CLINICAL CASES   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2002 April;161(2):97-9

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

Fever of unknown origin with delay in the onset of SLE diagnostic criteria

Nocente R. ¹, Gentiloni Silveri N. ², Ceccanti M. ³, Bertazzoni G. ¹, Magarò M. ², Vastola M. ², Gasbarrini G. ²

¹ Emergency Department, University of Rome “La Sapienza”, Rome; ² Institute of Internal Medicine, Catholic University, Rome; ³ Institute of VI Medical Clinic, University of Rome “La Sapienza”, Rome

We re­port a ­case of a 47-­year-old man pre­sent­ing ­with fe­ver of un­known or­i­gin (FUO) and a ­high ESR. Laboratory ­tests ­showed CD4 lym­pho­cy­to­pe­nia and poly­clo­nal hy­per­gam­mag­lo­bu­li­ne­mia. The pa­tient was HIV neg­a­tive. He was aner­gic to ­skin ­tests: Merieaux ­test ­score was 0 (n.r. >10). Only 7 ­months af­ter the on­set of py­rex­ia, the pos­i­tiv­ity of 5/11 di­ag­nos­tic American Rheumatism Association (ARA) cri­te­ria for system­ic lu­pus er­y­them­a­to­sus (SLE) be­came ev­i­dent and SLE was di­ag­nosed. It is there­fore pos­sible ­that, ­while not in­clud­ed ­among SLE ARA cri­te­ria, fe­ver may be the on­ly pre­sent­ing ­sign of SLE for sev­er­al ­months.