Pel-Ebstein fever

Pel-Ebstein fever
Classification and external resources
eMedicine med/1770

Pel-Ebstein fever, also known as Ebstein-Cardarelli fever,[1] 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]

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]

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 Wilhelm Ebstein and 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. Interestingly, a long-term dispute persisted between Pel and Ebstein on the etiology of the condition.

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. 1 2 Mauch, Peter; James Armitage; Volker Diehl; Richard Hoppe; Laurence Weiss (1999). Hodgkin's Disease. Lippincott Williams & Wilkins. pp. 327–328. ISBN 0-7817-1502-4.
  3. 1 2 "eMedicine - Pel-Ebstein Fever : Article by Ephraim P Hochberg, MD". Retrieved 2007-07-08.
  4. ↑ Ree, HJ (1987). "Stromal macrophage-histiocytes in Hodgkin's disease. Their relation to fever". Cancer 60 (1479): 1479–84. doi:10.1002/1097-0142(19871001)60:7<1479::AID-CNCR2820600713>3.0.CO;2-G. PMID 3621125.
  5. ↑ Ebstein, Wilhelm (1887). "Das chronische Ruckfallsfieber, eine neue Infectionskrankheit". Berlin Klin Wochenschr 24 (565).
  6. ↑ Pel, PK (1887). "Pseudoleukaemie oder chronisches Ruckfallsfieber?". Berlin Klin Wochenschr 24 (565).
  7. ↑ synd/438 at Who Named It?
  8. ↑ Hilson, A.J.W.; DiNubile, M.J. (1995-07-06). "Correspondence". New England Journal of Medicine 333 (1): 66–67. doi:10.1056/NEJM199507063330118. PMID 7777006. Retrieved 2008-03-18.. They cite Richard Asher's lecture Making Sense (Lancet, 1959, 2, 359)
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