Comparison of classical diagnostic criteria and Chinese revised diagnostic criteria for fever of unknown origin in Chinese patients

Systemic lupus erythematosus (SLE) is one of the most complex rheumatological diseases, occurring with a variety of clinical forms and manifestations. The debuts and variants of the course of SLE can vary significantly, so it is called ‘chameleon disease’ or ‘the great imitator of diseases’. In 2019, a group of experts from the European Anti-Rheumatic League and the American College of Rheumatology developed the latest criteria for the diagnosis of systemic lupus erythematosus. A prerequisite for the diagnosis is a positive antinuclear factor in combination with the seven clinical criteria for SLE (constitutional, hematological, neuropsychiatric, skin‑mucosal, polyserositis, renal) and the three immunological signs (antiphospholipid antibodies, levels of complement and its fractions, SLE‑specific autoantibodies) The article describes a case of systemic lupus erythematosus, diagnosed in a patient who was admitted to the hospital with a directional diagnosis of ‘fever of unknown origin’. The diagnosis of systemic lupus erythematosus was established on the basis of seven clinical criteria and two immunological diagnostic criteria.

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Regional Colitis Presenting as Fever of Unknown Origin: Report of a Case With Three Skip Lesions

Gastroenterology ◽

10.1016/s0016-5085(51)80102-1 ◽

1951 ◽

Vol 17 (2) ◽

pp. 269-274 ◽

Cited By ~ 1

Author(s):

Bertram Kertzner

Keyword(s):

Fever Of Unknown Origin ◽

Unknown Origin ◽

Skip Lesions

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Kikuchi-Fujimoto Disease Is a Rare Cause of Lymphadenopathy and Fever of Unknown Origin in Children: Report of Two Cases and Review of the Literature

Yearbook of Pediatrics ◽

10.1016/s0084-3954(08)70164-7 ◽

2007 ◽

Vol 2007 ◽

pp. 296-298

Author(s):

J.A. Stockman

Keyword(s):

Fever Of Unknown Origin ◽

Unknown Origin ◽

Review Of The Literature

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Patients with fever of unknown origin (FUO): diagnosis by nuclear medicine imaging

Nuklearmedizin ◽

10.1055/s-0038-1623872 ◽

2001 ◽

Vol 40 (03) ◽

pp. 59-70 ◽

Cited By ~ 13

Author(s):

W. Becker ◽

J. Meiler

Keyword(s):

Nuclear Medicine ◽

Fever Of Unknown Origin ◽

Tumor Imaging ◽

White Blood Cells ◽

Unknown Origin ◽

Final Diagnosis ◽

Recurrent Fever ◽

Nuclear Medicine Imaging

SummaryFever of unknown origin (FUO) in immunocompetent and non neutropenic patients is defined as recurrent fever of 38,3° C or greater, lasting 2-3 weeks or longer, and undiagnosed after 1 week of appropriate evaluation. The underlying diseases of FUO are numerous and infection accounts for only 20-40% of them. The majority of FUO-patients have autoimmunity and collagen vascular disease and neoplasm, which are responsible for about 50-60% of all cases. In this respect FOU in its classical definition is clearly separated from postoperative and neutropenic fever where inflammation and infection are more common. Although methods that use in-vitro or in-vivo labeled white blood cells (WBCs) have a high diagnostic accuracy in the detection and exclusion of granulocytic pathology, they are only of limited value in FUO-patients in establishing the final diagnosis due to the low prevalence of purulent processes in this collective. WBCs are more suited in evaluation of the focus in occult sepsis. Ga-67 citrate is the only commercially available gamma emitter which images acute, chronic, granulomatous and autoimmune inflammation and also various malignant diseases. Therefore Ga-67 citrate is currently considered to be the tracer of choice in the diagnostic work-up of FUO. The number of Ga-67-scans contributing to the final diagnosis was found to be higher outside Germany than it has been reported for labeled WBCs. F-l 8-2’-deoxy-2-fluoro-D-glucose (FDG) has been used extensively for tumor imaging with PET. Inflammatory processes accumulate the tracer by similar mechanisms. First results of FDG imaging demonstrated, that FDG may be superior to other nuclear medicine imaging modalities which may be explained by the preferable tracer kinetics of the small F-l 8-FDG molecule and by a better spatial resolution of coincidence imaging in comparison to a conventional gamma camera.

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