eMedicine Specialties > Oncology > Special Topics in Oncology

Pel-Ebstein Fever: Follow-up

Author: Ephraim P Hochberg, MD, Instructor in Medicine, Cancer Center, Massachusetts General Hospital
Contributor Information and Disclosures

Updated: Jun 26, 2006

Follow-up

Further Inpatient Care

  • No particular inpatient requirements are indicated for the management of Pel-Ebstein fever.

Further Outpatient Care

  • No particular outpatient therapy is warranted.

Inpatient & Outpatient Medications

  • Antipyretics are a mainstay of therapy, along with chemotherapy for HL.

Complications

  • Several reported cases of hemolysis have been associated with Pel-Ebstein fever. Whether the degree of hemolysis is inappropriate for the degree of fever or whether this is merely a temperature-related hemolytic reaction has not been determined. Additionally, 2 cases of cyclic pancytopenia have been reported.

Prognosis

  • B-type symptoms are a negative prognostic factor for HL.

Patient Education

  • Patients should be educated on the appropriate timing of antipyretic therapy.

Miscellaneous

Medicolegal Pitfalls

  • The differential diagnosis of relapsing fever is a possible source of malpractice liability.
 


More on Pel-Ebstein Fever

Overview: Pel-Ebstein Fever
Differential Diagnoses & Workup: Pel-Ebstein Fever
Treatment & Medication: Pel-Ebstein Fever
Follow-up: Pel-Ebstein Fever
References
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References

  1. Colvett KL, Patel D, Smith JK. Multiple Beau''s lines in a patient with fever of unknown origin. South Med J. Dec 1993;86(12):1424-6. [Medline].

  2. Dankbaar H, Willemze R, Bieger R. Bone marrow disorders in Hodgkin''s disease: cyclic pancytopenia coinciding with Pel-Ebstein fever. Neth J Med. 1983;26(3):74-6. [Medline].

  3. Good GR, DiNubile MJ. Images in clinical medicine. Cyclic fever in Hodgkin''s disease (Pel- Ebstein fever). N Engl J Med. Feb 16 1995;332(7):436. [Medline].

  4. Hilson AJ. Pel-Ebstein fever [letter; comment]. N Engl J Med. Jul 6 1995;333(1):66-7. [Medline].

  5. Koopmans RP, van den Born BJ, Kersten MJ, Hart W. [Clinical reasoning and decision making in practice. A 41-year old with periodic fever of unknown origin]. Ned Tijdschr Geneeskd. Sep 13 2003;147(37):1778-83. [Medline].

  6. McKenna W, Lampert I, Oakley C, Goldman J. Pel-Ebstein fever coinciding with cyclical haemolytic anaemia and splenomegaly in a patient with Hodgkin''s disease. Scand J Haematol. Nov 1979;23(5):378-80. [Medline].

  7. Molina Boix M, Ortega Gonzalez G, Garcia Perez B, Perez Gracia A. [Pel-Ebstein fever, hemolytic anemia and Hodgkin''s disease (letter)]. An Med Interna. Jul 1989;6(7):388-9. [Medline].

  8. Racchi O, Rapezzi D, Ferraris AM, Gaetani GF. Unusual bone marrow relapse of Hodgkin''s disease with typical Pel- Ebstein fever. Ann Hematol. Jul 1996;73(1):39-40. [Medline].

  9. Reimann HA. Periodic (Pel-Ebstein) fever of lymphomas. Ann Clin Lab Sci. Jan-Feb 1977;7(1):1-5. [Medline].

  10. Storgaard L, Karle H. Fever and haemolysis in Hodgkin''s diseases. Acta Med Scand. Apr 1975;197(4):311-6. [Medline].

  11. Talbot TR. Cases from the Osler Medical Service at Johns Hopkins University. Hodgkin''s disease with Pel-Ebstein fevers. Am J Med. Mar 2002;112(4):312-3. [Medline].

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Further Reading

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Keywords

Pel-Ebstein fever, periodic fever of lymphomas, Hodgkin disease, Hodgkin's disease, HD, Hodgkin's episodic fever, Hodgkin episodic fever, B symptoms, B-type symptoms, Hodgkin lymphoma, Hodgkin's lymphoma, HL, lymphoma, lymphoma-related fever, relapsing fever, hemolysis, hemolytic anemia, periodic fever spikes

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Contributor Information and Disclosures

Author

Ephraim P Hochberg, MD, Instructor in Medicine, Cancer Center, Massachusetts General Hospital
Ephraim P Hochberg, MD is a member of the following medical societies: American Society of Clinical Oncology and American Society of Hematology
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey M Zaks, MD, Clinical Associate Professor of Medicine, Wayne State University School of Medicine; Vice President, Medical Affairs, Chief Medical Officer, Department of Internal Medicine, Providence Hospital
Jeffrey M Zaks, MD is a member of the following medical societies: American College of Cardiology, American College of Healthcare Executives, American College of Physician Executives, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Joseph F John Jr, MD, FACP, FIDSA, FSHEA, Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina; Associate Chief of Staff for Education, Ralph H Johnson Veteran's Administration Medical Center
Disclosure: BioMerieux Honoraria Review panel membership; Cubist Honoraria Review panel membership; Pfizer Honoraria Speaking and teaching; Merck Stock dividends stock holdings

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

John S Macdonald, MD, Professor of Medicine, New York Medical College; Chief, Division of Medical Oncology, St Vincent's Hospital and Medical Center; Medical Director, Saint Vincent's Comprehensive Cancer Center
Disclosure: Nothing to disclose.

 
 
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