title: Retractile mesenteritis presenting as fever of unknown origin and autoimmune haemolytic anaemia.
abstract: Retractile mesenteritis is an extremely rare disease characterised by a non-specific inflammatory and fibrotic process of the mesenteric adipose tissue, which is usually accompanied by pain and a variety of other abdominal symptoms. We describe here the case of a patient with retractile mesenteritis presenting with prolonged high-grade fever and autoimmune haemolytic anaemia without abdominal symptoms. The patient's illness was complicated by chylous ascites. Diagnosis was suspected by computed tomography and confirmed histologically following exploratory laparotomy. The patient was treated with prednisone and azathioprine, and he had a rapid improvement in anaemia and fever relief, but no substantial change in the mesenteric lesions. Our case adds autoimmune haemolytic anaemia to the wide spectrum of manifestations of retractile mesenteritis and implies the possible involvement of immune mechanisms in the pathogenesis of the disease.
authors.affiliation: Department of Haematology, University of Crete School of Medicine, University Hospital of Heraklion, Greece.
authors.forename: H A
authors.initials: HA
authors.lastname: Papadaki
authors.forename: E A
authors.initials: EA
authors.lastname: Kouroumalis
authors.forename: K
authors.initials: K
authors.lastname: Stefanaki
authors.forename: M
authors.initials: M
authors.lastname: Roussomoustakaki
authors.forename: M E
authors.initials: ME
authors.lastname: Daskalogiannaki
authors.forename: D
authors.initials: D
authors.lastname: Reppa
authors.forename: G D
authors.initials: GD
authors.lastname: Eliopoulos
mesh_terms: D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy / Q000209:etiology*; D001379:Azathioprine / Q000008:administration & dosage; D001707:Biopsy, Needle; D004359:Drug Therapy, Combination; D005335:Fever of Unknown Origin / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015436:Panniculitis, Peritoneal / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D001379:Azathioprine; D011241:Prednisone