evaluation of fever, headache, and fatigue. Results of a right temporal artery biopsy were consistent with giant cell arteritis (GCA). She was treated with prednisone (50 mg/d) and initially improved, but after 6 weeks of therapy, she again experienced feelings of malaise. Her erythrocyte sedimentation rate (ESR) remained elevated at 75 mm/h.
- A 65-year-old previously healthy woman presented to her primary care physician with a 6-week history of increasing dyspnea, accompanied by a dry cough, fatigue, malaise, and poor appetite. Before her initial presentation and the onset of the aforementioned symptoms, she had attributed her illness to an upper respiratory tract infection. She also reported a 1-week history of passing dark urine and had been treated empirically 2 weeks previously with a 3-day course of oral trimethoprim-sulfamethoxazole for presumptive urinary tract infection.
- A 35-year-old woman presented to the outpatient clinic with a 2-week history of episodic palpitations. She noted that each episode was abrupt in onset and would last approximately 1 to 2 hours before abating gradually. She denied chest pain, shortness of breath, and light-headedness and had no history of similar symptoms.
- A 22–year-old woman who had no notable previous medical history reported increasing fatigue during the past few months. Her mother noticed that she looked pale and suggested she visit her family physician. Her family and personal histories were noncontributory. Findings on physical examination were remarkable only for pallor. In particular, she had no hepatosplenomegaly or lymphadenopathy.