PMC6051248_01
Clinical course of patient, M.J. The three timelines overlap laboratory findings with therapeutic regimen and clinical course.
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fig1
At the time the leukopenia occurred, the patient did not have clinical manifestations of drug-induced SLE (rash, arthritis, hypocomplementemia, or proteinuria/hematuria); he was found to have +ANA (1 : 160, homogeneous pattern) and negative double-stranded DNA. A thorough hematological workup ruled out any other causes of leukopenia, and a decision was made to avoid TNFi's and to start the patient on secukinumab (complete clinical course is shown in Figure 1).
Panel image demonstrating new-onset auricular chondritis and hyperemia in the above two panels, with nasal chondritis visualized in the bottom panel.
CRIRH2018-6760806.002.jpg
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fig2
Bilateral auricular chondritis was present, with moderate hyperemia of the right ear (Figure 2).