Pel–Ebstein fever

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Pel–Ebstein fever
Other namesEbstein–Cardarelli fever[1]
Symptomsfever, enlargement of lymph nodes, night sweats

Pel–Ebstein fever is a rarely seen condition noted in patients with

Hodgkin's lymphoma in which the patient experiences fevers which cyclically increase then decrease over an average period of one or two weeks.[2] A cyclic fever may also be associated with other conditions, but it is not called "Pel–Ebstein fever" unless the fever is associated with Hodgkin's.[3]

Signs and symptoms

It is a special type of fever that cycles between a 3-10 day febrile period followed by the same length of afebrile period.

Causes

The cause is currently unknown although speculation centers on host immune response – particularly the cyclical release of

cytokines, lymph node necrosis, and damaged stromal cells.[4]

Diagnosis

Cyclical fevers normally require periodic temperature monitoring to detect, though it is possible one could sense subjective changes in body temperature as well. To count as Pel-Ebstein fever diagnostic workup for Hodgkin's lymphoma would be required as well if that diagnosis was not already made.[citation needed]

Treatment

Treatment with

non-steroidal anti-inflammatory agents or treatment of the underlying Hodgkin's (usually with chemotherapy) will help the symptoms.[2]

Eponym

The condition is named after

P. K. Pel who both published papers in 1887 noting the phenomenon.[5][6][7] Both doctors published in the same journal, though Pel published first by several months. A long-term dispute persisted between Pel and Ebstein on the etiology of the condition.[citation needed
]

Controversy

Researchers have speculated whether this condition truly exists, since some authorities anecdotally estimate only a 5–10% occurrence rate.[3] In his Lettsomian Lecture Making Sense, delivered to the Medical Society of London in 1959, Richard Asher refers to Pel–Ebstein fever as an example of a condition that exists only because it has a name. "Every student and every doctor knows that cases of Hodgkin's disease may show a fever that is high for one week and low for the next week and so on. Does this phenomenon really exist at all?..."[8]

References

  1. ^ G. Fradà – Semeiotica Medica nell' adulto e nell'anziano. Piccin p.48
  2. ^
    ISBN 978-0-7817-1502-7
    .
  3. ^ a b Hochberg, Ephraim P. "eMedicine – Pel–Ebstein Fever". Retrieved 2007-07-08.
  4. PMID 3621125
    .
  5. ^ Ebstein, Wilhelm (1887). "Das chronische Ruckfallsfieber, eine neue Infectionskrankheit". Berlin Klin Wochenschr. 24 (565).
  6. ^ Pel, P. K. (1887). "Pseudoleukaemie oder chronisches Ruckfallsfieber?". Berlin Klin Wochenschr. 24 (565).
  7. Who Named It?
  8. PMID 7777006.. They cite Richard Asher's
    lecture Making Sense (Lancet, 1959, 2, 359)

External links

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