对源不明的发烧与正常血清C-反应蛋白进行范围审查
Yasuhiro Kano1, Yukinori Harada2,3, Toshinori Nishizawa3,4,5
1Department of Emergency and General Medicine, 13771 Tokyo Metropolitan Tama Medical Center , Fuchu, Tokyo, Japan.
Diagnosis (Berlin, Germany)
|April 11, 2025
概括
源不明的发烧与正常的炎症标志物 (FUO-NIL) 呈现出一个独特的诊断挑战. 除了标准的发烧工作之外,具体的调查对于准确的诊断至关重要.
科学领域:
- 内部医学 内部医学
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
背景情况:
- 不知源发烧 (FUO) 诊断是复杂的,特别是当炎症标志物正常时.
- 没有炎症实验室证据 (FUO-NIL) 的未知来源的发烧缺乏定义的概念和差异诊断.
- 在这项研究中,正常的血清C反应蛋白 (CRP) 定义了FUO-NIL.
研究的目的:
- 为FUO-NIL.提出一个概念.
- 为了探索FUO-NIL的差异诊断.
主要方法:
- 对FUO-NIL案件进行了范围审查.
- 在PubMed,Embase,CENTRAL,Web of Science和谷歌学者中进行了搜索.
- 包括具有最终诊断和正常CRP值的研究.
主要成果:
- 17篇文章和19个案例符合纳入标准.
- 疾病类别包括感染 (52.6%),恶性病 (15.8%),非传染性炎症性疾病 (21.1%) 和各种 (10.5%).
- 具体的差异诊断包括真菌感染,结核病,恶性瘤,SLE,粒状细胞病,法布里病,HLH和功能性热升.
结论:
- 与炎症性FUO相比,FUO-NIL可能具有明显的差异诊断和病因学.
- 建议针对FUO-NIL量身定制的诊断策略.
- 在FUO-NIL工作中考虑动物接触史,缺水症和心理社会压力因素.
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