Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review

Objective. To describe four peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response mimicking infection. Methods. Between 2017 and 2019, four patients with the final diagnosis of peripheral spondyloarthritis had atypical presentation of fever and severe...

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Main Authors: Ibrahim Abdulmomen, Eman Satti, Basem Awadh
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2023/6651961
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author Ibrahim Abdulmomen
Eman Satti
Basem Awadh
author_facet Ibrahim Abdulmomen
Eman Satti
Basem Awadh
author_sort Ibrahim Abdulmomen
collection DOAJ
description Objective. To describe four peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response mimicking infection. Methods. Between 2017 and 2019, four patients with the final diagnosis of peripheral spondyloarthritis had atypical presentation of fever and severe systemic inflammatory response requiring hospital admission and extensive workup. Results. We reported four patients who were admitted to the hospital for fever and arthritis. They all had laboratory tests of the severe systemic inflammatory response (leukocytosis, thrombocytosis, high ESR, and high CRP) concerning infection. They underwent extensive workup for infectious causes, including septic arthritis, which came back negative. Other rheumatic diseases that are known to present with fever such as adult-onset Still’s disease, reactive arthritis, and crystal arthritis were all excluded. The final diagnosis of spondyloarthritis was made during their follow-up: three patients with peripheral spondyloarthritis and one with psoriatic arthritis. All patients received conventional DMARDs (methotrexate and sulfasalazine) and two patients received tumor necrosis factor inhibitors in addition to conventional DMARDs to control their disease. Conclusion. We observed a subgroup of peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response requiring hospitalization. Recognition of this subgroup is important and should be considered once an infection is ruled out.
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spelling doaj-art-9fec79824315475989087f9a6619d5202025-02-03T06:48:31ZengWileyCase Reports in Rheumatology2090-68972023-01-01202310.1155/2023/6651961Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature ReviewIbrahim Abdulmomen0Eman Satti1Basem Awadh2Rheumatology DivisionRheumatology DivisionRheumatology DivisionObjective. To describe four peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response mimicking infection. Methods. Between 2017 and 2019, four patients with the final diagnosis of peripheral spondyloarthritis had atypical presentation of fever and severe systemic inflammatory response requiring hospital admission and extensive workup. Results. We reported four patients who were admitted to the hospital for fever and arthritis. They all had laboratory tests of the severe systemic inflammatory response (leukocytosis, thrombocytosis, high ESR, and high CRP) concerning infection. They underwent extensive workup for infectious causes, including septic arthritis, which came back negative. Other rheumatic diseases that are known to present with fever such as adult-onset Still’s disease, reactive arthritis, and crystal arthritis were all excluded. The final diagnosis of spondyloarthritis was made during their follow-up: three patients with peripheral spondyloarthritis and one with psoriatic arthritis. All patients received conventional DMARDs (methotrexate and sulfasalazine) and two patients received tumor necrosis factor inhibitors in addition to conventional DMARDs to control their disease. Conclusion. We observed a subgroup of peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response requiring hospitalization. Recognition of this subgroup is important and should be considered once an infection is ruled out.http://dx.doi.org/10.1155/2023/6651961
spellingShingle Ibrahim Abdulmomen
Eman Satti
Basem Awadh
Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review
Case Reports in Rheumatology
title Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review
title_full Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review
title_fullStr Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review
title_full_unstemmed Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review
title_short Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review
title_sort peripheral spondyloarthritis presenting with fever and severe systemic inflammatory response mimicking infection a case series and literature review
url http://dx.doi.org/10.1155/2023/6651961
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AT emansatti peripheralspondyloarthritispresentingwithfeverandseveresystemicinflammatoryresponsemimickinginfectionacaseseriesandliteraturereview
AT basemawadh peripheralspondyloarthritispresentingwithfeverandseveresystemicinflammatoryresponsemimickinginfectionacaseseriesandliteraturereview