Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review.
Journal
Case reports in rheumatology
ISSN: 2090-6889
Titre abrégé: Case Rep Rheumatol
Pays: United States
ID NLM: 101585353
Informations de publication
Date de publication:
2023
2023
Historique:
received:
22
01
2023
revised:
07
07
2023
accepted:
12
07
2023
medline:
28
7
2023
pubmed:
28
7
2023
entrez:
28
7
2023
Statut:
epublish
Résumé
To describe four peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response mimicking infection. Between 2017 and 2019, four patients with the final diagnosis of peripheral spondyloarthritis had atypical presentation of fever and severe systemic inflammatory response requiring hospital admission and extensive workup. We reported four patients who were admitted to the hospital for fever and arthritis. They all had laboratory tests of the severe systemic inflammatory response (leukocytosis, thrombocytosis, high ESR, and high CRP) concerning infection. They underwent extensive workup for infectious causes, including septic arthritis, which came back negative. Other rheumatic diseases that are known to present with fever such as adult-onset Still's disease, reactive arthritis, and crystal arthritis were all excluded. The final diagnosis of spondyloarthritis was made during their follow-up: three patients with peripheral spondyloarthritis and one with psoriatic arthritis. All patients received conventional DMARDs (methotrexate and sulfasalazine) and two patients received tumor necrosis factor inhibitors in addition to conventional DMARDs to control their disease. We observed a subgroup of peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response requiring hospitalization. Recognition of this subgroup is important and should be considered once an infection is ruled out.
Identifiants
pubmed: 37502695
doi: 10.1155/2023/6651961
pmc: PMC10371696
doi:
Types de publication
Case Reports
Langues
eng
Pagination
6651961Informations de copyright
Copyright © 2023 Ibrahim Abdulmomen et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
Références
Arthritis Rheumatol. 2019 Oct;71(10):1599-1613
pubmed: 31436036
Autoimmun Rev. 2016 Aug;15(8):820-32
pubmed: 27288842
Autoimmun Rev. 2018 Sep;17(9):935-941
pubmed: 30005857
Ann Rheum Dis. 2012 Feb;71(2):313-4
pubmed: 21803748
Arthritis Rheum. 2007 Jan;56(1):215-23
pubmed: 17195225
Autoimmun Rev. 2016 Jul;15(7):673-83
pubmed: 26970491
Autoimmun Rev. 2015 Dec;14(12):1142-6
pubmed: 26254734
RMD Open. 2020 May;6(1):
pubmed: 32385142
N Engl J Med. 2001 Aug 2;345(5):340-50
pubmed: 11484692
Clin Exp Immunol. 2019 Apr;196(1):123-138
pubmed: 30554407
N Engl J Med. 2009 Jul 30;361(5):496-509
pubmed: 19641206
Arthritis Rheum. 2004 Feb;50(2):345-9
pubmed: 14872474
PLoS One. 2014 Dec 16;9(12):e115424
pubmed: 25514237
Autoimmun Rev. 2014 Aug;13(8):822-30
pubmed: 24726868
PLoS One. 2017 Sep 14;12(9):e0184323
pubmed: 28910361
Joint Bone Spine. 2018 Mar;85(2):201-205
pubmed: 28238883
Rheum Dis Clin North Am. 2009 Feb;35(1):21-44
pubmed: 19480995
Autoimmun Rev. 2014 Sep;13(9):892-900
pubmed: 25149390
Nat Rev Rheumatol. 2017 Jun;13(6):359-367
pubmed: 28446810
Arch Immunol Ther Exp (Warsz). 1999;47(1):25-32
pubmed: 11729825