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October 14, 1974

Periodic Fever

Author Affiliations

Foothills Hospital Calgary, Alberta, Canada

JAMA. 1974;230(2):208. doi:10.1001/jama.1974.03240020016004

To the Editor.—  I read with interest the article by Reimann and McCloskey on periodic fever (228:1662, 1974). I think it is worthwhile to record a similar case of eight years' duration in which the patient's physicians were not frustrated by an "absence of effective therapy."Our patient, examined at Prince Henry's Hospital in Melbourne, Australia, is a 66-year-old English-born, retired industrial inspector, who experienced periodic episodes of fever, beginning in 1956. Each episode consisted of chills, malaise, anorexia, constipation, muscle stiffness, and fever to 40 C (104 F). There was predictable cyclicity to his episodes, which occurred every 21 days, lasted five to seven days, and completely disappeared in the interval.Interesting differences from the case of Reimann and McCloskey occurred in this patient. He had a noticeable urinary sediment consisting of amorphous urates and selective proteinuria and transient biochemical abnormalities with each episode. Elevated erythrocyte sedimentation rate, slight