Severity: Warning
Message: file_get_contents(https://...@gmail.com&api_key=61f08fa0b96a73de8c900d749fcb997acc09&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 197
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 197
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 271
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3165
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 597
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 511
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 317
Function: require_once
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A 76-year-old woman with a 19-year history of rheumatoid arthritis (RA) presented with progressive cachexia and constitutional symptoms. Imaging revealed a suspicious hypermetabolic lesion in the cervical region, initially raising concerns of malignancy. Following excision, histopathology identified the lesion as a rheumatoid nodule, a rare extra-articular manifestation of RA in deep tissues like the thyroid membrane. The patient's symptoms were attributed to her autoimmune disease and cognitive decline. This case highlights the importance of considering rheumatoid nodules in the differential diagnosis of cervical masses in RA patients, potentially avoiding unnecessary surgical interventions.
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