A fully active, 70-year old female was suffering from hypertension for the last 3 decades. She was a smoker and took clonidine, estrogen, and hydrochlorothiazide. Recently published data showed that estrogen is associated with breast cancer and other complications and hence, it was withdrawn a month earlier.
The patient started experiencing fatigue soon after estrogen withdrawal. Physical examination Cough and minimal sputum Low-grade fever Weight loss of around 5 pounds A month later, the patient lost more weight, had cramping abdominal pain with a temperature around 101 F that worsened at night. Laboratory examination WBC count: Normal Differential count: Normal Hematocrit: 43-40 MCV: 86 Blood culture and urine: Negative Alkaline phosphatase: 228 Sedimentation rate: 101 Chest and abdominal CT: Negative Colonoscopy: Negative The patient appeared to be even more ill in the following…
