[Fever in rheumatological diseases]

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Fever is a common and significant symptom in rheumatological diseases, often indicating disease activity.
• The incidence of fever varies considerably among different rheumatological conditions.
• Molecular insights are beginning to explain these variations, particularly concerning pyrogenic cytokines.

Purpose of the Study:

• To provide an overview of fever physiology.
• To describe the relevance of fever in specific rheumatological diseases.
• To propose a clinical workflow for evaluating fever in rheumatological patients.

Main Methods:

• Literature review on fever physiology and rheumatological diseases.
• Analysis of molecular mechanisms underlying fever in different conditions.
• Development of a diagnostic algorithm for fever in rheumatology.

Main Results:

• Fever is nearly constant in autoinflammatory syndromes due to genetic overactivation of pyrogenic cytokines.
• Fever is less frequent in polyarthritis and myositis, typically occurring in severe disease courses.
• Common differential diagnoses for fever include infections, malignancies, drug side effects, and hypersensitivity reactions.

Conclusions:

• Fever's presentation in rheumatological diseases is diverse and linked to underlying molecular pathology.
• A systematic approach is crucial for diagnosing fever in rheumatological patients, considering various differential diagnoses.
• This article offers a framework for clinicians to manage fever in the context of rheumatological conditions.