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A 26-year-old U.S. soldier was referred to our institution with a two-week history of unexplained fever and weight loss. The physical examination was unremarkable. Laboratory examination revealed anemia, leukopenia, mild proteinuria, and IgG and IgA hypergammaglobulinemia. Multiple blood cultures for bacteria and fungi were negative. Serologic tests for fungi and viruses, including an enzyme-linked immunosorbent assay for the human immunodeficiency virus and a test for p24 antigen, were also negative, as were titers of antinuclear antibodies and extractable nuclear antigens. Computed tomographic scanning of the chest, abdomen, and pelvis revealed only mild splenomegaly.
A bone marrow biopsy performed to rule . . . [Full Text of this Article] |
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