Oka Takakazu
Department of Psychosomatic Medicine, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-8520, Japan.
Biopsychosoc Med. 2024 Mar 26;18(1):9. doi: 10.1186/s13030-024-00306-8.
I previously reported a case of functional hyperthermia (FH) in a patient with an axillary temperature just slightly above 37.0 °C who persistently requested treatment. Because the severity of her fatigue increased remarkably when her axillary temperature increased above 37.0 °C, she felt that the temperature of 37.0 °C was disabling. In the present study, I analyzed a larger number of patients with FH to investigate the incidence of disabling symptoms with increasing body temperature, the kinds of symptoms associated with increased body temperature, and the temperatures at which these symptoms became disabling.
Twenty patients with FH (7 men, 13 women; mean age ± standard deviation, 31.2 ± 10.9 years) who visited my department were asked whether they had any disabling symptoms associated with an increase in axillary temperature and, if so, at what temperature the symptoms became disabling. Sixteen of 20 patients (80.0%) responded that they had such symptoms, which included worsening of general fatigue (n = 12, 75.0%), feelings that their brain did not work properly (n = 5, 31.3%), inability to move (n = 4, 25.0%), hot flashes/feeling of heat (n = 3, 18.8%), headache (n = 2, 12.5%), dizziness (n = 2, 12.5%) and anorexia (n = 1, 6.3%). The axillary temperatures at which patients felt worsening fatigue ranged from 37.0 °C to 37.4 °C in 7 of the 12 patients (58.3%) who experienced worsening fatigue. The patients also reported that the disabling symptoms, with the exception of headache, were not alleviated by antipyretics.
Many patients with FH reported worsening fatigue as a disabling symptom associated with increased axillary temperature; more than half of those patients experienced worsening fatigue in the temperature range of 37.0 °C to 37.4 °C. These findings suggest that the reasons patients with FH consider 37 °C disabling and seek medical treatment are that physical symptoms such as fatigue worsen at 37 °C, although this temperature is assumed by many physicians to be within the normal range or just above the normal range of axillary temperature, and that most hyperthermia-associated symptoms are not alleviated by antipyretic drugs.
我之前报告过一例功能性体温过高（FH）患者，其腋窝温度略高于37.0°C，且一直要求治疗。由于当她的腋窝温度高于37.0°C时，疲劳严重程度显著增加，她觉得37.0°C的体温使人丧失能力。在本研究中，我分析了更多的FH患者，以调查随着体温升高致残症状的发生率、与体温升高相关的症状种类以及这些症状变得致残时的体温。
20例前来我科室就诊的FH患者（7例男性，13例女性；平均年龄±标准差，31.2±10.9岁）被询问是否有与腋窝温度升高相关的致残症状，若有，症状在什么温度时变得致残。20例患者中有16例（80.0%）回答有此类症状，包括全身疲劳加重（n = 12，75.0%）、感觉大脑运转不正常（n = 5，31.3%）、无法活动（n = 4，25.0%）、潮热/发热感（n = 3，18.8%）、头痛（n = 2，12.5%）、头晕（n = 2，12.5%）和食欲不振（n = 1，6.3%）。在经历疲劳加重的12例患者中，有7例（58.3%）感到疲劳加重时的腋窝温度范围为37.0°C至37.4°C。患者还报告称，除头痛外，退热药并不能缓解致残症状。
许多FH患者报告疲劳加重是与腋窝温度升高相关的致残症状；超过一半的患者在37.0°C至37.4°C的温度范围内经历疲劳加重。这些发现表明，FH患者认为37°C使人丧失能力并寻求治疗的原因是，尽管许多医生认为这个温度在腋窝温度的正常范围内或略高于正常范围，但疲劳等身体症状在37°C时会恶化，而且大多数与体温过高相关的症状不能通过退热药缓解。
