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June 22, 1994

Viral Imitations of Host Defense ProteinsFlattery That Turns to Battery

Author Affiliations

From the Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.

JAMA. 1994;271(24):1948-1952. doi:10.1001/jama.1994.03510480072037

CASE PRESENTATION  A 40-year-old Indian woman with Takayasu's arteritis presented to the National Naval Medical Center with chest pain of 1 day's duration. One year previously, she had presented with malaise, diminished left upper extremity pulses, and an elevated erythrocyte sedimentation rate. A diagnosis of Takayasu's arteritis had been made by angiographic demonstration of stenosis of the left subclavian artery. She had been treated initially with 1 mg/kg per day of prednisone with angiographically evident improvement, and the drug dosage had been tapered over the past year to 10 mg of prednisone every other day.On the day of admission she noted constant, sharp left chest pain without radiation and without dyspnea. Her past medical history was otherwise unremarkable. The physical examination revealed a woman who appeared well nourished. Her temperature was 38.5°C orally. Her heart rate was 92 beats per minute, and her blood pressure was 126/78 mm Hg.

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