Thirty patients (19 females, 11 males), with a mean age of 42 +/- 21 y
ears, who presented a fever associated whith a normal sedimentation ra
te were prospectively studied, Mean fever duration at admission was 11
days (range: 1-90). Diagnosis included bacterial (12 cases) or viral
(9 cases) infections, malaria (2 cases), systemic diseases (2 cases),
abnormal temperature control (2 cases) and lymphoma (1 case). One pati
ent simulated fever, and in the remaining case fever was of unknown or
igin, Identified factors implied in the mechanisms of normal sedimenta
tion rate were: intravascular disseminated coagulation (5 cases), haem
olysis (5 cases), late increase of inflammatory proteins (8 cases), re
d blood cell abnormalities (7 cases), cryoglobulinaemia (1 case). This
study suggests that the striking association of fever and normal sedi
mentation rate should lend clinicians to look for plasma and red bloo
d cell abnormalities after ruling out a non inflammatory febrile disor
der.