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Fever during a flare?

My 10 year old D is currently having a bad flare. Remicade isn't working anymore (antibodies) and she's being switched to Humira. She's been running a fever of 102 for the past three days with no other symptoms. I remember before she was diagnosed that she would get random fevers with no other symptoms, but they would usually only last a day. But nothing that went on for days.

Is that a common with a flare? (I took her to her pediatric and they didn't see anything that would indicate strep or other specific viruses).
 

my little penguin

Moderator
Staff member
Definitely talk to her Gi as well
Humira takes 3-5 months to take be effective
She may need bridge therapy until then
Such as een or steroids
Hope they have answers soon
 
Absolutely! Any inflammation in the body can result in a fever.

She definitely needs a bridge therapy. They shouldn't let a flare take hold otherwise it will be hard to get ahead of it.

I would also call GI. They may want labs (blood and stool) to rule out other infections before they simply assume inflammation and suppress her immune system with steroids.
 

Maya142

Moderator
Staff member
Yes, inflammatory fevers do occur. My daughter has low grade fevers but only when she is flaring. Once the disease is mostly controlled, her temp. is completely normal. I'd tell her GI.

Humira can kick in quickly or can take time. Are they doing a loading dose for your daughter? The loading dose is 160 mg (Four 40 mg shots) on day 0, 80 mg (Two 40 mg shots) on day 15 and then 40 mg every other week. My younger daughter was on Humira twice, and the first time she was put on it, it took 6 whole months to kick in and we had to increase the dose to weekly before it worked. The second time, we did the loading doses and she started improving much more quickly - i'd say it took about 6 weeks or so.

So a loading dose can really help. Also remember that the new version of Humira that is citrate free - the new version apparently doesn't burn at all. The old one, with citrate, really, REALLY burned when injected, so the 4 shots for the loading dose were hard on many kids. But now they're supposed to be much less painful.
 
Thanks for all the responses. The GI did a stool test to make sure she didn't have other infections that we didn't know about and everything came back negative. So he prescribed a course of Prednisone that she started last the weekend. The fever was gone 24 hours later. Whether that is because it had run its course or the steroids were helping, who knows. But I don't think it is a bad thing for her to be on the steroids regardless. She also had her first Humira injection this morning (80mg loading dose in the syringe--because of her weight she is on the lower dose). She barely blinked. So I'm really relieved about that and feel badly for all the parents and kids who had to deal with the Humira that burned. Fingers crossed that it starts to work soon.
 

Maya142

Moderator
Staff member
Glad the shots went well!! The old Humira was awful, so I'm really glad the new Humira hurts much less!! That's wonderful! Hope she starts improving soon. Fwiw, my daughter's fevers (which are low grade - up to 100.5) disappear completely on steroids, which is why they are considered inflammatory.
 
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