Blood disease fever

Blood diseases are more serious diseases of the hematopoietic system. Fever, anemia, and bleeding are the biggest characteristics of this type of disease. There are many causes for blood diseases. Chemical factors, physical factors, biological factors, and genetics are all common causes. We must be aware of the main blood diseases and receive timely treatment once they occur to avoid serious impacts on our health.

1. Hemolytic anemia

Hemolytic anemia may cause low or moderate fever, rarely high fever. Clinically, acute hemolytic anemia is mostly induced by the use of drugs (such as antipyretic analgesics, sulfonamides, etc.) or infection. The mechanism by which hemolytic anemia causes fever may be related to red blood cell destruction and the primary disease that causes hemolysis (such as connective tissue diseases). Common febrile hemolytic anemias include thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, other intravascular hemolysis, and autoimmune hemolytic anemia.

Fever caused by hemolytic anemia is often accompanied by anemia and hemolysis, and the body temperature gradually returns to normal as the hemolysis is controlled. Hemolytic anemia caused by malaria can cause high fever, chills, sweating, etc. The clinical manifestations of acute hemolytic anemia are sudden high fever, abdominal pain, vomiting, back pain, anemia, jaundice and tea-colored urine. In severe cases, shock and acute renal failure may occur. The course of the disease lasts from 1 to 2 days to about 1 week.

2. Malignant histiocytosis

The disease is usually characterized by high fever, which may persist or occur irregularly. The onset is acute, the course is short, and the prognosis is poor. The disease is often accompanied by hepatosplenomegaly, lymphadenopathy, jaundice, pancytopenia and progressive systemic failure. The mechanism by which malignant tumors cause hyperthermia is unknown. Definitive diagnosis depends on bone marrow or other site biopsy to detect abnormal tissue cells and to exclude reactive histiocytosis.

3. Hemophagocytic syndrome

The onset is generally acute, the course of the disease progresses rapidly, and fever is often accompanied by anemia, bleeding, hepatomegaly, and even liver failure. The disease can be caused by various infections (such as EBV, parasites), diseases, and blood diseases, especially lymphoma. When diagnosing, attention should be paid to finding the cause. For reactive hemophagocytic syndrome caused by infection, the infection should be controlled and then the fever should be controlled.

4. Aplastic Anemia

Aplastic anemia itself does not cause fever; the fever is caused by secondary infection. Severe aplastic anemia has an acute onset and often presents with high fever early on. Due to the lack of granulocytes, the cells that mediate inflammatory responses are significantly reduced, the symptoms and signs of infection are usually mild, the infection foci are not easy to be localized, and auxiliary examinations are not easy to find meaningful clues. In addition to fever, aplastic anemia is also accompanied by anemia and bleeding, but the liver, spleen, and lymph nodes are generally not enlarged, and the peripheral blood picture shows three deficiencies, with a decrease in reticulocytes.

5. Lymphoma

Lymphoma fever may be persistent or periodic, usually low-grade and unresponsive to antibiotics. Adrenal cortex hormone and chemotherapy are effective. This type of fever is accompanied by symptoms of lymphoma, such as superficial or deep lymph node enlargement, widened mediastinum, hepatosplenomegaly or gastrointestinal infiltration, skin infiltration, and may also be accompanied by weight loss, night sweats, chest, ascites, abdominal masses, etc.

There are many causes of fever in lymphoma, mainly the following: (1) Various cytokines produced by tumor cells and macrophages, such as interleukins, tumor necrosis factor, and interferon, act as endogenous pyrogens on the body temperature regulation center and cause an increase in body temperature; (2) Lymphoma patients are susceptible to infection by various bacteria, viruses, and fungi due to low immune function or local compression of the tumor resulting in poor drainage; (3) Lymphoma cells invade the central nervous system and cause changes in body temperature.

Lymphoma cells can be detected through pathology. Some patients develop into the lymphoma leukemia stage, and tumor cells can be seen in the peripheral blood and bone marrow.

6. Acute Leukemia

Leukemia is a malignant disease caused by the tumorous proliferation of immature cells in the bone marrow and its hematopoietic tissue. It can cause tumor fever itself, or it can cause various infection-related fevers secondary to neutropenia or reduced immune function. The fever of leukemia is occasionally high fever, occasionally low fever, and the fever pattern is often irregular. Low-grade fever is generally considered to be tumor-related fever, while high-grade fever indicates the presence of secondary infection. There are also cases of high fever without infection. Antibiotics are ineffective for people without infection. In addition to fever, leukemia patients often have anemia, bleeding, enlarged liver, spleen, lymph nodes, bone and joint pain, etc. It is not difficult to make a diagnosis through leukemia-related examinations.

7. Bone Marrow Necrosis

Regardless of the cause of bone marrow necrosis, it can cause fever, even high fever. The cause may be related to the primary disease that causes bone marrow necrosis, as well as abnormal immunity and heat absorption by necrotic tissue. This type of fever is difficult to control. Most have a poor prognosis.

8. Fever related to hematologic disease treatment

Chemotherapy for malignant blood diseases, especially the prevention and treatment of central nervous system leukemia, can cause chemotherapy-irritant vasculitis and meningitis, and then fever; blood transfusion and the use of blood products and biological products can cause immune fever due to heat sources.

9. Hematologic diseases combined with infectious fever

It is very common that the use of antibiotics to control infection can also lead to "antibiotic fever".

10. Infectious Mononucleosis

It is more common in children and adolescents. It is caused by Epstein-Barr virus infection. Clinical manifestations include fever, pharyngitis, and lymphadenopathy. Fever is often high and lasts for 1 to 2 weeks. Superficial lymphadenopathy throughout the body and abnormal liver function. Laboratory examinations showed peripheral blood lymphocytosis and EBV test was positive.