Nawabalmost 6 years ago

HPC: 50 year-old woman who presents with 2 months Hx of worsening cough productive of yellowish sputum, intermittent fever, dyspnoea on exertion and ARTHRALGIA. ROS: Loss of hearing PMHx: Scleritis 2000 , pneumonia 2012 PSHx , social history and family history: NIL PE: rhonchi in both lung fields Labs: Normocytic anaemia, creatinine 124 mmol/l, CRP 3 mg/dl, ESR 50 mm/hr, ANA -, ANCA +, urine: PR 3 + CXR: bilateral alveolar infiltrates and cavitary lesion on the left lower lobe