Fever and Immune Disorders: Insights on Symptoms and Blood Tests - Internal Medicine

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Fever and immune disorders can be complex and multifaceted, often requiring careful evaluation and interpretation of symptoms and laboratory results. Your experience of experiencing slight elevations in body temperature, particularly in the evening or after periods of fatigue, can be indicative of several underlying conditions. It is important to understand that a mild fever, defined as a body temperature between 37.0°C (98.6°F) and 38.3°C (100.9°F), can be a normal physiological response to various stimuli, including physical exertion, stress, or even the body's circadian rhythm.

In your case, the fluctuations in temperature that you describe could be related to your underlying condition of ankylosing spondylitis (AS), which is a type of inflammatory arthritis that primarily affects the spine and can lead to systemic inflammation. Patients with AS may experience periods of increased inflammation, which can manifest as fever, fatigue, and malaise. The fact that your temperature returns to normal after rest suggests that it may not be a persistent infection but rather a response to inflammation or fatigue.

Regarding your blood test results, the increase in your monocyte (Mono) count from 5.4 to 11.1 over the past year is noteworthy. Monocytes are a type of white blood cell that plays a role in the immune response, particularly in fighting off infections and in inflammation. An elevated monocyte count can indicate several conditions, including chronic inflammation, infection, or even hematological disorders. In the context of your known autoimmune condition, it is possible that the increase in monocytes is a reflection of ongoing inflammation related to your ankylosing spondylitis. It is essential to monitor these levels in conjunction with your clinical symptoms and any other laboratory findings.

On the other hand, the decrease in lymphocyte (Lymp) count from 123 to 107.6 could be concerning, depending on the reference range used by your laboratory. Lymphocytes are another type of white blood cell that are crucial for the immune response, particularly in fighting viral infections and in the regulation of the immune system. A significant drop in lymphocyte count can indicate an underlying issue, such as an acute infection, stress response, or even a more chronic condition affecting the immune system. However, slight fluctuations in lymphocyte counts can also occur due to various benign factors, including hydration status, time of day, and recent physical activity.

Given your history of ankylosing spondylitis and the recent changes in your blood work, it is advisable to consult with your healthcare provider or a specialist in rheumatology or immunology. They can provide a more comprehensive evaluation, considering your symptoms, medical history, and laboratory results. They may recommend further testing, such as inflammatory markers (e.g., C-reactive protein or erythrocyte sedimentation rate), imaging studies, or even a referral to a hematologist if there are concerns regarding your blood counts.

In summary, your symptoms of low-grade fever and the changes in your blood work may be interconnected and warrant further investigation. It is crucial to maintain open communication with your healthcare team to ensure that any underlying issues are addressed promptly and appropriately. Regular follow-up and monitoring of your condition will help in managing your ankylosing spondylitis and any associated symptoms effectively.