title: Fever of unknown origin as unique symptom of an indolent mastocytosis.
abstract: A 39-years-old man afferred to our hospital for a fever lasting for more than 6 months, without abnormalities at physical examination (in particular no skin alterations); a recent laboratory and instrumental investigation was ineffective and so a fever of unknown origin (FUO) was diagnosed Since he reported an history of infantile mastocytosis (usually auto-resolving) we evaluated his serum-tryptase levels that resulted of 49 ug/L (normal value 20 ug/L), raising the doubt of the presence of an active mastocytosis. The following bone marrow evaluation showed aggregates of CD117 positive cells and a c-Kit point mutation at codon D 816V confirming the diagnosis of indolent mastocytosis.The present case confirm that FUO can be caused by an otherwise asymptomatic indolent mastocytosis, thus suggesting to include the serum-tryptase level measurement in the diagnostic approach to this pathological condition, at least in selected cases.
authors.affiliation: Department of Internal Medicine I Ospedale di Faenza AUSL Ravenna, Italy. gf.stefanini@ausl.ra.it
authors.forename: G F
authors.initials: GF
authors.lastname: Stefanini
authors.forename: O
authors.initials: O
authors.lastname: Quercia
authors.forename: F
authors.initials: F
authors.lastname: Emiliani
authors.forename: N
authors.initials: N
authors.lastname: Stefanini
authors.forename: A C
authors.initials: AC
authors.lastname: Dall'Aglio
authors.forename: A
authors.initials: A
authors.lastname: Lanzi
authors.forename: F G
authors.initials: FG
authors.lastname: Foschi
mesh_terms: D000328:Adult; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D008297:Male; D008415:Mastocytosis / Q000150:complications*; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D053802:Tryptases / Q000097:blood
chemical_list: D019009:Proto-Oncogene Proteins c-kit; D053802:Tryptases