Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia
An 18-year-old male was admitted for his second induction chemotherapy treatment for an acute lymphoblastic leukaemia with cyclophosphamide, cytarabine, and mercaptopurine. He presented with high fever, abdominal pain, non-bloody diarrhoea, portal hypertension and leukopenia. Stool sample analysis,...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/34402 |
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I10-R327-article-344022022-09-29T15:08:29Z Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia Fiebre de origen desconocido neutropénica y enfermedad granulomatosa diseminada en un paciente con leucemia linfoblástica aguda Febre de origen desconhecida neutropênica e doença granulomatosa disseminada em um paciente com leucemia linfoblástica aguda Santarelli, Ignacio Martín Manzella, Pedro Oscar Ingold, Julián José Legnoverde, Sofía Falcón, María Florencia Fernández, Sofía Isabel Melero, Marcelo José fever of unknown origin neutropenia granuloma fiebre de origen desconocido neutropenia granuloma febre de Causa Desconhecida neutropenia granuloma An 18-year-old male was admitted for his second induction chemotherapy treatment for an acute lymphoblastic leukaemia with cyclophosphamide, cytarabine, and mercaptopurine. He presented with high fever, abdominal pain, non-bloody diarrhoea, portal hypertension and leukopenia. Stool sample analysis, blood cultures and extensive work-up were negative. The only microbiologic evidence was the presence of cytomegalovirus DNA detected by PCR. A profound hypogammaglobulinemia was documented. Pathology material reported non-caseating granulomas in liver, bone marrow, duodenum and colon with negative cytomegalovirus immunostaining. What is your diagnosis? Un varón de 18 años se internó para recibir el segundo ciclo de inducción por una leucemia linfoblástica aguda con ciclofosfamida, citarabina y mercaptopurina. Desarrolló fiebre alta, dolor abdominal, diarrea no sanguinolenta, hipertensión portal y leucopenia. El análisis de materia fecal, cultivos de sangre y una evaluación exhaustiva fueron negativas. La única evidencia microbiológica fue la detección de ADN de citomegalovirus en sangre por PCR. También se documentó una hipogamaglobulinemia profunda. El material de patología reportó granulomas no caseificantes en hígado, médula ósea, duodeno y colon con inmunohistoquímica negativa para citomegalovirus. ¿Cuál es su diagnóstico? Um homem de 18 anos foi internado para o segundo ciclo de indução de leucemia linfoblástica aguda com ciclofosfamida, citarabina e mercaptopurina. Ele desenvolveu febre alta, dor abdominal, diarreia não sanguinolenta, hipertensão portal e leucopenia. A análise das fezes, as hemoculturas e uma avaliação abrangente foram negativas. A única evidência microbiológica foi a detecção de DNA de citomegalovírus no sangue por PCR. Hipogamaglobulinemia profunda também foi documentada. O material patológico relatou granulomas não caseosos no fígado, medula óssea, duodeno e cólon com imunohistoquímica negativa para citomegalovírus. Qual é o seu diagnóstico? Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-09-16 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Text Texto Texto text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/34402 10.31053/1853.0605.v79.n3.34402 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. 3 (2022); 304-306 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. 3 (2022); 304-306 Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. 3 (2022); 304-306 1853-0605 0014-6722 10.31053/1853.0605.v79.n3 eng https://revistas.unc.edu.ar/index.php/med/article/view/34402/38533 https://revistas.unc.edu.ar/index.php/med/article/view/34402/38806 Derechos de autor 2022 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Inglés |
| format |
Artículo revista |
| topic |
fever of unknown origin neutropenia granuloma fiebre de origen desconocido neutropenia granuloma febre de Causa Desconhecida neutropenia granuloma |
| spellingShingle |
fever of unknown origin neutropenia granuloma fiebre de origen desconocido neutropenia granuloma febre de Causa Desconhecida neutropenia granuloma Santarelli, Ignacio Martín Manzella, Pedro Oscar Ingold, Julián José Legnoverde, Sofía Falcón, María Florencia Fernández, Sofía Isabel Melero, Marcelo José Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia |
| topic_facet |
fever of unknown origin neutropenia granuloma fiebre de origen desconocido neutropenia granuloma febre de Causa Desconhecida neutropenia granuloma |
| author |
Santarelli, Ignacio Martín Manzella, Pedro Oscar Ingold, Julián José Legnoverde, Sofía Falcón, María Florencia Fernández, Sofía Isabel Melero, Marcelo José |
| author_facet |
Santarelli, Ignacio Martín Manzella, Pedro Oscar Ingold, Julián José Legnoverde, Sofía Falcón, María Florencia Fernández, Sofía Isabel Melero, Marcelo José |
| author_sort |
Santarelli, Ignacio Martín |
| title |
Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia |
| title_short |
Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia |
| title_full |
Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia |
| title_fullStr |
Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia |
| title_full_unstemmed |
Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia |
| title_sort |
neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia |
| description |
An 18-year-old male was admitted for his second induction chemotherapy treatment for an acute lymphoblastic leukaemia with cyclophosphamide, cytarabine, and mercaptopurine. He presented with high fever, abdominal pain, non-bloody diarrhoea, portal hypertension and leukopenia. Stool sample analysis, blood cultures and extensive work-up were negative. The only microbiologic evidence was the presence of cytomegalovirus DNA detected by PCR. A profound hypogammaglobulinemia was documented. Pathology material reported non-caseating granulomas in liver, bone marrow, duodenum and colon with negative cytomegalovirus immunostaining. What is your diagnosis? |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2022 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/34402 |
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