Interactive Quiz: Pain and Swelling in the Thigh

Answer: Soft-tissue swelling

CT scans of the right thigh showed soft-tissue swelling but no fasciitis or abscess.

Results of complete blood cell counts (CBCs) taken throughout his hospitalization are shown below. Results of a peripheral blood smear revealed anisocytosis, few target cells, no fragmented red blood cells, a decreased white blood cell (WBC) count, a decreased platelet count with few giant platelets, no immature cells, and no dysplastic cells.

Liver function test results were consistent with the patient’s history of AIH, with elevated total bilirubin (3.5 mg/dL), direct bilirubin (2.2 mg/dL), aspartate aminotransferase (192 U/L), and alanine aminotransferase (164 U/L) levels. The alkaline phosphatase level was 92 U/L, and the albumin level was low at 2.9 g/dL.

The patient’s C-reactive protein level was 61.57 mg/L (reference value, < 5.00 mg/L), and the erythrocyte sedimentation rate was 68 mm/h (reference range, 0-15 mm/h). Vitamin B₁₂ and serum folate levels were within normal limits.

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