Pleural effusion with @entity9440 as manifestations of recurrence of XXXX following prolonged remission.

@entity1 @entity1143 @entity662 @entity3329 @entity1353 @entity5 @entity229 @entity1151 @entity358 @entity1410 @entity1344 @entity370 @entity9440 @entity5406 @entity385
A 55-year-old @entity1 presented with a 3-week history of dry cough and left @entity662 with a new exudative @entity1143 . Sixteen years earlier, he was diagnosed with @entity370 presenting with @entity3329 , @entity5406 , mildly disturbed liver function tests and noncaseating granulomata on liver biopsy, with no evidence of @entity358 . He was treated with @entity229 and in recent years maintained at a low daily dose, until it was eventually discontinued two years prior to his present illness. There was no evidence of @entity5 , and the fluid resolved following treatment with naproxen. Three weeks later the @entity1 presented with sudden onset of @entity1353 and left @entity662 . After starting intravenous heparin for suspected @entity1151 , the @entity1 developed @entity1344 which was accompanied by abdominal tenderness and decreasing hematocrit. @entity9440 was diagnosed, and the @entity1 underwent splenectomy. Pathology specimens revealed a @entity385 with subcapsular @entity1410 , and numerous noncaseating granulomata within the splenic tissue. This @entity1 had recurrent @entity370 with two rare manifestations of the disease, 2 years after withdrawing low dose @entity229 , given for a prolonged time. The possibility of reemergence of the disease in organs other than the organs involved in the initial presentation should always be considered in @entity370 .
