Presentation is:
- weight loss
- arthralgia
- diarrhoea
- malaise
- fever
Other symptoms may occur in relation to the malabsorption, for example signs of hypocalcaemia or vitamin C deficiency.
Possible clinical signs include:
• lymphadenopathy
• perioral hyperpigmentation
Cardiac involvement can result in an endocarditis, and CNS involvement can cause a reversible dementia.
It is commonest in males (9:1) and is associated with HLA B27.
Treatment is 2 weeks IV ceftriaxone then oral co-trimoxazole for one year.
Now for some excess magnesium...
