Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine

Background. The presence of ulcerative colitis (UC) with no bowel symptoms, as fever of unknown origin (FUO), is uncommon. Objective. To describe the case of an 80-year-old woman who presented with fever, with a history of UC under treatment with mesalazine. Case Presentation. She was admitted due t...

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Main Authors: Panagiota Voukelatou, Elissavet Sfendouraki, Theodoros Karianos, Sofia Saranti, Dimitrios Tsitsimelis, Ioannis Vrettos, Andreas Kalliakmanis
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2016/4396256
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author Panagiota Voukelatou
Elissavet Sfendouraki
Theodoros Karianos
Sofia Saranti
Dimitrios Tsitsimelis
Ioannis Vrettos
Andreas Kalliakmanis
author_facet Panagiota Voukelatou
Elissavet Sfendouraki
Theodoros Karianos
Sofia Saranti
Dimitrios Tsitsimelis
Ioannis Vrettos
Andreas Kalliakmanis
author_sort Panagiota Voukelatou
collection DOAJ
description Background. The presence of ulcerative colitis (UC) with no bowel symptoms, as fever of unknown origin (FUO), is uncommon. Objective. To describe the case of an 80-year-old woman who presented with fever, with a history of UC under treatment with mesalazine. Case Presentation. She was admitted due to fever lasting for 12 days with no associated symptoms. Seven years earlier, she was diagnosed with UC. After an extended workup for FUO that failed to reach the diagnosis, she underwent a gallium-67 scintigraphy. This revealed a persistent diffuse concentration of gallium-67 in the ascending colon at 24-hour imaging that remained stable at 48- and 72-hour imaging without any topographic change after the use of laxatives. Considering the results and in the absence of another diagnosis, the patient was treated with 30 mg prednisone daily and mesalazine, as treatment of active UC. Subsequently, the patient’s condition improved markedly and the fever retreated. One month later, she was reevaluated with a gallium-67 scintigraphy with total absence of gallium-67 concentration in the ascending colon. Conclusion. UC activity must be included in the differential diagnosis of FUO in patients with longstanding disease, since fever may present alone, with no other manifestations.
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spelling doaj-art-4616c22abf7746419aecd7b9fc759a242025-02-03T07:26:07ZengWileyCase Reports in Medicine1687-96271687-96352016-01-01201610.1155/2016/43962564396256Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with MesalazinePanagiota Voukelatou0Elissavet Sfendouraki1Theodoros Karianos2Sofia Saranti3Dimitrios Tsitsimelis4Ioannis Vrettos5Andreas Kalliakmanis62nd Department of Internal Medicine, General Oncological Hospital of Kifissia “Ag. Anargyroi”, Kifissia, 145 64 Athens, Greece2nd Department of Internal Medicine, General Oncological Hospital of Kifissia “Ag. Anargyroi”, Kifissia, 145 64 Athens, GreeceDepartment of Nuclear Medicine, General Oncological Hospital of Kifissia “Ag. Anargyroi”, Kifissia, 145 64 Athens, GreeceDepartment of Nuclear Medicine, General Oncological Hospital of Kifissia “Ag. Anargyroi”, Kifissia, 145 64 Athens, GreeceDepartment of Radiology, General Oncological Hospital of Kifissia “Ag. Anargyroi”, Kifissia, 145 64 Athens, Greece2nd Department of Internal Medicine, General Oncological Hospital of Kifissia “Ag. Anargyroi”, Kifissia, 145 64 Athens, Greece2nd Department of Internal Medicine, General Oncological Hospital of Kifissia “Ag. Anargyroi”, Kifissia, 145 64 Athens, GreeceBackground. The presence of ulcerative colitis (UC) with no bowel symptoms, as fever of unknown origin (FUO), is uncommon. Objective. To describe the case of an 80-year-old woman who presented with fever, with a history of UC under treatment with mesalazine. Case Presentation. She was admitted due to fever lasting for 12 days with no associated symptoms. Seven years earlier, she was diagnosed with UC. After an extended workup for FUO that failed to reach the diagnosis, she underwent a gallium-67 scintigraphy. This revealed a persistent diffuse concentration of gallium-67 in the ascending colon at 24-hour imaging that remained stable at 48- and 72-hour imaging without any topographic change after the use of laxatives. Considering the results and in the absence of another diagnosis, the patient was treated with 30 mg prednisone daily and mesalazine, as treatment of active UC. Subsequently, the patient’s condition improved markedly and the fever retreated. One month later, she was reevaluated with a gallium-67 scintigraphy with total absence of gallium-67 concentration in the ascending colon. Conclusion. UC activity must be included in the differential diagnosis of FUO in patients with longstanding disease, since fever may present alone, with no other manifestations.http://dx.doi.org/10.1155/2016/4396256
spellingShingle Panagiota Voukelatou
Elissavet Sfendouraki
Theodoros Karianos
Sofia Saranti
Dimitrios Tsitsimelis
Ioannis Vrettos
Andreas Kalliakmanis
Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine
Case Reports in Medicine
title Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine
title_full Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine
title_fullStr Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine
title_full_unstemmed Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine
title_short Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine
title_sort ulcerative colitis activity presenting as fever of unknown origin in a patient with longstanding disease under continuous treatment with mesalazine
url http://dx.doi.org/10.1155/2016/4396256
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