Background Fever is one of the main symptoms leading to the admission of patients with systemic lupus erythematosus (SLE) and its causes are usually complicated.
Objectives To explore the prevalence and clinical characteristics of fever in Chinese SLE patients at the time of their first admission and to find out whether fever is related to a poor prognosis.
Methods A follow-up study aimed to delineate SLE prognosis had been conducted by our Lupus Collaborative Group under the supervisor of Jiangsu Rheumatology Association to collect the data of patients who had ever recorded first admissions during the 1999–2009 decade (1). Among which, those with admission temperature documented were extracted for the assessment of potential factors associated with fever. The independency of various clinical features linked to fever was established by binary logistic regression analysis, and the relation between fever and patient's survival was determined by Cox regression analysis.
Results Totally 1,348 patients were enrolled, in which 1,049 (77.8%) had normal temperature, 221 (16.4%) had low and moderate fever and 78 (5.8%) had high fever at the time of their first hospitalization. Compared with those having normal temperature, fever patients were more likely to have short disease duration (RR 0.74), concurrent infection (RR 3.29) and gastrointestinal (RR 1.57) as well as hematological involvements (RR 1.56). High C reactive protein level (RR 2.08) and positive anti-Sm antibody (RR1.55) were the two laboratory factors related to fever at admission. However, age, gender, SLEDAI score or erythrocyte sedimentation rate was not independently associated with fever in this cohort. Cox regression analysis showed that there was no correlation between fever and overall deaths (Figure 1) as well as infection induced deaths.
Conclusions Both infection and lupus itself (especially gastrointestinal and hematological involvements) contribute to fever in SLE patients. Although the presence of fever increases the complexity of disease treatment, it does not constitute a risk factor for patient's long-term outcome.
Feng X, Pan W, Liu L, et al. Prognosis for hospitalized patients with systemic lupus erythematosus in China: 5-year update of the Jiangsu cohort. PLoS One. 2016;11(12):e0168619.
Acknowledgements This study was supported by National Natural Science Foundation of China (81373198) and Jiangsu Provincial Special Program of Medical Science (BE2015602).
Disclosure of Interest None declared