[Fever in rheumatological diseases].
Fieber bei rheumatologischen Erkrankungen.
Autoimmunity
Autoinflammation
Cytokines
Differential diagnostic clarification
Pyrogens
Journal
Zeitschrift fur Rheumatologie
ISSN: 1435-1250
Titre abrégé: Z Rheumatol
Pays: Germany
ID NLM: 0414162
Informations de publication
Date de publication:
18 Apr 2024
18 Apr 2024
Historique:
accepted:
20
02
2024
medline:
18
4
2024
pubmed:
18
4
2024
entrez:
18
4
2024
Statut:
aheadofprint
Résumé
Fever is a frequent and important symptom in patients with rheumatological diseases and can be an expression of activity of the underlying rheumatological disease. There is great variability in the incidence of fever as a symptom of the disease between individual diseases. The growing understanding of the molecular signatures of the diseases can help to explain these discrepancies: A genetic overactivation of potently pyrogenic cytokines is the reason why fever is nearly always present in autoinflammatory syndromes. In contrast, fever is less common in polyarthritis and myositis and mostly limited to severe courses of disease. In the diagnostic work-up of fever, frequent differential diagnoses, such as infections, malignancies, side effects of drugs and hypersensitivity reactions should be considered. This article provides an overview of the physiology of the development of fever, describes the relevance of fever in individual rheumatological diseases and proposes a workflow for the clinical clarification of rheumatological patients who present with fever. Fieber bei PatientInnen mit rheumatologischen Erkrankungen ist ein häufiges und wichtiges Symptom, das durch die Aktivität der rheumatologischen Grunderkrankung bedingt sein kann. Dabei zeigt sich bei der Inzidenz von Fieber als Krankheitssymptom eine große Streubreite zwischen den einzelnen Erkrankungen. Das wachsende Verständnis der molekularen Signaturen der Krankheitsbilder kann helfen, diese Diskrepanzen zu erklären: So ist die genetisch bedingte Überaktivierung von stark pyrogenen Zytokinen die Ursache dafür, dass Autoinflammationssyndrome sich fast immer mit Fieber präsentieren. Im Gegensatz dazu tritt Fieber bei Polyarthritiden und Myositiden seltener auf und beschränkt sich in der Regel auf schwere Krankheitsverläufe. In der diagnostischen Abklärung sollten häufige Differenzialdiagnosen wie Infekte, Malignome, Medikamentennebenwirkungen und Hypersensitivitätsreaktionen berücksichtigt werden. In diesem Beitrag geben wir einen Überblick über die Physiologie der Fieberentstehung, beschreiben die Relevanz von Fieber bei einzelnen rheumatologischen Erkrankungen und schlagen einen Workflow für die klinische Abklärung bei rheumatologischen PatientInnen mit Fieber vor.
Autres résumés
Type: Publisher
(ger)
Fieber bei PatientInnen mit rheumatologischen Erkrankungen ist ein häufiges und wichtiges Symptom, das durch die Aktivität der rheumatologischen Grunderkrankung bedingt sein kann. Dabei zeigt sich bei der Inzidenz von Fieber als Krankheitssymptom eine große Streubreite zwischen den einzelnen Erkrankungen. Das wachsende Verständnis der molekularen Signaturen der Krankheitsbilder kann helfen, diese Diskrepanzen zu erklären: So ist die genetisch bedingte Überaktivierung von stark pyrogenen Zytokinen die Ursache dafür, dass Autoinflammationssyndrome sich fast immer mit Fieber präsentieren. Im Gegensatz dazu tritt Fieber bei Polyarthritiden und Myositiden seltener auf und beschränkt sich in der Regel auf schwere Krankheitsverläufe. In der diagnostischen Abklärung sollten häufige Differenzialdiagnosen wie Infekte, Malignome, Medikamentennebenwirkungen und Hypersensitivitätsreaktionen berücksichtigt werden. In diesem Beitrag geben wir einen Überblick über die Physiologie der Fieberentstehung, beschreiben die Relevanz von Fieber bei einzelnen rheumatologischen Erkrankungen und schlagen einen Workflow für die klinische Abklärung bei rheumatologischen PatientInnen mit Fieber vor.
Identifiants
pubmed: 38634905
doi: 10.1007/s00393-024-01505-y
pii: 10.1007/s00393-024-01505-y
doi:
Types de publication
English Abstract
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
Références
Abdelgalil Ali Ahmed S, Adam Essa ME, Ahmed AF et al (2021) Incidence and Clinical Pattern of Mixed Connective Tissue Disease in Sudanese Patients at Omdurman Military Hospital: Hospital-Based Study. Open Access Rheumatol 13:333–341
pubmed: 34916856
pmcid: 8668256
doi: 10.2147/OARRR.S335206
Abdulmomen I, Satti E, Awadh B (2023) Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review. Case Rep Rheumatol 2023:6651961
pubmed: 37502695
pmcid: 10371696
Alpay-Kanitez N, Celik S, Bes C (2019) Polyarthritis and its differential diagnosis. Eur J Rheumatol 6:167–173
pubmed: 31657698
doi: 10.5152/eurjrheum.2019.19145
Benbassat J, Gefel D, Larholt K et al (1985) Prognostic factors in polymyositis/dermatomyositis. A computer-assisted analysis of ninety-two cases. Arthritis Rheum 28:249–255
pubmed: 3977973
doi: 10.1002/art.1780280303
Bennett RM, O’connell DJ (1980) Mixed connective tisssue disease: a clinicopathologic study of 20 cases. Semin Arthritis Rheum 10:25–51
pubmed: 7414333
doi: 10.1016/0049-0172(80)90013-X
Betteridge ZE, Gunawardena H, Chinoy H et al (2009) Clinical and human leucocyte antigen class II haplotype associations of autoantibodies to small ubiquitin-like modifier enzyme, a dermatomyositis-specific autoantigen target, in UK Caucasian adult-onset myositis. Ann Rheum Dis 68:1621–1625
pubmed: 18930994
doi: 10.1136/ard.2008.097162
Bleeker-Rovers CP, Vos FJ, De Kleijn E et al (2007) A prospective multicenter study on fever of unknown origin: the yield of a structured diagnostic protocol. Medicine 86:26–38
pubmed: 17220753
doi: 10.1097/MD.0b013e31802fe858
Bolko L, Jiang W, Tawara N et al (2021) The role of interferons type I, II and III in myositis: A review. Brain Pathol 31:e12955
pubmed: 34043262
pmcid: 8412069
doi: 10.1111/bpa.12955
Buchbinder R, Forbes A, Hall S et al (2001) Incidence of malignant disease in biopsy-proven inflammatory myopathy. A population-based cohort study. Ann Intern Med 134:1087–1095
pubmed: 11412048
doi: 10.7326/0003-4819-134-12-200106190-00008
Bush LM (2022) Fever. In: Biology of Infectious Disease. Merck Manuals,
Byun SJ, Bae WH, Jung SM et al (2017) Fever as an initial manifestation of spondyloarthritis: A retrospective study. PLoS ONE 12:e184323
pubmed: 28910361
pmcid: 5598956
doi: 10.1371/journal.pone.0184323
Calamia KT, Hunder GG (1981) Giant Cell Arteritis (Temporal Arteritis) Presenting as Fever of Undetermined Origin. 24:1414–1418
Carsons SE (1996) Fever in rheumatic and autoimmune disease. Infect Dis Clin North Am 10:67–84
pubmed: 8698995
doi: 10.1016/S0891-5520(05)70286-5
Chauhan K, Jandu JS, Brent LH et al (2023) Rheumatoid Arthritis. In: StatPearls. ineligible companies, Treasure Island (FL)
Chen Z, Cao M, Plana MN et al (2013) Utility of anti-melanoma differentiation-associated gene 5 antibody measurement in identifying patients with dermatomyositis and a high risk for developing rapidly progressive interstitial lung disease: a review of the literature and a meta-analysis. Arthritis Care Res 65:1316–1324
doi: 10.1002/acr.21985
Courcoul A, Brinster A, Decullier E et al (2018) A bicentre retrospective study of features and outcomes of patients with reactive arthritis. Joint Bone Spine 85:201–205
pubmed: 28238883
doi: 10.1016/j.jbspin.2017.01.013
Crouser ED, Maier LA, Wilson KC et al (2020) Diagnosis and Detection of Sarcoidosis. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 201:e26–e51
pubmed: 32293205
pmcid: 7159433
doi: 10.1164/rccm.202002-0251ST
Dantas AT, Goncalves SM, Pereira MC et al (2015) Interferons and systemic sclerosis: correlation between interferon gamma and interferon-lambda 1 (IL-29). Autoimmunity 48:429–433
pubmed: 26057401
doi: 10.3109/08916934.2015.1054028
Efstathiou SP, Pefanis AV, Tsiakou AG et al (2010) Fever of unknown origin: discrimination between infectious and non-infectious causes. Eur J Intern Med 21:137–143
pubmed: 20206887
doi: 10.1016/j.ejim.2009.11.006
El-Radhi AS (2019) Pathogenesis of Fever. Clin Man Fever Child: 53–68
El-Radhi AS (2019) Pathogenesis of Fever. Clin Man Fever Child. https://doi.org/10.1007/978-3-319-92336-9_3
doi: 10.1007/978-3-319-92336-9_3
Essien F, Wolfley G, Tate J et al (2021) Fevers, Sweats, Weight Loss, Oh My! When IgG 4 Related Disease Comes Knocking. Clin Med Insights Case Rep 14:11795476211046398
pubmed: 34733106
pmcid: 8558582
doi: 10.1177/11795476211046398
Felice C, Leccese P, Scudeller L et al (2019) Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis. Clin Exp Immunol 196:123–138
pubmed: 30554407
pmcid: 6422654
doi: 10.1111/cei.13246
Flores R, Caridade S (2023) Lofgren Syndrome: Clinical Presentation, Clinical Course, and Literature Review. Cureus 15:e33651
pubmed: 36788849
pmcid: 9912994
Font J, Cervera R, Ramos-Casals M et al (2004) Clusters of clinical and immunologic features in systemic lupus erythematosus: analysis of 600 patients from a single center. Semin Arthritis Rheum 33:217–230
pubmed: 14978660
doi: 10.1053/S0049-0172(03)00133-1
Galloway J, Cope AP (2015) The ying and yang of fever in rheumatic disease. Clin Med 15:288–291
doi: 10.7861/clinmedicine.15-3-288
Gelber AC, Brener MI, O’connell K et al (2018) Febrile Calcinosis in Scleroderma. Am J Med 131:e500–e501
pubmed: 30076824
doi: 10.1016/j.amjmed.2018.07.019
Gelber AC, Manno RL, Shah AA et al (2013) Race and association with disease manifestations and mortality in scleroderma: a 20-year experience at the Johns Hopkins Scleroderma Center and review of the literature. Medicine 92:191–205
pubmed: 23793108
pmcid: 4553970
doi: 10.1097/MD.0b013e31829be125
Geneva I, Cuzzo B, Fazili T et al (2019) Normal Body Temperature: A Systematic Review. Open Forum Infect Dis 6:ofz32
pubmed: 30976605
pmcid: 6456186
doi: 10.1093/ofid/ofz032
Gladman DD, Shuckett R, Russell ML et al (1987) Psoriatic arthritis (PSA)—an analysis of 220 patients. Q J Med 62:127–141
pubmed: 3659255
Grazioli-Gauthier L, Marcoli N, Vanini G et al (2021) Giant Cell Arteritis among Fevers of Unknown Origin (FUO): An Atypical Presentation. Eur J Case Rep Intern Med 8:2254
pubmed: 33768070
pmcid: 7977053
Guillevin L, Cohen P, Gayraud M et al (1999) Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients. Medicine 78:26–37
pubmed: 9990352
doi: 10.1097/00005792-199901000-00003
Gunawardena H (2017) The Clinical Features of Myositis-Associated Autoantibodies: a Review. Clin Rev Allergy Immunol 52:45–57
pubmed: 26453338
doi: 10.1007/s12016-015-8513-8
Gupta MN, Sturrock RD, Field M (2001) A prospective 2‑year study of 75 patients with adult-onset septic arthritis. Rheumatology 40:24–30
pubmed: 11157138
doi: 10.1093/rheumatology/40.1.24
Hall S, Barr W, Lie JT et al (1985) Takayasu arteritis. A study of 32 North American patients. Medicine 64:89–99
pubmed: 2858047
doi: 10.1097/00005792-198503000-00002
Harvey AM, Shulman LE, Tumulty PA et al (1954) Systemic lupus erythematosus: review of the literature and clinical analysis of 138 cases. Medicine 33:291–437
pubmed: 13223169
doi: 10.1097/00005792-195412000-00001
Hoffman GS, Kerr GS, Leavitt RY et al (1992) Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med 116:488–498
pubmed: 1739240
doi: 10.7326/0003-4819-116-6-488
Hoffman IE, Peene I, Meheus L et al (2004) Specific antinuclear antibodies are associated with clinical features in systemic lupus erythematosus. Ann Rheum Dis 63:1155–1158
pubmed: 15308527
pmcid: 1755119
doi: 10.1136/ard.2003.013417
Jansen AFM, Raijmakers RPH, Van Deuren M et al (2019) Chronic Q fever associated with systemic sclerosis. Eur J Clin Invest 49:e13123
pubmed: 31077590
doi: 10.1111/eci.13123
Johnson DH, Cunha BA (1996) Drug fever. Infect Dis Clin North Am 10:85–91
pubmed: 8698996
doi: 10.1016/S0891-5520(05)70287-7
Kanayama Y, Kim T, Inariba H et al (1989) Possible involvement of interferon alfa in the pathogenesis of fever in systemic lupus erythematosus. Ann Rheum Dis 48:861–863
pubmed: 2818022
pmcid: 1003896
doi: 10.1136/ard.48.10.861
Kaul DR, Flanders SA, Beck JM et al (2006) Brief report: incidence, etiology, risk factors, and outcome of hospital-acquired fever: a systematic, evidence-based review. J Gen Intern Med 21:1184–1187
pubmed: 17026728
pmcid: 1831668
doi: 10.1111/j.1525-1497.2006.00566.x
Kazanjian PH (1992) Fever of unknown origin: review of 86 patients treated in community hospitals. Clin Infect Dis 15:968–973
pubmed: 1457669
doi: 10.1093/clind/15.6.968
Lawry GV 2nd, Fan PT, Bluestone R (1988) Polyarticular versus monoarticular gout: a prospective, comparative analysis of clinical features. Medicine 67:335–343
pubmed: 3412175
doi: 10.1097/00005792-198809000-00004
Masuda I, Ishikawa K (1988) Clinical features of pseudogout attack. A survey of 50 cases. Clin Orthop Relat Res: 173–181
Mavragani CP, Moutsopoulos HM (2014) Sjögren syndrome. CMAJ 186:E579–E586
pubmed: 24566651
pmcid: 4203623
doi: 10.1503/cmaj.122037
Mccrindle BW, Rowley AH, Newburger JW et al (2017) Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation 135:e927–e999
pubmed: 28356445
doi: 10.1161/CIR.0000000000000484
Mcgee J, Minagar A (2015) Heerfordt’s Syndrome: An interesting and under-recognised manifestation of sarcoidosis. Sultan Qaboos Univ Med J 15:e7–e8
pubmed: 25685388
pmcid: 4318609
Mcgregor AC, Moore DA (2015) Infectious causes of fever of unknown origin. Clin Med 15:285–287
doi: 10.7861/clinmedicine.15-3-285
Morgan ND, Shah AA, Mayes MD et al (2017) Clinical and serological features of systemic sclerosis in a multicenter African American cohort: Analysis of the genome research in African American scleroderma patients clinical database. Medicine 96:e8980
pubmed: 29390428
pmcid: 5758130
doi: 10.1097/MD.0000000000008980
Moroncini G, Mori S, Tonnini C et al (2013) Role of viral infections in the etiopathogenesis of systemic sclerosis. Clin Exp Rheumatol 31:3–7
pubmed: 23910606
Myklebust G, Gran JT (1996) A prospective study of 287 patients with polymyalgia rheumatica and temporal arteritis: clinical and laboratory manifestations at onset of disease and at the time of diagnosis. Br J Rheumatol 35:1161–1168
pubmed: 8948307
doi: 10.1093/rheumatology/35.11.1161
Narula N, Iannuzzi M (2020) Sarcoidosis: Pitfalls and Challenging Mimickers. Front Med 7:594275
doi: 10.3389/fmed.2020.594275
Nesher G, Osborn TG, Moore TL (1995) Parvovirus infection mimicking systemic lupus erythematosus. Semin Arthritis Rheum 24:297–303
pubmed: 7604297
doi: 10.1016/S0049-0172(95)80001-8
Nolan JP, Klatskin G (1965) The Fever of Sarcoidosis. Clin Notes Respir Dis 3:12–13
pubmed: 14251392
Olivieri I, Cantini F, Castiglione F et al (2014) Italian Expert Panel on the management of patients with coexisting spondyloarthritis and inflammatory bowel disease. Autoimmun Rev 13:822–830
pubmed: 24726868
doi: 10.1016/j.autrev.2014.04.003
Pagnoux C, Seror R, Henegar C et al (2010) Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French Vasculitis Study Group Database. Arthritis Rheum 62:616–626
pubmed: 20112401
doi: 10.1002/art.27240
Pistiner M, Wallace DJ, Nessim S et al (1991) Lupus erythematosus in the 1980s: a survey of 570 patients. Semin Arthritis Rheum 21:55–64
pubmed: 1948102
doi: 10.1016/0049-0172(91)90057-7
Ragan C (1962) The clinical features of rheumatoid arthritis. Prognostic indices. JAMA 181:663–667
pubmed: 14489862
doi: 10.1001/jama.1962.03050340001001
Ruffer N, Holzer MT, Gkanatsas Y et al (2022) Chronic Tropheryma whipplei infection: an important differential diagnosis of refractory polyarthritis. Z Rheumatol
Ryu S, Fu W, Petri MA (2017) Associates and predictors of pleurisy or pericarditis in SLE. Lupus Sci Med 4:e221
pubmed: 29118999
pmcid: 5663266
doi: 10.1136/lupus-2017-000221
Schnabel A, Hellmich B, Gross WL (2005) Interstitial lung disease in polymyositis and dermatomyositis. Curr Rheumatol Rep 7:99–105
pubmed: 15760588
doi: 10.1007/s11926-005-0061-4
Seyahi E, Karaaslan H, Ugurlu S et al (2013) Fever in Behcet’s syndrome. Clin Exp Rheumatol 31:64–67
pubmed: 24064017
Seyahi E, Ugurlu S, Amikishiyev S et al (2023) Behcet disease, familial Mediterranean fever and MEFV variations: More than just an association. Clin Immunol 251:109630
pubmed: 37216220
doi: 10.1016/j.clim.2023.109630
Shi XC, Liu XQ, Zhou BT et al (2013) Major causes of fever of unknown origin at Peking Union Medical College Hospital in the past 26 years. Chin Med J 126:808–812
pubmed: 23489781
doi: 10.3760/cma.j.issn.0366-6999.20121799
Sireci G, Badami GD, Di Liberto D et al (2021) Recent Advances on the Innate Immune Response to Coxiella burnetii. Front Cell Infect Microbiol 11:754455
pubmed: 34796128
pmcid: 8593175
doi: 10.3389/fcimb.2021.754455
Skaug B, Assassi S (2020) Type I interferon dysregulation in Systemic Sclerosis. Cytokine 132:154635
pubmed: 30685202
doi: 10.1016/j.cyto.2018.12.018
Soto ME, Espinola N, Flores-Suarez LF et al (2008) Takayasu arteritis: clinical features in 110 Mexican Mestizo patients and cardiovascular impact on survival and prognosis. Clin Exp Rheumatol 26:S9–S15
pubmed: 18799047
Stahl NI, Klippel JH, Decker JL (1979) Fever in systemic lupus erythematosus. Am J Med 67:935–940
pubmed: 316284
doi: 10.1016/0002-9343(79)90633-8
Timlin H, Syed A, Haque U et al (2018) Fevers in Adult Lupus Patients. Cureus 10:e2098
pubmed: 29581911
pmcid: 5866120
Um SJ, Lee SK, Kim YH et al (2010) Clinical features of drug-induced hypersensitivity syndrome in 38 patients. J Investig Allergol Clin Immunol 20:556–562
pubmed: 21313995
Vogelpoel LT, Baeten DL, De Jong EC et al (2015) Control of cytokine production by human fc gamma receptors: implications for pathogen defense and autoimmunity. Front Immunol 6:79
pubmed: 25759693
pmcid: 4338787
doi: 10.3389/fimmu.2015.00079
Wallace ZS, Perugino C, Matza M et al (2019) Immunoglobulin G4-related Disease. Clin Chest Med 40:583–597
pubmed: 31376893
pmcid: 7133392
doi: 10.1016/j.ccm.2019.05.005
Walsh SA, Creamer D (2011) Drug reaction with eosinophilia and systemic symptoms (DRESS): a clinical update and review of current thinking. Clin Exp Dermatol 36:6–11
pubmed: 21143513
doi: 10.1111/j.1365-2230.2010.03967.x
Wang Q, Li Y‑M, Li Y et al (2019) 18F-FDGPET/CT in fever of unknown origin and inflammation of unknown origin: a Chinese multi-center study. Eur J Nucl Med Mol Imaging 46:159–165
pubmed: 30099578
doi: 10.1007/s00259-018-4121-1
Weinberger A, Kesler A, Pinkhas J (1985) Fever in various rheumatic diseases. Clin Rheumatol 4:258–266
pubmed: 2415294
doi: 10.1007/BF02031605
Yuen E (2001) Unusual Cause of Fever in a 35-Year-Old Man. 8:34–37
Zhan Q, Zhang J, Lin Y et al (2023) Pathogenesis and treatment of Sjogren’s syndrome: Review and update. Front Immunol 14:1127417
pubmed: 36817420
pmcid: 9932901
doi: 10.3389/fimmu.2023.1127417