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A Case of Systemic Vasculitis Presented as Fever of Unknown Origin
Eun Suk Jung, M.D.1, Chung Ho Kim, M.D.1, Young Youl Hyun, M.D.1, Gang Jee Ko, M.D.1, Byoung Yun Hwang, M.D.1, Hee Jin Cheong, M.D.1, Woo Joo Kim, M.D.1 and Nam Hee Won, M.D.2
Department of Internal Medicine1, Department of Pathology2, College of Medicine, Korea University, Seoul, Korea
Vol.36 Num.6 (p377~380)
Fever of unknown origin (FUO) means fever that does not resolve spontaneously in the period expected for self-limited infection and whose cause cannot be ascertained despite considerable diagnostic efforts. We experienced a case of FUO associated with systemic vasculitis, which was diagnosed with clinical manifestation, radiographic findings, the presence of anti-neutrophil cytoplasmic antibody (ANCA), and renal biopsy. A 54-year-old female was admitted to our hospital with remittent fever of 3 months. A paranasal sinus (PNS) view revealed maxillary and ethmoidal sinusitis, and urine analysis showed microscopic hematuria. We performed a renal biopsy on the basis of positive ANCA and microscopic hematuria. The renal biopsy showed pauci-immune crescentic glomerulonephritis without granuloma, interstitial inflammation, and small vessel vasculitis. Under the diagnosis of ANCA-associated systemic vasculitis, she was treated with steroid and cyclophosphamide. She showed marked clinical improvement.
Keywords : Fever of unknown origin (FUO), Systemic vasculitis, ANCA