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Pulmonary sarcoidosis as a cause of intermittent fever of unknown origin in a hemodialysis patient with renal cell carcinoma: A case report and literature review
Author(s) -
Shima Hisato,
Nishitani Masaaki,
Tashiro Manabu,
Inoue Tomoko,
Kawahara Kazuhiko,
Okada Kazuyoshi,
Minakuchi Jun,
Kawashima Shu
Publication year - 2019
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12695
Subject(s) - medicine , hemodialysis , sarcoidosis , renal cell carcinoma , lymph node , prednisolone , scintigraphy , gastroenterology , pathology , radiology
Abstract Hemodialysis patients have weakened immune systems and can exhibit fever due to various causes. Herein, we describe the case of a 61‐year‐old hemodialysis patient who exhibited intermittent low‐grade fever after a pacemaker had been implanted 2 months before due to sick sinus syndrome. She had a medical history of subcutaneous sarcoidosis and uveitis. Active pulmonary sarcoidosis was diagnosed based on elevated soluble interleukin‐2 receptor, elevated lysozyme level, and gallium‐67 scintigraphy uptake in hilar and mediastinal lymph nodes. She was also diagnosed with renal cell carcinoma via contrast computed tomography. However, because her C‐reactive protein level remained normal, the possibility of neoplastic fever was considered low. After the initiation of prednisolone administration, her fever gradually disappeared. Her serum soluble interleukin‐2 receptor and lysozyme level improved in parallel with the enlargement of the mediastinal lymph node and gallium‐67 scintigraphy uptake.