An 80-year-old man, a former truck driver from the Dominican Republic, was admitted
with 3 months of abrupt-onset bilateral pain and swelling of his hands and feet, fever,
and malaise. His symptoms were causing increasing difficulty with his daily activities,
evident by a decline in ambulation and ability to grip. Three weeks prior to symptom
onset, due to a hemoglobin A1c of 14% accompanied by an unintentional 7-kg weight
loss, his outpatient physician had started him on sitagliptin to better control his
type 2 diabetes mellitus. In addition to diabetes, the patient had benign prostate
hypertrophy, hypertension, and history of a mitral valve repair. He had been managed
chronically with aspirin, atorvastatin, chlorthalidone, losartan, nifedipine, metformin,
and gabapentin.
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Article info
Publication history
Published online: February 20, 2021
Thomas J. Marrie, MD, Section EditorFootnotes
Funding: None.
Conflicts of Interest: The authors declare that there are no conflicts of interest.
Authorship: All authors had access to the data and a role in writing the manuscript. JL: Conceptualization, roles/writing—original draft, visualization; PCN: Visualization, writing—review and editing; AN: Writing—review and editing; DL: Supervision, conceptualization, writing—review and editing.
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