[Fever with normal sedimentation rate. 30 cases]

Thirty patients (19 females, 11 males), with a mean age of 42 +/- 21 years, who presented a fever associated with a normal sedimentation rate prospectively studied. Mean fever duration at admission was 11 days (range: 1-90). Diagnosis included bacterial (12 cases) or viral (9 cases) infections, malaria (2 cases), systemic disease (2 cases), abnormal temperature control (2 cases) and lymphoma (1 cases). One patient simulated fever, and in the remaining case fever was of unknown origin. Identified factors implied in the mechanisms of normal sedimentation rate were: intravascular disseminated coagulation (5 cases), haemolysis (5 cases), late increase of inflammatory proteins (8 cases), red blood cell abnormalities (7 cases), cryoglobulinaemia (1 cases). This study suggests that the striking association of fever and normal sedimentation rate should lead clinicians to look for plasma and red blood cell abnormalities after ruling out a non inflammatory febrile disorder.