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Fever and rheumatic disease

Fever and rheumatic disease


Descriptions of fever in the context of rheumatic diseases date back to  Hippocrates , with early descriptions of  rheumatic fever.


The prevalence of fever in different inflammatory diseases (e.g. Adult-onset Still’s disease, systemic lupus erythematosus, Systemic vasculitis) is likely to be dictated by the production of specific pyrogens (e.g. IL-1, IL-6 and immune complexes).


  • Low grade fever is common in chronic inflammatory diseases
  • Inflammatory process is driven by inflammatory mediators that also serve to function as pyrogens.
  • Drugs commonly used to treat immune-mediated inflammatory disease, such as    NSAIDs and Glucocorticoids may mask the febrile component of rheumatic disease.
  • Anti-rheumatic drugs  may also cause fever.
  • An acute polyarthritis presenting with fever may well be associated with an acute viral infection (e.g. parvovirus).
  • A rule of thumb remains that fever must prompt systematic and robust investigation to exclude infection