ArticlePloS one2017
Fever as an initial manifestation of spondyloarthritis: A retrospective study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 10 citations in OpenAlex.
- Diagnostic and therapeutic challenges in a patient with coexisting ankylosing spondylitis and Löfgren's syndrome: A case report.The Journal of international medical research · 2026Review
- Late onset axial spondyloarthritis presenting with fever of unknown origin. A case-based review.Rheumatology international · 2026Article
- Development and implementation of the international AIDA network spondylarthritis registry.Frontiers in medicine · 2025Article
- Imaging findings in patients with axial spondyloarthritis presenting with recurrent fever attacks: data from the international AIDA network spondyloarthritis registry.Frontiers in medicine · 2025Article
- [Fever in rheumatological diseases].Zeitschrift fur Rheumatologie · 2024Review
- Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review.Case reports in rheumatology · 2023Article
- Axial spondyloarthritis in patients with recurrent fever attacks: data from the AIDA network registry for undifferentiated autoInflammatory diseases (USAIDs).Frontiers in medicine · 2023Article
- A Case of a Non-Radiographic Axial Spondyloarthritis in a 14-Year-Old Girl Presenting with Muscle Weakness and Hyperthyroidism.International medical case reports journal · 2020Article
- Ankylosing spondylitis presenting with enthesitis at an uncommon site and fever of unknown origin.BMJ case reports · 2019Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe 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.
methodsWe 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.
resultsThere 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).
conclusionVarious 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.
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