20th February 2025

A 45-year-old woman is referred to respiratory clinic with a 4-month history of a dry cough and weight loss.

A 45-year-old woman is referred to respiratory clinic with a 4-month history of a dry cough and weight loss. She also reports she has struggled to do her job as a medical secretary, but this is due to the fact her eyes have become painful and she struggles with light. Her past medical history includes hypothyroidism for which she is taking levothyroxine. She has no allergies.

Examination of her chest is unremarkable. There are no rashes or tender joints. You note marked redness in her eyes. 

Her CXR shows bilateral hilar lymphadenopathy.

What is the most appropriate therapy to commence on this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.