Abstract
In April, 2009, a 30-year old man of Turkish origin was referred to our hospital with a 5-year history of asthenia and arthralgias. 2 years earlier he had been diagnosed with rheumatoid arthritis, which did not respond to non-steroidal anti-inflammatory drugs. On examination, he had unexplained splenomegaly (span 22 cm). Laboratory tests showed thrombocytopenia (92 × 109/L), and a normal ESR. Immunological tests including antibodies to cyclic citrullinated protein were inconclusive. Ultrasonography of the knee joints showed bilateral synovial proliferation.
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