title: [A case of fulminant ulcerative colitis initially presenting as fever of unknown origin].
abstract: A 40's man was referred to our hospital for the investigation of fever of unknown origin lasting for a month. The laboratory data showed a prominent inflammatory reaction and a high titer of PR3-ANCA. Despite the various imaging studies and bacteriological examinations, the cause of the fever could not be detected until he complained of abdominal pain with bloody stool that appeared during hospitalization and which prompted colonoscopy, resulting in the diagnosis of moderate ulcerative colitis of the descending colon. Although temporal improvement was achieved by mesalazine administration, the symptom exacerbated again. Then, a combination of steroid administration and the leukocytapheresis (LCAP) was performed, but it was also not effective. His rapidly deteriorating condition with the lesion extending to whole colon necessitated subtotal colectomy. He has been afebrile and in good condition since the operation, which indicates the cause of the fever was due to ulcerative colitis.
authors.affiliation: Department of Gastroenterological Medicine, Tokyo Metropolitan Komagome Hospital.
authors.forename: Taku
authors.initials: T
authors.lastname: Tabata
authors.forename: Go
authors.initials: G
authors.lastname: Kuwata
authors.forename: Kensuke
authors.initials: K
authors.lastname: Takuma
authors.forename: Hajime
authors.initials: H
authors.lastname: Anjiki
authors.forename: Sawako
authors.initials: S
authors.lastname: Kuruma
authors.forename: Hideto
authors.initials: H
authors.lastname: Egashira
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Egawa
authors.forename: Junko
authors.initials: J
authors.lastname: Fujiwara
authors.forename: Takeo
authors.initials: T
authors.lastname: Arakawa
authors.forename: Kumiko
authors.initials: K
authors.lastname: Momma
authors.forename: Kouichi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Hishima
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications*; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D008297:Male