title: High fever, renal failure, disseminated intravascular coagulation and myelodysplasia accompanied with enhanced angiogenesis possibly due to overexpression of vascular endothelial growth factor.
abstract: A 44-year-old woman suffered from recurrent fever, edema and fatigue. Laboratory data revealed renal dysfunction, low proteinemia, disseminated intravascular coagulation (DIC) and myelodysplasia. A renal and lymph node biopsy showed a marked angiogenesis. Serum levels of vascular endothelial growth factor (VEGF), and interleukin (IL)-6 were markedly increased, suggesting a pathogenesis related to VEGF-induced angiogenesis. The symptoms were remitted after treatment with cyclosporin A. No evidence of solid tumors, malignant lymphoma, Castleman's disease or POEMS (polyneuropathy, organomegaly, endocrine disorder, M-proteinemia and skin change) syndrome, reported to induce a high serum VEGF level, was obtained. This case may have involved an unknown mechanism which induced an overexpression of VEGF and IL-6.
authors.affiliation: Department of Internal Medicine, Social Insurance Chuo General Hospital, Tokyo.
authors.forename: H
authors.initials: H
authors.lastname: Murata
authors.forename: H
authors.initials: H
authors.lastname: Yoshimoto
authors.forename: T
authors.initials: T
authors.lastname: Ryu
authors.forename: M
authors.initials: M
authors.lastname: Masuo
authors.forename: J
authors.initials: J
authors.lastname: Toyama
authors.forename: H
authors.initials: H
authors.lastname: Tokuda
authors.forename: S
authors.initials: S
authors.lastname: Kitamura
authors.forename: Y
authors.initials: Y
authors.lastname: Miura
mesh_terms: D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D016228:Endothelial Growth Factors / Q000097:blood*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007668:Kidney / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D009436:Neural Tube Defects / Q000209:etiology*; D012008:Recurrence; D051437:Renal Insufficiency / Q000209:etiology*
chemical_list: D016228:Endothelial Growth Factors; D015850:Interleukin-6