June 26, 1972

Anicteric Hepatitis And Polyarthritis

Author Affiliations

Henry Ford Hospital Detroit

JAMA. 1972;220(13):1744-1745. doi:10.1001/jama.1972.03200130072024

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To the Editor.—  The recent article by Stevens et al reported two patients with anicteric hepatitis presenting as polyarthritis (220:687, 1972). We would like to record a similar case we saw recently.

Report of a Case.—  A 29-year-old black woman was admitted to the hospital with rash, pruritus, and fever. She had been well until one day before admission when she noted perioral edema and diffuse arthritis associated with a vesiculopapular, erythematous rash over the knees and smaller joints of both hands. On the day of admission, she awoke with painful, tender metacarpal, phalangeal, and interphalangeal joints of both hands, shoulders, elbows, knees, ankles, and toes with obvious redness and warmth. Roentgenographic examination failed to reveal any abnormalities of the joints. The patient had received 2 units of whole blood and 2 units of plasma three months prior, during an admission for laparotomy for bowel obstruction.Results of a physical