系统性红斑狼疮合并不明原因发热的病因分析

A clinical analysis on fever of unknown origin in in-patients with systemic lupus erythematosus

回顾性分析系统性红斑狼疮（SLE）合并不明原因发热（FUO）的病因，为SLE合并FUO的鉴别诊断提供帮助。2012年1月至2014年12月北京协和医院住院SLE患者928例，符合SLE合并FUO患者50例（5．4％），单纯病情控制不佳或复发引起的发热17例（34．0％）；单纯感染引起发热33例（66．0％），病原学检查提示细菌感染17例（其中结核分枝杆菌感染5例），病毒感染11例，真菌感染5例；无恶性肿瘤引起发热。50例SLE合并FUO患者中，非感染者17例，感染者33例。感染者较非感染者c反应蛋白、降钙素原升高。SLE合并FUO以感染多见，临床应予重视。

To investigate the etiology and differential diagnoses of patients with systemic lupus erythematosus （SLE） and fever of unknown origin （FUO）. From January 2012 to December 2014, a total of 928 SLE patients were admitted to Peking Union Medical College Hospital. Only 50 patients were combined with FUO （5.4%）. The most common reason of fever was caused by infections （ 33 cases, 66.0% ）, including bacterial infection in 17 cases with 5 tuberculosis, viral infection in 11 cases, and fungal infection in 5 cases. The second reason offerer was due to poor disease control or recurrence in 17 patients （34.0%）. No fever was caused by malignant tumor. When clinical data was compared between 17 non-infected patients versus 33 infected patients, C reactive protein and procalcitonin in the infected group were significantly higher than those in the non-infected group. In SLE patients combined with FUO, infection is the most common etiology which is necessary to be paid attention to.