Protocolo diagnóstico de la fiebre en las enfermedades reumáticas autoinmunes sistémicas

Abstract

Fever is a common symptom in patients with systemic autoimmune rheumatic diseases (SARD) such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and vasculitis. Its emergence can be attributed to multiple causes, including the inflammatory activity of the underlying disease, opportunistic infections related to immunosuppression, and, in more infrequent cases, underlying neoplasms. It is crucial to consider that some infections, such as bacterial, viral, or fungal infections, can simulate a flare-up of immune-mediated disease, leading to diagnostic confusion and a potential delay in appropriate treatment. In addition, certain drugs used in the management of SARDs, such as immunosuppressants or biologics, may predispose to these infections, further complicating the differential diagnosis. A systematic approach that includes a detailed case history, thorough physical examination, and appropriate selection of laboratory and imaging tests is essential to identify the underlying cause. This protocol aims to optimize early diagnosis and treatment, reducing complications and improving patient prognosis.