title: Autoimmune cholangitis presented as fever of unknown origin.
abstract: Autoimmune cholangitis is a rare chronic cholestatic liver disease. Fever of unknown origin is defined as a temperature higher than 38.3 degrees C that lasts for more than 3 weeks with no obvious source despite appropriate investigation. We describe the case of a 62-year-old woman who presented with fever, fatigue and weight loss. The serum biochemical study showed an increase in alkaline phosphatase and gamma-glutamyl transpeptidase levels. Antinuclear, antimitochondrial, anti-smooth-muscle antibodies and antibodies against the cytoplasm of neutrophils were negative. Liver biopsy was compatible with autoimmune cholangitis. The patient was successfully treated with methylprednisolone and ursodeoxycholic acid. We describe here a rare case of fever as preceding and leading symptom of autoimmune cholangitis.
authors.affiliation: 2nd Department of Internal Medicine, Hellenic Red Cross Hospital, Athens, Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Petrogiannopoulos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Papamichael
authors.forename: Georgios
authors.initials: G
authors.lastname: Karachalios
authors.forename: Iris
authors.initials: I
authors.lastname: Karachaliou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kostakos
authors.forename: Kalypso
authors.initials: K
authors.lastname: Barbati
authors.forename: Antonios
authors.initials: A
authors.lastname: Zacharof
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D002761:Cholangitis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D005260:Female; D005335:Fever of Unknown Origin / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D008775:Methylprednisolone