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Rheumatic Causes for Fever of Unknown Origin

Jul 27, 2022 4:06 pm

Fever of unknown origin (FUO) represents a diagnostic challenge to many physicians and while cancer and infectious causes need to be excluded, rheumatic disorders are amongst the most common causes of FUO.

A recent metanalysisi of the medical literature from 2002 to 2021, included studies with ≥50 patients reporting on causes of FUO/IUO (inflammation of unknown origin). This series included 16884 patients.

Rheumatic etiologies were found in 22% of cases; lead by adult-onset Still's disease (AOSD - 22.8%), giant cell arteritis (11.4%), and systemic lupus erythematosus (11.1%).

Rheumatic causes of FUO were significantly higher with higher vs lower-income countries (25.9% vs. 19.5%) and in prospective studies (27%  vs 20.6% retrospective studies). According to multivariable meta-regression analysis rheumatic disease was associated with the duration of fever (P=0.01).

Rheumatologists are likely to be engaged in the evaluation and care of those considered to have FUO or IUO. 

The author has no conflicts of interest to disclose related to this subject

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