Nies Jasper F, Krusche Martin
Klinik II für Innere Medizin: Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
III. Medizinische Klinik und Poliklinik für Nephrologie, Rheumatologie und Endokrinologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.
Z Rheumatol. 2024 Jun;83(5):341-353. doi: 10.1007/s00393-024-01505-y. Epub 2024 Apr 18.
Fever is a frequent and important symptom in patients with rheumatological diseases and can be an expression of activity of the underlying rheumatological disease. There is great variability in the incidence of fever as a symptom of the disease between individual diseases. The growing understanding of the molecular signatures of the diseases can help to explain these discrepancies: A genetic overactivation of potently pyrogenic cytokines is the reason why fever is nearly always present in autoinflammatory syndromes. In contrast, fever is less common in polyarthritis and myositis and mostly limited to severe courses of disease. In the diagnostic work-up of fever, frequent differential diagnoses, such as infections, malignancies, side effects of drugs and hypersensitivity reactions should be considered. This article provides an overview of the physiology of the development of fever, describes the relevance of fever in individual rheumatological diseases and proposes a workflow for the clinical clarification of rheumatological patients who present with fever.
发热是风湿病患者常见且重要的症状，可能是潜在风湿病活动的一种表现。作为疾病症状，发热在不同个体疾病中的发生率差异很大。对疾病分子特征的深入了解有助于解释这些差异：强效致热细胞因子的基因过度激活是自身炎症综合征几乎总是伴有发热的原因。相比之下，发热在多关节炎和肌炎中较少见，且大多局限于疾病的严重病程。在发热的诊断检查中，应考虑常见的鉴别诊断，如感染、恶性肿瘤、药物副作用和过敏反应。本文概述了发热发生的生理学，描述了发热在个别风湿病中的相关性，并提出了对发热的风湿病患者进行临床诊断的工作流程。
