renal disease masquerading as pyrexia of unknown origin

renal disease masquerading as pyrexia of unknown origin

;D Korivi;V Billa;K Patel;C Madiwale
journal of the chemical society - perkin transactions 1 2013 Vol. 23 pp. 312-315
165
korivi2013indianrenal

Abstract

Pyrexia of unknown origin is a challenging clinical problem. Infections, malignancies, and connective tissue diseases form the major etiologies for this condition. We report a case of a 57-year-old diabetic male who presented with fever of unknown origin for several months. The course of investigations led to a kidney biopsy which clinched the cause of his fever as well as the underlying diagnosis. The light microscopy findings of expansile storiform fibrosis with a dense inflammatory infiltrate suggested the diagnosis which was confirmed by positive staining of Immunoglobulin G4, the dense lympho-plasmacytic infiltrate and elevated serum IgG4 concentrations. A course of steroids followed by mycophenolate mofetil as maintenance immunosuppression rendered the patient afebrile with improvement of renal function.

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180246
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