Case 14-1984

Presentation of CaseA 29-year-old woman was admitted to the hospital because of increasing cough and dyspnea.She was well until nine years earlier, when mild dyspnea and a chronic cough developed during her first pregnancy and gradually increased in severity. Ten months before admission the dyspnea became more marked. Five months before entry the cough and dyspnea worsened acutely, and arthralgia and fever developed. She was admitted to this hospital. She had lost 18 kg in weight in three years, including 9 kg during the last six months. Examination revealed dyspnea, crackles, rhonchi, and wheezes in both lungs, shotty . . .