A 52-year-old female presents with numbness and
weakness of her upper and lower limbs.
She developed asthma at the age of 50 and her general
practitioner treated her with steroids and antibiotics approximately one month
prior to the onset of these symptoms.
On examination she looks unwell. She has palpable
purpura over her face and over her elbows and knees.
On neurological examination she has a left sided wrist
drop and there is weakness of dorsiflexion of her right hallux and weakness of
dorsiflexion of her right foot.
Sensation is impaired over the dorsum of her right
Lungs are clear.
CXR is normal
Hb 10.9 g/dL MCV 88 fl
WBC 23,000 10 9 /l
In this patient abdominal pain could be due to:
Gall bladder infarction
Vasculitis of the gastrointestinal tract