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Lupus

Lupus Fevers

03/30/2004

Question:

Is there any cause or anything that can be done for the fevers that occur in SLE? I have been having fevers every day for over a month now. In the mornings I feel fine and my temp is normal, but by the afternoon I am achy and my temp is always over 100 and sometimes over 101. I have had numerous blood and urine tests done and everything is fine except for the ANA and dsdna. Also had chest x-ray and cat scans done which are normal. My doctor said he is not too concerned since all tests are negative for any infections and it is probably just due to the lupus. I have been taking prednisone, plaquenil and naproxen but have not been on any additional meds since the fevers started.

Answer:

It is always good to rule out any type of infection when patients suffer from diseases of the immune system and also when they are on immunosuppressive medication (steroids, etc). It is good the tests are normal. If infection is ruled out, the fever can be from active lupus disease or `lupus flare`. The question now is where is the disease flaring? A flare can present with joint inflammation, pleurisy, pericarditis, rashes, oral sores, or an organ involvement accompanied by fatigue, fever, malaise. It is important to evaluate and see where is the disease flaring because this changes the type of treatment given. Having a higher-than-usual dsDNA and a low complement panel, low blood counts or urine abnormalities points towards a lupus flare. 

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Response by:

Yolanda   Farhey, MD Yolanda Farhey, MD
Associate Professor
College of Medicine
University of Cincinnati