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Free Content Fever of unknown origin and isolated noncaseating granuloma of the marrow: Could this be sarcoidosis?

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Abstract:

Fever of unknown origin (FUO) is both a clinical and a diagnostic challenge. Furthermore, an FUO case with isolated marrow noncaseating granuloma can further confound diagnosis. However, these two findings together may help narrow down the pathological possibilities. This article presents a case report of FUO and lymphopenia for 2 months. Multiple studies to evaluate infectious etiology were unremarkable. Bone marrow biopsy revealed isolated bone marrow granuloma, suggestive of sarcoid. The patient responded well to glucocorticosteroids with resolution of lymphopenia. Sarcoid should enter the differential of lymphopenia and FUO even without lymphadenopathy or abnormal chest radiography. This article provides a of review of CD4 lymphopenia, noncaseating granuloma of the marrow, and sarcoidosis.

Keywords: BONE MARROW GRANULOMA; CD4 LYMPHOPENIA; FEVER OF KNOWN ORIGIN; NONCASEATING GRANULOMA; SARCOID

Document Type: Case Report

DOI: http://dx.doi.org/10.2500/aap.2007.28.2982

Affiliations: 1: Departments of Internal Medicine and Emergency Medicine, State University of New York Downstate Medical Center and Kings County Hospital Center Brooklyn, New York 2: Division of Allergy and Immunology, University of South Florida College of Medicine and James A. Haley VA Hospital, Tampa, Florida 3: M.D./Ph.D. Program, Loyola University Stritch School of Medicine, Maywood, Illinois

Publication date: March 1, 2007

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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