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Relapse and Remission

*Recidivus, Remissio*

For medical students2 min readUpdated 2026-10-10

Relapse is the return or intensification of symptoms following a quiescent period of a disease. Remission represents a temporary alleviation or complete disappearance of pathological signs.

CyclicalityRemission is frequently a natural stage followed by a relapse.

Clinical pictureRelapse symptoms typically repeat the initial ones, but can sometimes be modified.

Types of remissionDistinguished into complete (disappearance of symptoms) and incomplete (alleviation).

ExamplesRelapsing fever, malaria, juvenile idiopathic arthritis.

Essence of Relapse

Recidivus refers to the recurrence of a disease after it has been managed or significantly alleviated. It is important to note that the clinical presentation during a relapse most often duplicates the initial presentation. However, there are exceptions: for example, in chronic myeloid leukemia, a recurrent flare-up may manifest primarily with signs of anemia rather than the symptoms typical of disease onset.

Classification of Remissions

The remissio period is a temporary lull in the pathological process. Depending on the depth of this process, the following are distinguished:

Complete remission: temporary but complete elimination of all clinical signs of the disease.
Incomplete remission: a state in which symptoms persist, but their severity is substantially reduced.

For a number of diseases, such as malaria or relapsing fever, the alternation of remissions and relapses is a natural stage of development.

Complications and Other Outcomes

In addition to cyclical changes, a disease may be accompanied by the development of secondary pathological processes. They are not obligatory for the underlying disease, but arise as a result of its causes or pathogenetic mechanisms. A striking example is the development of angiopathies or comatose states in diabetes mellitus. In unfavorable cases, the disease may become chronic or lead to death.

Mnemonic

Relapse = Re- (again) + lapse (fall): the disease 'falls back' onto the body. Remission = Re- (again) + mission (mission accomplished): the disease temporarily retreats.

Frequently asked questions

What risk factors and conditions contribute to breaking remission and developing a relapse?

Factors and conditions directly indicated in sources as provoking relapse or associated with its causes:

hypothermia/cooling;
intoxications;
infections;
drug intolerance, including antibiotics and vitamins;
in relapse of deep vein thrombosis during therapy: inadequate (reduced) doses of direct oral anticoagulants, failure to meet the target INR range when taking vitamin K antagonists, undiagnosed malignancy, antiphospholipid syndrome.

What are the possible outcomes of a disease, besides chronicity and death?

In addition to transition into a chronic form and death, disease outcomes include:

recovery — complete or incomplete;
relapse — recurrence or repeated intensification of disease symptoms after their elimination or substantial alleviation;
remission — a period of temporary alleviation or elimination of disease signs; incomplete remission — temporary alleviation of symptoms, complete remission — temporary elimination of symptoms;
complication — a pathological process developing against the background of the underlying disease, but not obligatory for it.

Are relapse symptoms always identical to the initial ones?

In most cases, yes. However, the clinical picture can sometimes change, as seen in chronic myeloid leukemia, where signs of anemia may come to the forefront.

What is the difference between complete and incomplete remission?

In complete remission, the signs of the disease temporarily disappear entirely, whereas in incomplete remission, they merely weaken.

Is a complication an obligatory part of a disease?

No, a complication is a pathological process developing against the background of the primary disease, but it is not obligatory for it.

Go deeper

Mechanisms of transition from remission to relapse.
Differential diagnosis of relapse versus exacerbation.
The role of pathogenetic links in the development of complications.
Criteria for assessing the stability of remission in various nosologies.
Impact of therapy on the frequency of relapses.