Violation Of Thermoregulation : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 23/08/2022

Violation of thermoregulation is a deviation of body temperature from normal values, which is usually accompanied by general malaise, body aches, and headaches. The symptom is caused by various reasons: external temperature factors, infectious processes, systemic inflammatory diseases, pathology of the endocrine organs, malignant tumors. To identify the etiological factor that caused thermoregulatory disorders, clinical and serological blood tests, a bacteriological method, and instrumental diagnostics are prescribed. Until the cause of the disorder is established, antipyretics are used with caution.

general characteristics

The temperature may rise gradually or abruptly over several hours. Often, prodromal phenomena first appear in the form of aches in the joints and muscles, headache, then a severe chill develops, the person shakes. The skin is cold to the touch and very pale. There is a characteristic gleam in the eyes. During the transition to the second phase and the development of persistent hyperthermia, chills are replaced by a feeling of heat, the skin becomes bright pink in color. The patient throws off his blankets, there is a strong thirst. There is an intense blush on the cheeks, the lips are dry and chapped.

The elevated temperature persists from several days to several months, depending on the cause of the violation of thermoregulation. With a decrease in fever, hyperhidrosis appears, headaches and muscle pains subside. With a rapid fall in numbers, pallor of the skin is observed, a sharp weakness up to collapse. Patients with abnormally low temperatures develop lethargy, acrocyanosis, and muscle tremors. As the condition progresses, drowsiness, problems with memory and concentration appear. Any violation of thermoregulation is a sufficient reason to consult a doctor.

Development mechanism

Normally, the thermoregulation system, the central link of which is located in the hypothalamus, maintains a constant thermal balance, independent of the temperature regime of the environment. High temperature is due to an increase in heat production processes - an increase in the breakdown of fats and carbohydrates with the release of energy, contractile muscle thermogenesis. The situation is aggravated in the case of joining heat transfer disorders: impaired sweating, vasoconstriction of the skin. Hypothermia is characterized by opposite changes: an increase in heat transfer, a decrease in heat production.

Fever, as a special reaction of the body to infectious and non-infectious causes, has a unique mechanism of development. For its occurrence, it is necessary to accumulate pyrogens in the bloodstream - special chemical compounds that act on the thermoregulation center and provoke a rise in temperature. These substances include exogenous factors - decay products of microbial cells and exotoxins, as well as endogenous cytokines - special blood serum proteins that are pro-inflammatory mediators. At the same time, a balance is maintained between production and heat transfer.

 

Classification

Violations in the thermoregulation system are endogenous and exogenous. Endogenous are caused by pathological processes occurring in the body: changes in the water and electrolyte balance and volume of circulating blood, endocrine pathologies, inflammation. The causes of exogenous disturbances are the influence of environmental temperature indicators, the inconsistency of clothing with the weather, the impact of chemical and radiation factors, and the waste products of bacteria. The classification according to the pathogenetic mechanism and clinical manifestations is widely used:

  • Hypothermia . Low body temperature - less than 35 ° C. The symptom often occurs under the influence of an external cause: hypothermia, bathing in cold water. Low temperature occurs with severe blood loss, shock and coma. Separately, therapeutic hypothermia is isolated, which is used in neurology and cardiac surgery to reduce the oxygen demand of tissues.
  • Hyperthermia . The rise in temperature over 37 ° C due to the breakdown of thermoregulation mechanisms. This condition is characterized by a long uncontrolled increase in temperature indicators. Absolute values ​​sometimes reach 43 ° C. The condition is observed with overheating and heat stroke, thyroid pathologies, hysteria, prolonged psycho-emotional overstrain.
  • Fever . A special type of elevated body temperature, which is characterized by the preservation of heat balance, but at a higher level than usual. The causes of fever are infectious (with all viral, bacterial and fungal diseases) and non-infectious (with traumatic brain injuries, malignant neoplasms, autoimmune processes).

According to absolute indicators, violations of thermoregulation are classified into subfebrile body temperature - 37-38 ° C, febrile - 38-39 ° C, pyretic (high) - up to 41 ° C and hyperpyretic - over 41 ° C. Hypothermia has 3 degrees: mild (32 -35 ° C), moderate (28-32 ° C) and severe - below 28 ° C. With a duration of symptoms up to 2 days, they speak of short-term fever, from 2 days to 2 weeks - acute fever, up to 6 weeks - subacute, in if the temperature rises for more than 6 weeks, chronic violations of thermoregulation are diagnosed.

According to fluctuations in temperature indicators during the day, several types of temperature curve are distinguished: constant, laxative, hectic, etc. A separate category of thermoregulation disorders includes chills, which occurs both during hypothermia and in the initial stage of fever. The cause of this symptom is a spasm of superficial blood vessels and increased uncoordinated contractions of small muscle groups (trembling). In addition to the above factors, the manifestation can cause fluctuations in female sex hormones, cardiovascular disorders.

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