A curious case of Fever and hyperpigmentation

Area of Science:

• Hematology
• Nutritional Science
• Dermatology

Background:

• Megaloblastic anemia is typically associated with hematological symptoms.
• Fever and skin hyperpigmentation are uncommon presenting signs of megaloblastic anemia.
• Differential diagnosis for pyrexia and hyperpigmentation includes various systemic conditions.

Observation:

• A patient presented with concurrent fever and skin hyperpigmentation.
• Initial investigations excluded infectious, inflammatory, autoimmune, and endocrine causes.
• The patient was diagnosed with megaloblastic anemia due to vitamin B12 and folate deficiency.

Findings:

• Megaloblastic anemia can manifest with unusual symptoms like fever and hyperpigmentation.
• This case represents an exceedingly rare simultaneous presentation of these symptoms.
• Exclusion of other causes was crucial for accurate diagnosis.

Implications:

• Highlights the importance of considering nutritional deficiencies in unexplained fever and hyperpigmentation.
• Suggests that vitamin B12 and folate deficiency should be investigated in patients with these rare presenting signs.
• Timely diagnosis and supplementation can lead to rapid and complete recovery.