[Fever of unknown origin with granulomatous hepatitis, uveitis and acute renal failure].
A 46-year-old man was referred to our hospital because of fever of unknown origin (FUO). Two months before admission, he noted fever, weight loss, and asthenia. Physical examination revealed only mechanical pains of the right shoulder. In the past, patient's father had a tuberculosis. At the age of 29 years, Brucella granulomatous hepatitis and B hepatitis were diagnosed. The past three years, he developed two episodes of uveitis which resolved with local treatment. The hepatic biopsy revealed only a non specific granulomatous hepatitis. Few days after admission, the patient developed acute renal failure without proteinuria or hematuria. The renal biopsy confirmed the presence of noncaseating granulomas. In the context of the patient, we diagnosed a sarcoidosis. All the symptoms resolved with the initiation of prednisone treatment. The FUO differential diagnosis, and the different aspects of renal sarcoidosis are discussed.
Moret
Ch
Ch
Service de Médecine A, Département de Médecine, CHUV, Institut Universitaire de Pathologie, Lausanne.
Meier
P
P
Rotman
S
S
Lepori
M
M
Lamy
O
O
D001707:Biopsy, Needle; D002006:Brucellosis / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D005335:Fever of Unknown Origin / Q000209:etiology* / Q000473:pathology; D006099:Granuloma / Q000209:etiology* / Q000473:pathology; D006505:Hepatitis / Q000209:etiology* / Q000473:pathology; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000473:pathology; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D012507:Sarcoidosis / Q000175:diagnosis* / Q000473:pathology; D014605:Uveitis / Q000209:etiology* / Q000473:pathology