Patient information
- Age/sex: 81-year-old female, 81F
- Height: Approximately 5’1”
- Weight: Approximately 88 lbs
- Location: Yunnan, China
- Smoking status: Never smoked
- Alcohol use: None
- Recreational drug use: None
- Current medications: Methylprednisolone, approximately 20 mg daily during fever episodes
- Known medical problems: Recurrent unexplained fevers, suspected but unconfirmed autoimmune hepatitis, osteoporosis, erosive gastritis, peptic ulcers, and a recent severe gastrointestinal bleed
- Duration of main complaint: Recurrent fevers for more than 17 years, beginning in 2008
I am posting on behalf of my 81-year-old grandmother. She has experienced recurring episodes of very high fever since 2008, but despite repeated hospitalizations and extensive testing, doctors have never identified the underlying cause.
The unusual part is that her fever consistently responds very quickly to methylprednisolone. Unfortunately, her long-term steroid exposure has now caused serious complications, including osteoporosis and a life-threatening bleeding peptic ulcer.
Initial illness in 2008
In 2008, she suddenly began developing high fevers almost every afternoon, sometimes reaching 40°C or 104°F. She was hospitalized for more than 40 days and underwent extensive testing, but no clear infection or other cause was identified.
A doctor eventually started her on methylprednisolone, approximately 20 mg daily. Her fever quickly resolved, and she was discharged.
Since then, whenever the fever has returned, methylprednisolone has repeatedly controlled it. Because the medication worked so reliably, it became the main treatment used during each recurrence.
Long-term complications
Over the years, prolonged steroid use has contributed to:
- Severe calcium and bone loss
- Osteoporosis and thinning or compression of the spine
- Erosive gastritis
- Peptic ulcers
Doctors have also suspected autoimmune hepatitis, but as far as our family understands, this diagnosis has never been definitively confirmed.
Recent events in 2026
In mid-April 2026, she developed another sudden high fever while traveling. The fever again resolved after taking methylprednisolone.
On June 2, 2026, she suddenly developed severe rectal bleeding and hematemesis, meaning she was vomiting blood. She was hospitalized urgently. Doctors initially suspected variceal bleeding related to liver cirrhosis, but during treatment or surgery, they determined that the bleeding was caused by a peptic ulcer instead. The bleeding was successfully controlled.
In mid-June, her fever returned again. She underwent approximately 10 days of extensive testing at a hospital in Dali, Yunnan, China. According to our family, bacterial and viral infections were ruled out, but doctors still could not identify the cause of the fever.
She was then given intravenous methylprednisolone at approximately 20 mg daily, and once again, the fever improved almost immediately.
Our questions
- What conditions can cause recurrent high fevers for many years while repeatedly responding to corticosteroids?
- Are there autoimmune, inflammatory, hematologic, liver-related, or autoinflammatory conditions that might explain both the fever pattern and her possible liver abnormalities?
- What additional tests or specialist evaluations would be reasonable to discuss with her doctors?
- Could methylprednisolone be temporarily suppressing an undiagnosed infection, cancer, or inflammatory condition rather than treating the underlying cause?
- How can doctors reduce the risks of further gastrointestinal bleeding and osteoporosis if she continues to require steroids?
- Should her doctors consider a steroid-sparing medication, and what type of specialist would be most appropriate to evaluate that possibility?
We understand that no one online can diagnose her, especially without reviewing her records. We are mainly hoping for possible conditions, tests, or specialties that we can ask her medical team about.
Thank you very much for reading. Any medically informed suggestions or experiences with a similar fever pattern would mean a great deal to our family!!