QJM Advance Access published online on October 21, 2009
QJM, doi:10.1093/qjmed/hcp150
© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Sick patient, normal tests
From the 1Department of Medicine, 2Department of Neurology, Kaplan Medical Centre, Rehovot and Hebrew University Hadassah Medical School, Jerusalem and 3Sieratzki Chair of Neurology, Tel-Aviv University Medical School, Ramat-Aviv, Tel-Aviv, Israel
Address Correspondence to Prof. Ami Schattner, Department of Medicine, Kaplan Medical Centre, Rehovot, Faculty of Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel. email: amimd@clalit.org.il
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A 51-year-old physician was found in a taxi unable to tell the driver her address. At the emergency room, she was barely able to speak, disoriented and incontinent with mild left hemiparesis. Her history included transient left hemiparesis 8 years before when primary antiphospholipid syndrome (APS) as well as autoimmune hepatitis and Hashimoto's thyroiditis were diagnosed. She was on warfarin, azathioprine, eltroxin and olanzapine/valproic acid for an undefined psychosis
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