spasms), and opsoclonus (irregular, rapid eye movements). Other symptoms may include difficulty speaking, poorly articulated speech, or an inability to speak. A decrease in muscle tone, lethargy, irritability, and malaise (a vague feeling of bodily discomfort) may also be present.8

Optic neuritis: Inflammation of the optic nerve.1

Pancreatitis: Inflammation of the pancreas.1

Pertussis: An acute infectious inflammation of the larynx, trachea, and bronchi caused by Bordetella pertussis; characterized by recurrent bouts of spasmodic coughing that continues until the breath is exhausted, then ending in a noisy inspiratory stridor (the “whoop”) caused by laryngeal spasm.1

Pneumonia: Inflammation of the lung parenchyma characterized by consolidation of the affected part, the alveolar air spaces being filled with exudate, inflammatory cells, and fibrin.1

Polyarteritis nodosa: Segmental inflammation, with infiltration by eosinophils, and necrosis of medium-sized or small arteries, more common in males, with varied symptoms related to involvement of arteries in the kidneys, muscles, gastrointestinal tract, and heart.1

Psoriatic arthritis: The concurrence of psoriasis and polyarthritis, resembling rheumatoid arthritis but thought to be a specific disease entity, sero-negative for rheumatoid factor and often involving the digits.1

Randomized controlled trial (RCT): An epidemiologic experiment in which subjects in a population are randomly allocated into groups, usually called study and control groups, to receive or not receive an experimental preventive or therapeutic procedure, maneuver, or intervention. The results are assessed by rigorous comparison of rates of disease, death, recovery, or other appropriate outcome in the study and control groups. RCTs are generally regarded as the most scientifically rigorous method of hypothesis testing available in epidemiology and medicine. Nonetheless, they may suffer serious lack of generalizability, due, for example, to the nonrepresentativeness of patients who are ethically and practically eligible, chosen, or consent to participate.4

Reactive arthritis: Sterile, usually transient polyarthropathy following various infectious diseases.1

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