A case of periodic fever--reevaluation of etiocholanolone fever as an established clinical entity

Abstract

A case of periodic fever is reported in a 28-year-old male. The patient's clinical and laboratory findings fulfilled diagnostic criteria for etiocholanolone fever (EF). The most crucial endocrine data comprised higher values of both urinary etiocholanolone/androsterone ratio and plasma unconjugated etiocholanolone on febrile days, as compared to the values on afebrile days. However, the author hesitates to promptly diagnose him as EF, because of arguments against EF as an isolated clinical entity, and also because of the presence of auto-antibodies suggestive of an early stage of collagen disease(s). If the patient should develop a florid collagen disease in later clinical course, this case could be another evidence against EF as an established clinical entity, thus a careful follow-up is needed.