PMC3046014_01
Chest X-rays in August 21, 2001 (A), September 3, 2004 (B), and February 25, 2009 (C). A slight left pleural effusion developed on chest X-rays in August 2001, and an increase in chest fluid on X-rays was documented in September 2004. No remarkable change in February 2009.
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September 2004 (Fig. 1A). She became aware of swelling of both hands and elbows in April 1999. A slight amount of pleural effusion was found on her chest X-rays in August 2001 (Fig. 1B), and she was hospitalized.
Appearance of nails. All of the patient's nails were yellow. July 2004 (A), and February 2010 (B).
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All of her nails were yellow (Fig. 2A). The yellowing of her nails (Fig. 2B), pulmonary effusion (Fig. 1C) and leg edema persisted (Fig. 3B) in February 2009.
Bilateral lower limb edema and yellow toenails. Nonpitting edema of both lower limbs was noted. July 2004 (A), and February 2010 (B).
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Nonpitting edema of both lower limbs was noted (Fig. 3A). The yellowing of her nails (Fig. 2B), pulmonary effusion (Fig. 1C) and leg edema persisted (Fig. 3B) in February 2009.