Without a single diagnostic test or symptoms that are easily confused with other medical conditions (such as rheumatoid arthritis, fibromyalgia and hypothyroidism), lupus can often take months or even years to diagnose. In an effort to speed up the process and get patients diagnosed and treated properly before, scientists have been looking for clues to help doctors differentiate early lupus from other conditions. One possible clue: the unexplained fever.
In a recent multi-center trial, whose results were published in the journal Arthritis & Rheumatology , researchers reviewed data from 616 patients who had been referred to one of seven academic centers (in Asia, Europe, North America or South America) within the previous three years because they were suspected of having lupus. Doctors at individual centers finally diagnosed 389 of the participants with early lupus and 227 of them with a condition of “lupus imitation,” such as undifferentiated connective tissue disease (UCTD) or the syndrome of Sjögren.
Not surprisingly, people who really had lupus were more likely to meet some of the 11 standard criteria used to diagnose lupus, such as a butterfly-shaped rash on the face, sensitivity to light, and mouth or mouth ulcers. the skin. But they were also more likely to have an unexplained fever, which is not among the current diagnostic criteria. About 35 percent of patients diagnosed with lupus had it, compared with only 14 percent in the group that simulates lupus.
Blood tests also highlighted some key differences, since patients with lupus were more likely to test positive for specific antibodies (ANA, anti-dsDNA, anti-RNP and antiphospholipid) that are associated with autoimmune disease. People with lupus were also susceptible to having a positive Coombs test and having hemolytic anemia, a condition in which red blood cells are destroyed too quickly.
Members of both groups were equally likely to have a low white blood cell count, low platelet count or anti-Ro / La antibodies.
“This study is an element in the item generation phase of an ongoing international effort to design new classification criteria for SLE with a focus on early disease,” the authors wrote. What kind of changes could come? It remains to be determined, but the authors of this study pointed out that when they added fever, hair loss, hypocomplementemia (lack of proteins in a part of the immune system) and a positive anti-RNP test to the current diagnostic criteria for Lupus, ” patient classification accuracy improved significantly. ”