Fever in Rheumatic Diseases

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Fever in Rheumatic Diseases

Fever is the most common characteristic of systemic lupus erythematosus

(SLE) after arthritis and skin involvement. Although fever is common in

patients with SLE, it may also arise from infection since patients with SLE

are immunocompromised and many are taking medications that suppress the

immune system.

All patients with SLE who present with a fever should be evaluated for

infection. Blood cultures, chest x-ray, and urinalysis are generally

conducted. Fever can often be overlooked if the patient does not monitor

their temperature during periods of increased disease activity. Often

infections of the urinary tract can cause a low-grade temperature. All the

possible causes of an elevated temperature should be evaluated before the

fever is suppressed.

Fever is also common in gout. Temperatures may be elevated in an attack. 50%

of patients with gout may experience an elevated temperature. In gout,

certain substances called cytokines are released into the body when there is

an acute attack of gout. Cytokines regulate the intensity and duration of an

immune response.

Fever is common in rheumatoid arthritis as well. Fever occurs in

approximately 20% of patients with RA. Fever could indicate joint infection.

Osteoarthritis is not typically associated with fever. Although pain and

swelling are common, warmth, redness, and fever are generally not present.

Fever will likely occur in joint infections, and in such cases, joint fluid

analysis is needed to identify such infections.

Arthritis and fever could also indicate other rheumatic diseases such as

Scleroderma, connective tissue diseases, Polymyalgia rheumatica, and the

early stages of Lyme disease. Patients with these diseases usually also have

weight loss and fatigue. In these rheumatic diseases, patients with fever

will often exhibit other symptoms, which will direct the physician to the

right diagnosis.