A 64-year-old male introduced with a 6-month historical past of symmetric polyarthritis involving proximal interphalangeal joints and metacarpophalangeal joints of the fingers, wrists, and ankles. Related signs included vomiting, progressive fatigue, and weight reduction. Laboratory outcomes confirmed microcytic anemia, leukocytosis, thrombocytosis, elevated C-reactive protein and erythrocyte sedimentation price, and rheumatoid issue (RF) and anti-cyclic citrullinated …