ABSTRACT
A 58-year-old female gives a 4-week history of being generally unwell. She has had intermittent fever, loss of appetite and has lost almost 4 kg (8 pounds) in weight over 2 months. She has had joint pains affecting hands, wrists and ankles which have persisted despite treatment with diclofenac. She developed a generalised skin rash 3 days after commencing a course of amoxycillin. Some 6 months previously she had developed hypothyroidism.
