PMID- 7684743
OWN - NLM
STAT- MEDLINE
DCOM- 19930701
LR  - 20131121
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 76
IP  - 6
DP  - 1993 Jun
TI  - Recurrent fever associated with progesterone action and persistently elevated 
      serum levels of immunoreactive tumor necrosis factor-alpha and interleukin-6.
PG  - 1594-8
AB  - We describe two women who suffer from recurrent fever up to 40 C in association 
      with progesterone action and who have continuously elevated serum levels of 
      immunoreactive tumor necrosis factor-alpha (TNF alpha) and interleukin-6 (IL-6). 
      In patient 1, recurrent fever began at age 17 yr and has now continued for 11 yr. 
      The patient has had three early pregnancy terminations because of continuous 
      fever and, thereafter, three early pregnancy losses associated with fever. In 
      patient 2, fever first appeared at age 18 yr, and the attacks have now continued 
      for 3 yr. The association between fever and progesterone action is supported by 
      the following facts. 1) The episodes of fever appear in the midluteal phase of 
      the menstrual cycle concomitantly with the highest concentration of serum 
      progesterone. 2) Fever is further exaggerated in early pregnancy. 3) Synthetic 
      progestins induce fever regardless of the day of the menstrual cycle. 4) The 
      progesterone antagonist RU 486 and an agonist of GnRH, nafarelin, are capable of 
      preventing the fever, with no effect on serum cytokine levels. Although the 
      underlying mechanism of elevated TNF alpha and IL-6 levels in our patients 
      remains unknown, the data suggest that these cytokines cooperate with 
      progesterone in exerting a pyrogenic response in the hypothalamic 
      thermoregulatory center.
FAU - Rutanen, E M
AU  - Rutanen EM
AD  - Department II of Obstetrics and Gynecology, Helsinki University Central Hospital, 
      Finland.
FAU - Teppo, A M
AU  - Teppo AM
FAU - Stenman, U H
AU  - Stenman UH
FAU - Tiitinen, A
AU  - Tiitinen A
FAU - Fyhrquist, F
AU  - Fyhrquist F
FAU - Ylikorkala, O
AU  - Ylikorkala O
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Acute-Phase Proteins)
RN  - 0 (Cytokines)
RN  - 0 (Interleukin-6)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 1X0094V6JV (Nafarelin)
RN  - 320T6RNW1F (Mifepristone)
RN  - 4G7DS2Q64Y (Progesterone)
SB  - IM
MH  - Acute-Phase Proteins/analysis
MH  - Adolescent
MH  - Adult
MH  - Cytokines/blood
MH  - Female
MH  - Fever/drug therapy/*etiology
MH  - Humans
MH  - Interleukin-6/*blood
MH  - Luteal Phase
MH  - Mifepristone/therapeutic use
MH  - Nafarelin/therapeutic use
MH  - Progesterone/blood/*physiology
MH  - Radioimmunoassay
MH  - Recurrence
MH  - Tumor Necrosis Factor-alpha/*analysis
EDAT- 1993/06/01 00:00
MHDA- 1993/06/01 00:01
CRDT- 1993/06/01 00:00
PHST- 1993/06/01 00:00 [pubmed]
PHST- 1993/06/01 00:01 [medline]
PHST- 1993/06/01 00:00 [entrez]
AID - 10.1210/jcem.76.6.7684743 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 1993 Jun;76(6):1594-8. doi: 10.1210/jcem.76.6.7684743.