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[Recurrent fever of unknown etiology lasting more than 6 months. Report on 85 patients]
Abstract:
85 patients having recurrent fever of unclarified aetiology of more than 38.5 degrees C for more than 6 months were examined in a prospective study. Of these, 10 had an inflammation due to pathogens, 12 a malignant disease, 15 a collagenous or inflammatory vascular disease, while 9 had various diseases, 5 a familial Mediterranean fever and 18 a "periodic fever". In 16 patients, in most of whom the course of the disease extended over several years, the cause of the fever could not be clarified. Among the patients with polycyclic fever over many years or decades, alternating with symptom-free intervals, one can differentiate especially the systemic Still's syndrome, which also occurs in adults and which is identical with the so-called subsepsis allergica, the familial Mediterranean fever and the "periodic fever". There are no satisfactory pointers towards the existence of a relapsing fever of its own caused by an increase of unconjugated aetiocholanolone in the plasma ("aetiocholanolone fever").
Insights
This study investigated recurrent fevers of unknown origin in 85 patients. Many cases were diagnosed, but some remained unclarified, highlighting the complexity of diagnosing periodic fever syndromes.
Area of Science:
- Internal Medicine
- Rheumatology
- Pediatrics
Context:
- Recurrent fever of unclarified etiology presents a diagnostic challenge.
- A prospective study examined 85 patients with prolonged, high-grade fevers.
Purpose:
- To investigate the causes of recurrent fever of unclarified etiology.
- To differentiate various inflammatory, infectious, malignant, and autoimmune conditions presenting with fever.
Summary:
- 10 patients had infections, 12 malignant diseases, 15 collagenous/inflammatory vascular diseases, 9 various diseases, 5 familial Mediterranean fever, and 18 periodic fever.
- In 16 patients, the fever's cause remained unclarified despite extensive investigation.
- Systemic Still's syndrome, familial Mediterranean fever, and periodic fever are key differential diagnoses for chronic relapsing fevers.
Impact:
- This research aids in understanding and diagnosing complex fever syndromes.
- Improved diagnostic criteria for periodic fever syndromes can be developed.
- Highlights the need for continued research into unclarified fever cases.