Rheumatologic diseases as the cause of fever of unknown origin

C M Mulders-Manders; A Simon; C P Bleeker-Rovers

doi:10.1016/j.berh.2016.10.005

Rheumatologic diseases as the cause of fever of unknown origin

Best Pract Res Clin Rheumatol. 2016 Oct;30(5):789-801. doi: 10.1016/j.berh.2016.10.005. Epub 2016 Nov 9.

Authors

C M Mulders-Manders¹, A Simon², C P Bleeker-Rovers²

Affiliations

¹ Department of Internal Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: Karin.Mulders-Manders@radboudumc.nl.
² Department of Internal Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

PMID: 27964789
DOI: 10.1016/j.berh.2016.10.005

Abstract

In 30% of patients with fever or inflammation of unknown origin (FUO/IUO), the cause is eventually found to be a rheumatologic disease such as autoimmune or granulomatous disease or vasculitis. Most of these patients suffer from an uncommon presentation of a common disease, instead of an uncommon disease. We demonstrate the diagnostic challenge with several cases. The workup of FUO is based on the identification of potential diagnostic clues (PDCs). In the absence of PDCs, a standardized diagnostic protocol should be followed, including early FDG-PET/CT. Other imaging techniques or invasive diagnostic techniques should be reserved for those in whom PDCs are present.

Keywords: Autoimmune disease; FDG–PET; Fever of unknown origin; Inflammation of unknown origin; Rheumatology.

Publication types

Review

MeSH terms

Aged
Female
Fever of Unknown Origin / diagnosis*
Fever of Unknown Origin / etiology*
Humans
Male
Middle Aged
Rheumatic Diseases / complications*
Rheumatic Diseases / diagnosis*