Systemic vasculitis with prolonged pyrexia, recurrent facial urticaria, skin nodules, pleural effusions and venous thrombosis: an unusual presentation of an uncommon disease.
Classically presenting with multiple or single peripheral cytopenias of variable severity, the myelodysplastic syndromes may occasionally present with bizarre manifestations that confuse the clinical picture and result in significant delays in making the correct diagnosis. We describe the case of an elderly male patient whose presentation with prolonged unexplained fever coupled with cutaneous, pulmonary and other systemic features of inflammation was finally diagnosed as having a primary myelodysplastic syndrome with associated vasculitis after a delay of 4 years.
King Saud ibn Abdulaziz University for Health Sciences and the Department of Medicine 1443, King Abdulaziz Medical City, King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia. imadsahassan@yahoo.co.uk
Imad Salah
IS
Hassan
Javeed
J
Dar
D000368:Aged; D003937:Diagnosis, Differential; D005145:Face; D005334:Fever / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000175:diagnosis*; D010996:Pleural Effusion / Q000175:diagnosis* / Q000209:etiology; D012008:Recurrence; D056647:Systemic Vasculitis / Q000175:diagnosis* / Q000209:etiology; D014581:Urticaria / Q000175:diagnosis* / Q000209:etiology; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology