A NEW CAUSE OF PROLONGED FEVER OF UNDETER MINED ORIGIN - PROGESTERONESUBSTITUTION

Objectives: Over the last 3 years, we examined 15 patients on progeste rone substitution therapy who presented prolonged fever. Many explanat ions had been put forward before the diagnosis was suggested. We recal l the thermogenic effect of progesterone. Methods: Based on a retropec tive analysis, we reported the clinical and biological features of 15 patients with prolonged fever due to progesterone substitution therapy and prospectively followed the temperature curves of 9 menopaused wom en who received substitution therapy for the first time. Results: The 15 case reports were quite typical. Often onset occurred with an acute infectious episode. Following this episode, the patients continued to take their temperature and discovered persistant fever. The context w as often one of anxiety-depression rich in functional symptomatology. Laboratory findings included a normal sedimentation rate in all patien ts. Several days after treatment withdrawal temperature returned to no rmal. The prospective study confirmed the thermogenetic effect of almo st all progesterone substitution drugs. Conclusion: The thermogenic ef fect of natural progesterone is well known but it must be recalled tha t all progesterone agents with 5-beta metabolites have the same effect . Since metabolic clearance is long, the thermogenic effect may persis t for several days after withdrawal.