Recurring Fever

[fourss]

I have read all of the comments back to 2006.  What was ever discovered?  My seven year old is starting with a pattern of fevers.  Three this year and the last two were only 3 weeks apart.  Her second fever showed possitive for strep but the antibiotic didn't help.  She was sick with a fever for 6 days.  Four after the antibiotics were started.  Just as I am about to go back to the doctor the fever goes away.  This time, the fever is low in the AM and higher in the evening?  Thanks for any comments.


This discussion is related to 7 year old son with recurring fever.

[suztew3]

my niece has recurring fevers. it comes back almost every two weeks and lasts for like 2 days. shes been through so much and has had so many tests done.. now her doctors think she may have  whats called TRAPS The hereditary periodic fever syndromes are a group of disorders characterized by recurrent episodes or, in some cases, fluctuating degrees of fever and localized inflammation,1,2 initially described as affecting primarily the serosal and synovial surfaces and the skin, but now recognized to include a somewhat broader distribution of affected tissues. The prototypic and probably most common hereditary periodic fever syndrome is familial Mediterranean fever (FMF). The hereditary periodic fevers now also include the tumor necrosis factor (TNF) receptor–associated periodic syndrome (TRAPS), the hyperimmunoglobulinemia D with periodic fever syndrome (HIDS), and three different clinical disorders all caused by mutations in CIAS1, which encodes a protein denoted cryopyrin or NALP3.
The hereditary periodic fevers differ from autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis in that they lack high-titer autoantibodies or antigen-specific T-cells; they are termed autoinflammatory diseases (Table 1) to highlight this distinction.2 A number of other illnesses have subsequently been included under the autoinflammatory rubric, including Mendelian disorders such as Blau syndrome, as well as conditions with a more complex mode of inheritance, such as Behçet’s disease. Recent advances in the genetics and molecular biology of the hereditary periodic fever syndromes have defined important new gene families and pathways in the regulation of innate immunity, thus substantiating the distinction from autoimmune disorders, which more directly affect the adaptive immune system. Insights into the pathogenesis of the hereditary periodic fevers have also catalyzed dramatic advances in targeted biologic therapies for some of these conditions.

[merc1]

I have a 4 1/2 year old boy. For the past year he has had a fever of 105 for 5 days about every 2 months. They are always beging with neck pain. He was also a GERD baby. Have you found anything out?

[2wildboys]

I have a 22 month old with recurring fevers since February.  No other symptoms.  Had bloodwork done, many finger pricks, urine tests, trip to the ER w/ a high white count during one episode.  No diagnosis.  Infectious Disease will not see us until he's had these for a longer period.  I am wondering if it's possibly an allergy.  I think this is his 10th episode in 5 months.  High fever of 105+ on occasion.  Otherwise he's fine.  Developmentally very ahead of the curve.  Now they are checking his blood weekly to check his neutrophils to see if they spike or fall before an episode.  Nothing yet.  I have read some with PFAPA have issues resolved with removal of tonsils.  My son has no mouth ulcers though, which is inconsistent with PFAPA.

[daddy_JT]

I have an almost four year old with recurring fevers like clockwork since last September.  First, the following link provides a good bit of information regarding PFAPA but also other similar disorders, some of which of very similar symptoms to the what you have stated.  

http://my.clevelandclinic.org/disorders/periodic_fever_syndrome/rheumatology_overview.aspx

We have also been through an infectious disease specialist (House M.D., anyone?), and other specialists, we've run through $6k worth of blood tests to no avail trying to figure this thing out.  We visited an allergist to determine what allergies he may have that may be causing it, and learned a good deal about our bodies defenses and specific things he was allergic to, but still no clear indication of the cause.  

After going to various medical doctors with minimal success and large medical bills, we were referred to a chiropractor who practices CRA, or Contact Reflex Analysis (based on the success stories of two different individuals we know personally).  We are still pretty skeptical, but he diagnosed a Hiatal Hernia as we were going through the sequence of tests just that quickly.  Bizarre, but that diagnosis fits other symptoms he has or has had earlier in his life (GERD).  He has seen two other gastroenterologists previously who failed to determine this.  Hiatal Hernia is usually not a real problem (will go away as the child grows) and is also not something that can be easily diagnosed (endoscopy or special barium swallow xray) Of course, our initial thought was "this still doesn't address his periodic fevers (he has been diagnosed with PFAPA, which medically means, "we've run all the tests, we know what is isn't, yet we haven't got the foggiest idea, so lets just lump these cases all together with an acronym!").  But then, I came across the reference to “cimetidine,” a medicine that is used to treat stomach ulcers, that has reportedly prevented attacks from occurring in some patients.  “Cimetidine belongs to a class of medications called histamine H2-antagonists. Histamine is a natural chemical that stimulates stomach cells to produce acid. Histamine H2-antagonists inhibit the action of histamine on the acid-producing cells of the stomach and reduce stomach acid.”  Ok, so here is a potential link between this Hernia and the fevers.  So with that in mind, please answer the following Q’s:

1.  Does anybody's child with periodic fever syndrome have a history with GERD or reflux now or when younger?
2.  Does your child's stomach appear to “stick out” a little more than normal (for the rest of their body frame)?  
3.  Do they eat regular meal sizes or get full easily but want to eat again within 15-20 minutes (focusing on abnormal eating habits vs. typical kids wanting to snack)?

Basically, I am grasping at straws trying to make sense of this strange “disorder” which spikes my child’s temp every month.  I am not a doctor, (though I did stay at a holiday inn recently ;-) ) but the doctor’s we’ve seen don’t have any more of a clue than we do anyway.  Anyone observe other “different” habits/characteristics in their child?

[kthompsnp]

Do a web search on PFAPA (Periodic Fever Aphthous Stomatitis Adenitis) and see if these symptoms match your child! - I have a 15 month old that has been spiking a fever every 3-4 weeks for 6 months now...well between fevers, not feeling bad between or during the fevers.  This is the only think I can find that may match.

[tnybatmom]

I have a two year old who has had problems since she was born with developmental mile stones not being reached.  she has been sick at least once a month for over a year with fevers and she has had lots of tests from eeg, ekg, full body xrays, genetic testing and more. she has been treated for all the same things with no real relief. the fevers just pop up with no warning. they will get as high as 104-105 for 2-4 days and then it just disappears. when we give her the tylenol and motrin she does ok for about 2 hours and then her fevers goes right back up as if the medicine barely helps at all sometimes. she was just tested for a kidney problem and arthritus. she has been complaning about her joints and other parts of her body hurting ( do not know if this related to her fevers or not because she complains about her joints when she is not feverish also, she is hypertonic). the only difference this time is she says her mouth hurts. But her dr said the only thing she could see was the fever. Her fevers also happen 3-5 weeks apart. my sister-in -law said that when she was younger she had similar fever occurances and that is  how she lost her hearing. she ended up with nerve damage because the fevers were so high. so we are going to keep on eye on her hearing. i wish i knew what was the matter. i am just tired of all the testing with no answers.