Fever as an initial manifestation of spondyloarthritis: A retrospective study

Se Jin Byun, William Han Bae, Seung Min Jung, Sang Won Lee, Yong Beom Park, Jason Jungsik Song

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives We aimed to evaluate a wide spectrum of clinical features of adult patients with spondyloarthritis (SpA) whose initial manifestation was fever, using the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Methods We retrospectively collected the electronic medical records of hospitalized SpA patients who initially presented to the Severance Hospital (Seoul, Korea) with fever from January 2010 to May 2016. As a control group, we also recruited one-hundred consecutive patients who were diagnosed with SpA in our outpatient clinic. Clinical features and laboratory findings were compared in two patient groups. Results There were 26 patients who had fever as initial presentation of SpA (reactive arthritis 50%, undifferentiated SpA 26.9%, ankylosing spondylitis 15.4%, enteropathic arthritis 3.8%, psoriatic arthritis 3.8%). Peripheral SpA was more common in febrile SpA patients than in control SpA patients (65.4% vs 24.0%, p<0.001). Febrile SpA patients were less frequently HLA-B27 positive than control SpA patients (52.2% vs 77.0%, p<0.05). At baseline, systemic inflammatory markers were significantly higher in the febrile SpA patients (white blood cell count, 11.57 vs 7.81 cells/μL, p<0.001; erythrocyte sedimentation rate, 69.2 vs 41.0 mm/h, p<0.001; C-reactive protein, 109.6 vs 15.3 mg/L, p<0.001). The proportion of patients treated with systemic steroids was significantly higher in febrile SpA patients (57.7% vs. 11.0%, p<0.001). The proportion of patients who visited rheumatology specialty was significantly lower in febrile SpA patients than in control SpA patients (7.7% vs 59.0%, p<0.001). Conclusion Various subgroups of SpA can be presented with fever as an initial manifestation. Febrile SpA patients demonstrated higher systemic inflammation and a lower chance to visit rheumatology in early stage. When evaluating febrile patients with any clinical features of SpA, clinicians are advised to consider performing SpA-focused evaluation including HLA-B27 or a simple sacroiliac joint radiograph.

Original languageEnglish
Article numbere0184323
JournalPloS one
Volume12
Issue number9
DOIs
Publication statusPublished - 2017 Sep

Fingerprint

retrospective studies
fever
Fever
Retrospective Studies
HLA-B27 Antigen
Electronic medical equipment
Sedimentation
C-Reactive Protein
Blood
Steroids
Cells
arthritis
Rheumatology
Sacroiliac Joint
erythrocyte sedimentation rate
Reactive Arthritis
Psoriatic Arthritis
Electronic Health Records
Blood Sedimentation
Ankylosing Spondylitis

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Byun, S. J., Bae, W. H., Jung, S. M., Lee, S. W., Park, Y. B., & Song, J. J. (2017). Fever as an initial manifestation of spondyloarthritis: A retrospective study. PloS one, 12(9), [e0184323]. https://doi.org/10.1371/journal.pone.0184323
Byun, Se Jin ; Bae, William Han ; Jung, Seung Min ; Lee, Sang Won ; Park, Yong Beom ; Song, Jason Jungsik. / Fever as an initial manifestation of spondyloarthritis : A retrospective study. In: PloS one. 2017 ; Vol. 12, No. 9.
@article{c8b5e54cff62444294cee4434e761d53,
title = "Fever as an initial manifestation of spondyloarthritis: A retrospective study",
abstract = "Objectives We aimed to evaluate a wide spectrum of clinical features of adult patients with spondyloarthritis (SpA) whose initial manifestation was fever, using the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Methods We retrospectively collected the electronic medical records of hospitalized SpA patients who initially presented to the Severance Hospital (Seoul, Korea) with fever from January 2010 to May 2016. As a control group, we also recruited one-hundred consecutive patients who were diagnosed with SpA in our outpatient clinic. Clinical features and laboratory findings were compared in two patient groups. Results There were 26 patients who had fever as initial presentation of SpA (reactive arthritis 50{\%}, undifferentiated SpA 26.9{\%}, ankylosing spondylitis 15.4{\%}, enteropathic arthritis 3.8{\%}, psoriatic arthritis 3.8{\%}). Peripheral SpA was more common in febrile SpA patients than in control SpA patients (65.4{\%} vs 24.0{\%}, p<0.001). Febrile SpA patients were less frequently HLA-B27 positive than control SpA patients (52.2{\%} vs 77.0{\%}, p<0.05). At baseline, systemic inflammatory markers were significantly higher in the febrile SpA patients (white blood cell count, 11.57 vs 7.81 cells/μL, p<0.001; erythrocyte sedimentation rate, 69.2 vs 41.0 mm/h, p<0.001; C-reactive protein, 109.6 vs 15.3 mg/L, p<0.001). The proportion of patients treated with systemic steroids was significantly higher in febrile SpA patients (57.7{\%} vs. 11.0{\%}, p<0.001). The proportion of patients who visited rheumatology specialty was significantly lower in febrile SpA patients than in control SpA patients (7.7{\%} vs 59.0{\%}, p<0.001). Conclusion Various subgroups of SpA can be presented with fever as an initial manifestation. Febrile SpA patients demonstrated higher systemic inflammation and a lower chance to visit rheumatology in early stage. When evaluating febrile patients with any clinical features of SpA, clinicians are advised to consider performing SpA-focused evaluation including HLA-B27 or a simple sacroiliac joint radiograph.",
author = "Byun, {Se Jin} and Bae, {William Han} and Jung, {Seung Min} and Lee, {Sang Won} and Park, {Yong Beom} and Song, {Jason Jungsik}",
year = "2017",
month = "9",
doi = "10.1371/journal.pone.0184323",
language = "English",
volume = "12",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "9",

}

Fever as an initial manifestation of spondyloarthritis : A retrospective study. / Byun, Se Jin; Bae, William Han; Jung, Seung Min; Lee, Sang Won; Park, Yong Beom; Song, Jason Jungsik.

In: PloS one, Vol. 12, No. 9, e0184323, 09.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Fever as an initial manifestation of spondyloarthritis

T2 - A retrospective study

AU - Byun, Se Jin

AU - Bae, William Han

AU - Jung, Seung Min

AU - Lee, Sang Won

AU - Park, Yong Beom

AU - Song, Jason Jungsik

PY - 2017/9

Y1 - 2017/9

N2 - Objectives We aimed to evaluate a wide spectrum of clinical features of adult patients with spondyloarthritis (SpA) whose initial manifestation was fever, using the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Methods We retrospectively collected the electronic medical records of hospitalized SpA patients who initially presented to the Severance Hospital (Seoul, Korea) with fever from January 2010 to May 2016. As a control group, we also recruited one-hundred consecutive patients who were diagnosed with SpA in our outpatient clinic. Clinical features and laboratory findings were compared in two patient groups. Results There were 26 patients who had fever as initial presentation of SpA (reactive arthritis 50%, undifferentiated SpA 26.9%, ankylosing spondylitis 15.4%, enteropathic arthritis 3.8%, psoriatic arthritis 3.8%). Peripheral SpA was more common in febrile SpA patients than in control SpA patients (65.4% vs 24.0%, p<0.001). Febrile SpA patients were less frequently HLA-B27 positive than control SpA patients (52.2% vs 77.0%, p<0.05). At baseline, systemic inflammatory markers were significantly higher in the febrile SpA patients (white blood cell count, 11.57 vs 7.81 cells/μL, p<0.001; erythrocyte sedimentation rate, 69.2 vs 41.0 mm/h, p<0.001; C-reactive protein, 109.6 vs 15.3 mg/L, p<0.001). The proportion of patients treated with systemic steroids was significantly higher in febrile SpA patients (57.7% vs. 11.0%, p<0.001). The proportion of patients who visited rheumatology specialty was significantly lower in febrile SpA patients than in control SpA patients (7.7% vs 59.0%, p<0.001). Conclusion Various subgroups of SpA can be presented with fever as an initial manifestation. Febrile SpA patients demonstrated higher systemic inflammation and a lower chance to visit rheumatology in early stage. When evaluating febrile patients with any clinical features of SpA, clinicians are advised to consider performing SpA-focused evaluation including HLA-B27 or a simple sacroiliac joint radiograph.

AB - Objectives We aimed to evaluate a wide spectrum of clinical features of adult patients with spondyloarthritis (SpA) whose initial manifestation was fever, using the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Methods We retrospectively collected the electronic medical records of hospitalized SpA patients who initially presented to the Severance Hospital (Seoul, Korea) with fever from January 2010 to May 2016. As a control group, we also recruited one-hundred consecutive patients who were diagnosed with SpA in our outpatient clinic. Clinical features and laboratory findings were compared in two patient groups. Results There were 26 patients who had fever as initial presentation of SpA (reactive arthritis 50%, undifferentiated SpA 26.9%, ankylosing spondylitis 15.4%, enteropathic arthritis 3.8%, psoriatic arthritis 3.8%). Peripheral SpA was more common in febrile SpA patients than in control SpA patients (65.4% vs 24.0%, p<0.001). Febrile SpA patients were less frequently HLA-B27 positive than control SpA patients (52.2% vs 77.0%, p<0.05). At baseline, systemic inflammatory markers were significantly higher in the febrile SpA patients (white blood cell count, 11.57 vs 7.81 cells/μL, p<0.001; erythrocyte sedimentation rate, 69.2 vs 41.0 mm/h, p<0.001; C-reactive protein, 109.6 vs 15.3 mg/L, p<0.001). The proportion of patients treated with systemic steroids was significantly higher in febrile SpA patients (57.7% vs. 11.0%, p<0.001). The proportion of patients who visited rheumatology specialty was significantly lower in febrile SpA patients than in control SpA patients (7.7% vs 59.0%, p<0.001). Conclusion Various subgroups of SpA can be presented with fever as an initial manifestation. Febrile SpA patients demonstrated higher systemic inflammation and a lower chance to visit rheumatology in early stage. When evaluating febrile patients with any clinical features of SpA, clinicians are advised to consider performing SpA-focused evaluation including HLA-B27 or a simple sacroiliac joint radiograph.

UR - http://www.scopus.com/inward/record.url?scp=85029476566&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029476566&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0184323

DO - 10.1371/journal.pone.0184323

M3 - Article

C2 - 28910361

AN - SCOPUS:85029476566

VL - 12

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 9

M1 - e0184323

ER -