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 CASE REPORT
Year : 2013  |  Volume : 23  |  Issue : 4  |  Page : 312-315

Renal disease masquerading as pyrexia of unknown origin


1 Department of Nephrology, Bombay Hospital, New Marine Lines, Mumbai, Maharashtra, India
2 Department of Pathology, Bombay Hospital, New Marine Lines, Mumbai, Maharashtra, India
3 Department of Histopathology, PD Hinduja Hospital, Mahim, Mumbai, Maharashtra, India

Correspondence Address:
D Korivi
New Wing, Bombay Hospital, New Marine Lines, Mumbai - 400 020, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.114491

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Pyrexia of unknown origin is a challenging clinical problem. Infections, malignancies, and connective tissue diseases form the major etiologies for this condition. We report a case of a 57-year-old diabetic male who presented with fever of unknown origin for several months. The course of investigations led to a kidney biopsy which clinched the cause of his fever as well as the underlying diagnosis. The light microscopy findings of expansile storiform fibrosis with a dense inflammatory infiltrate suggested the diagnosis which was confirmed by positive staining of Immunoglobulin G4, the dense lympho-plasmacytic infiltrate and elevated serum IgG4 concentrations. A course of steroids followed by mycophenolate mofetil as maintenance immunosuppression rendered the patient afebrile with improvement of renal function.






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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07