Fever, splenomegaly and lymphopenia in sarcoidosis
- 1Department of Diseases of the Thorax, Pulmonology Unit, Pierantoni-Morgagni Hospital, Forlì, Italy
- 2Department of Pathology, Pierantoni-Morgagni Hospital, Forlì, Italy
- Correspondence to Dr Venerino Poletti, Pulmonology, Department of Thoracic Diseases, GB Pierantoni—L Morgagni Hospital, via C. Forlanini 34, 47100 Forlì, Italy; venerino.poletti{at}gmail.com
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Contributors All authors have made important contributions in the discussion of the clinical case and drafting the article.
- Infection control
- opportunist lung infections
- sarcoidosis
- bronchoscopy
- COPD Pathology
- drug induced lung disease
- histology/cytology
- interstitial fibrosis
- lung cancer
- lung cancer chemotherapy
- pleural disease
- alveolar cell cancer
- anca related vasculitides
- eosinophil biology
- lymphocyte biology
- macrophage biology
- respiratory infection
Clinical presentation
A 42-year-old woman was referred to our department with a 5 months history of intermittent fever and fatigue. Her past medical history included a consolidated diagnosis of sarcoidosis (obtained 7 years before with a sub-carinal lymph node biopsy) and in the previous years she had been treated with steroids, hydroxychloroquine, methotrexate and azathioprine with persistent and progressive enlargement of mediastino-hilar adenopathies and bilateral nodular infiltrates. Her symptoms progressed despite a course of antibiotics prescribed for presumed community-acquired pneumonia and a course of corticosteroids. The patient lived in Italy and there was no history of travels or other additional risk factors for infections.
At the time of admission, the patient had a temperature of …
