[Immunosuppression - too strong or too weak?].
A 52 year old patient with immunosuppressive therapy for ANCA-negative vasculitis presented with fever and paraparesis of the legs, laboratory findings displayed high inflammatory markers. The differential diagnosis comprised acute infection, an exacerbation of vasculitis or a drug reaction. Despite meticulous diagnostics, including FDG-PET, no definitive cause for the symptoms could be uncovered. Empirical antibiotic treatment in combination with high doses of glucocorticosteroids lead to prompt resolution of fever and inflammatory laboratory markers.
Klinik für Innere Medizin I, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93051 Regensburg. arne.schneidewind@klinik.uni-r.de
A
A
Schneidewind
M
M
Fleck
B
B
Salzberger
J
J
Schölmerich
B
B
Ehrenstein
D005335:Fever of Unknown Origin / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D020335:Paraparesis / Q000139:chemically induced* / Q000517:prevention & control*; D014657:Vasculitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D007166:Immunosuppressive Agents