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Pel–Ebstein fever

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]

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

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]

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

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. A long-term dispute persisted between Pel and Ebstein on the etiology of the condition.^{[citation needed]}

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]