Pel-Ebstein fever
Encyclopedia
Pel-Ebstein fever is a rarely seen condition noted in patients with Hodgkin's lymphoma
in which the patient experiences fever
s which cyclicly increase then decrease over an average period of one or two weeks. 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.
, and damaged stromal cells.
or treatment of the underlying Hodgkin's (usually with chemotherapy
) will help the symptoms.
and P.K. Pel who both published papers in 1887 noting the phenomenon. 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.
estimate only a 5-10% occurrence rate. 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?..."
Hodgkin's lymphoma
Hodgkin's lymphoma, previously known as Hodgkin's disease, is a type of lymphoma, which is a cancer originating from white blood cells called lymphocytes...
in which the patient experiences fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
s which cyclicly increase then decrease over an average period of one or two weeks. 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.
Causes
The cause is currently unknown although speculation centers on host immune response - particularly the cyclical release of cytokines, lymph node necrosisNecrosis
Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...
, and damaged stromal cells.
Treatment
Treatment with non-steroidal anti-inflammatory agentsNon-steroidal anti-inflammatory drug
Nonsteroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, but also referred to as nonsteroidal anti-inflammatory agents/analgesics or nonsteroidal Anti-inflammatory medicines , are drugs with analgesic and antipyretic effects and which have, in higher doses, anti-inflammatory...
or treatment of the underlying Hodgkin's (usually with chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
) will help the symptoms.
Eponym
The condition is named after Wilhelm EbsteinWilhelm Ebstein
Wilhelm Ebstein was a German physician.He studied medicine at the universities of Breslau and Berlin, graduating from the latter in 1859...
and P.K. Pel who both published papers in 1887 noting the phenomenon. 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
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
of the condition.
Controversy
Researchers have speculated whether this condition truly exists, since some authorities anecdotallyestimate only a 5-10% occurrence rate. In his Lettsomian Lecture Making Sense, delivered to the Medical Society of London in 1959, Richard Asher
Richard Asher
Richard Alan John Asher, FRCP was an eminent British Endocrinologist and Haematologist...
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?..."