Protocolo de actuación ante la fiebre en el paciente con lupus eritematoso sistémico

Abstract

Fever in systemic lupus erythematosus (SLE) is sometimes the first symptom of the disease, and more commonly appears during the course of the disease. A broad differential diagnosis must be entertained including infection, concomitant diseases (inflammatory or cancer), drug intake or activity specific to SLE. Infections are a common problem in SLE patients, facilitated by immunosuppressive therapy and underlying immune disorders, and it is often difficult to distinguish them from the activity of the disease. An accurate clinical history and thorough examination are therefore important and analytical parameters (cell count, complement, anti-stranded DNA antibodies, erythrocyte sedimentation rate, C-reactive protein, urinary sediment) and imaging tests (chest X-ray, echocardiogram, PET-CT), as well as cultures and serological studies to reach a diagnosis, bearing in mind that several causes may coexist.