Morning Report

Pleuritic chest pain Michael Marks, Nick R Murch, Michael A Beckles, Anja B Drebes, Huw L Beynon

What are the clinical manifestations of homocystinuria? How might this affect the differential diagnosis in a 44 year-old woman who presents with breathlessness, left sided pleuritic chest pain, and this chest x-ray? Test your diagnostic skills in this third Lancet Morning Report case, and listen to experts discussing the challenging management issues that are raised. Contributors MM wrote the first draft of the case and conducted the interviews with NRM, MAB, ABD, and HLB.

Lancet 2013; 382: e32 Department of Acute Medicine (M Marks MRCP, N R Murch MRCP, M A Beckles FRCP, H L Beynon FRCP), and Haematology, Haemophilia Centre and Thrombisis Unit (A B Drebes FRCPath), the Royal Free London NHS Foundation Trust, Pond Street, London NW3 2QG UK

Acknowledgments Patient consent to publish was obtained. We have no conflicts of interest.

Play this Morning Report Online at http://www.thelancet.com/morningreports/311013

www.thelancet.com Vol 382 November 30, 2013

e32

Pleuritic chest pain.

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