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A 41-year-old African American woman with no significant medical history presented to clinic reporting of episodic finger numbness and colour changes. She described feeling as if her fingers were frostbitten and noted her second, third and fourth digits appeared white distally. She additionally reported of occasionally feeling food stuck in her throat after consuming solids. Physical examination revealed no joint abnormalities or evidence of skin tightening. Laboratories revealed a creatinine level of 0.95 mg/dL and trace proteinuria. An antinuclear antibody test was positive at 1:1200 …
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