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[Fever with normal sedimentation rate. 30 cases]

E Mortier1, J Pouchot, H Gaudin

  • 1Service de Médecine V, Hôpital Louis-Mourier, Colombes.

Annales De Medecine Interne
|January 1, 1995
PubMed
Summary
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Fever with a normal sedimentation rate in patients may indicate underlying plasma or red blood cell abnormalities. Clinicians should investigate these factors after excluding non-inflammatory causes of fever.

Area of Science:

  • Internal Medicine
  • Hematology

Context:

  • Fever of unknown origin (FUO) presents a diagnostic challenge.
  • Normal erythrocyte sedimentation rate (ESR) is often associated with non-inflammatory conditions, complicating fever diagnosis.

Purpose:

  • To investigate the potential causes and associated hematological factors in patients presenting with fever and a normal sedimentation rate.

Summary:

  • A prospective study of 30 patients (mean age 42 years) with fever and normal ESR revealed diverse diagnoses including bacterial/viral infections, malaria, systemic diseases, and lymphoma.
  • Identified mechanisms for normal ESR included intravascular disseminated coagulation, hemolysis, late inflammatory protein increase, red blood cell abnormalities, and cryoglobulinemia.
  • One patient simulated fever, and one had fever of unknown origin.

Related Experiment Videos

Impact:

  • Highlights the importance of considering plasma and red blood cell abnormalities in patients with unexplained fever and normal ESR.
  • Suggests a diagnostic pathway prioritizing hematological evaluation when non-inflammatory febrile disorders are ruled out.