Pyrogenic Cytokines Did Not Mediate a Stress Interview-Induced Hyperthermic Response in a Patient With Psychogenic Fever: A Case Report

Authors:
  • TOTakakazu Oka
    Takakazu Oka
  • KYKazufumi Yoshihara
    Kazufumi Yoshihara
  • CKChiharu Kubo
    Chiharu Kubo
Publisher website
Google Scholar
Abstract
To investigate if pyrogenic cytokines mediated psychological stress-induced hyperthermic response in a patient with psychogenic fever. Despite many case reports on psychogenic fever, the mechanism responsible for how psychological stress increases core body temperature (Tc) in humans is not yet known. A 13-year-old girl with fever (>38°C) of unknown causes was referred to our department because psychogenic fever was suspected. To determine if the fever was actually induced by psychological stress, we conducted a 60-minute stress interview. Her baseline oral temperature was 36.60°C and it began to increase immediately after commencement of the interview, reaching a maximum of 37.42°C 20 minutes after the end of the interview. The plasma level of prostaglandin E2 and the serum interleukin-6 level were increased 90 minutes after the interview. Serum levels of interleukin-1α, interleukin-1β, and macrophage inflammatory protein-1α were all less than their minimum detectable level throughout the observation period. We also measured the patient's thermal preference by immersing her hands in warm (40°C) and cold (20°C) water. Her preference changed from cold to warm only during the increasing phase of oral temperature. This case report shows that a stress interview actually increased Tc in a patient with psychogenic fever. This study suggests that, although pyrogenic cytokines are not involved, the stress interview-induced increase in Tc was an active hyperthermia under the control of the brain, as is infection-induced fever.

This publication has 31 references indexed in Scilit: