Journal
INTERNAL MEDICINE
Volume 46, Issue 15, Pages 1197-1201Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.46.6414
Keywords
common variable immunodeficiency; corticoid; fever of unknown origin; granulomatous disease; sarcoidosis
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Non-caseating epithelioid granulomas have been described in a small number of patients with common variable immunodeficiency (CVID). We report a 26-year-old woman diagnosed with CVID nine years earlier, who developed non-caseating granulomas in the liver, bone marrow and skin. She was referred to our department for a fever of more than one year duration without apparent focus. Extensive search for underlying malignancy or occult infection was unremarkable. Empirical treatment with prednisone was begun and the patient showed a marked improvement. The literature on the association between CVID and non-caseating granulomatous disease, and the differential diagnosis of hepatic granulomas as a cause of fever of unknown origin, is also reviewed.
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