Healthbeat Report: Frequent Fevers

May 29, 2009 Watching your child's temperature climb can be an unnerving ordeal. But imagine a fever that pops up every couple weeks with no known cause.

Fevers are common in childhood and the most likely culprits are viral or bacterial illnesses. But what happens when a fever keeps showing up for no apparent reason.

One suburban family discovered there is an explanation. But it took years to get a diagnosis and a treatment.

For the most part Danny Wilk is a typical 12-year-old. He's full of boundless energy and has a passion for baseball.

Almost nothing that could keep him from playing the game except for maybe one thing.

It's not that unusual for a child to occasionally get a temperature but for Danny fevers aren't random.

"For the first three years, it was every 21 days precisely. You could call the school and say on March 22st he's be out for three days," said Lori Wilk, mother.

The Wilks say for the past 5 1/2 years, Danny has been getting fevers like clockwork.

"Like 104 or 104.5 but not all the time that high," said Danny Wilk, patient.

Usually it was just the fever, no other symptoms. But these odd episodes were uncomfortable and they kept him out of school. Viral and bacterial infections were ruled out so were cancer and autoimmune diseases.

"Many many nights just soaking him in the tub to just bring the fever down," said Dave Wilk, father.

After seeing several specialists, the Wilks finally got an answer at Children's Memorial Hospital. Danny was diagnosed with periodic fever syndrome.

"What we see are children with fevers every 3 or 4 weeks sometimes less often but on a periodic recurrent basis the episodes last 3-4 days at at time and then the body is able to get back on top of things," said Dr. Michael Miller, pediatric rheumatologist, Children's Memorial Hospital.

For the most part fevers are actually a healthy response to help fight infection.

In cases like Danny's the body may think there's an infection when there isn't and the fever process starts anyway.

There is no easy explanation for these syndromes which are not contagious. The inflammatory process in the body seems to be activated but it's not clear why.

In some cases the disease is a result of genetic mutations. In others the cause is a mystery.

"We have over the course of the last 10 years here at the nih seen over 11-hundred patients with various periodic fever syndromes. And of them only about 25-percent have a mutation," said Dr. Daniel Kastner , rheumatologist/geneticist, NIAMS/NIH.

At the National Institutes of Health, researchers are producing groundbreaking results, pinpointing specific genes behind some of these cases. And while these fever syndromes are not common researcher Daniel Kastner suspects there are cases being missed.

"These diseases are under recognized and certainly it's important for there to be increased awareness of these diseases," said Kastner.

There is no cure but in many cases after several years the syndrome will eventually go away without any long term complications.

Danny's been fever free for more than 100 days. He's now taking a medication usually prescribed for gout that also seems to stop these fever attacks.

"So far for us it's working and we are so grateful," said Lori Wilk.

In most children with the non genetic from, the disease will resolve itself usually after age 10.

What doctors want to stress is that these fever syndromes are unusual. Even if you child gets a temperature several times a year there is no cause for alarm.

If you have concerns it's best to first consult a primary care physician.

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