Linear IgA dermatosis: a new cause of fever of unknown origin

Blockmans, Daniel Engelbert; Bossuyt, L.; Degreef, Hugo; Knockaert, Daniël; Bobbaers, Herman

doi:10.1016/0300-2977(95)00012-x

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Fever of unknown origin may be caused by each of more than 200 diseases and is considered one of the major diagnostic challenges in medicine [2–4]. From time to time, new entities are added to the large list of causative diseases and then mainly in case reports [5–8]. All major textbooks of internal medicine pay considerable attention to this topic, which is also regularly updated in review articles [2, 3, 9, 10].…”

Section: Introductionmentioning

confidence: 99%

Fever of unknown origin in adults: 40 years on

Knockaert

Vanderschueren

Blockmans

2003

Journal of Internal Medicine

233

136

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A revision of the criteria of fever of unknown origin (FUO), established in 1961, is desirable because of important evolutions in medical practice and the emergence of new patient populations. The development of rapid laboratory tests and powerful diagnostic tools, such as ultrasonography, computed tomography and magnetic resonance imaging often makes hospitalization unnecessary and new categories of patients such as those with HIV infection, neutropenia, immunosuppression and nosocomial illness require an approach different from classical FUO. The more then 200 reported causes of FUO can be classified into four diagnostic categories; infections, tumours, noninfectious inflammatory diseases (NIID) and miscellaneous. A uniform classification system is highly wanted to allow comparison between different series. The reports of the 1990s show slight changes in the distribution of causes, namely less infections, less tumours, more NIID and more undiagnosed cases. A uniform diagnostic strategy cannot be determined. The initial investigation should be directed by potentially diagnostic clues revealed by extensive history, meticulous physical examination and a standard set of laboratory tests.18 Fluoro-deoxy-glucose-positron-emittedtomgraphy is a new valuable total body scintigraphy in the search for the site of origin of the fever. In view of the rather good long-term prognosis, a wait-andsee strategy may be more appropriate than a systematic staged approach. Elderly patients and patients with episodic fever represent two specific groups of classical FUO that require a distinct approach. HIVassociated, nosocomial and neutropenic FUO should be considered as separate clinical entities.

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Section: Introductionmentioning

confidence: 99%

Fever of unknown origin in adults: 40 years on

Knockaert

Vanderschueren

Blockmans

2003

Journal of Internal Medicine

233

136

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“…21 In a reciprocal manner, autoimmunity may be itself a reason for fever. 22 This is further supported by some reports noting that autoimmunity 23,24 and lymphoproliferative disorders 25 can be associated with fever of unknown origin.…”

Section: Discussionmentioning

confidence: 63%

Transient positivity of anti-tissue transglutaminase IgA autoantibody in febrile children: a case-control study

et al. 2021

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Background. Fever is a physiological response activated by integrative interactions between the neuronal and immune systems. The association of fever with the development of autoantibodies against various self-antigens is controversial. We here evaluated if fever was associated with increased levels of anti-tissue transglutaminase (tTG) IgA autoreactive antibodies in children.Methods. This was a case-control study performed the Amir-Al-Momenin Hospital of Zabol City from January to December 2018. Febrile children (N=135) and apparently healthy counterparts (N=135) were included. Total IgA and anti-tTG IgA were measured by ELISA.Results. From 270 children evaluated, 144 (53.6%) and 126 (46.4%) were males and females, respectively. The mean age was 4.7 ± 2.6 years. The mean total IgA titer was 208 ± 100 mg/dl, and the mean anti-tTG IgA titer was 15.9 ± 68 mg/dl. There was a significant difference in the mean titer of anti-tTG IgA between apparently healthy controls (1.97 ± 1.12 mg/dl) and febrile children (30.2 ± 94.9 mg/dl, p=0.002). Positivity for anti-tTG IgA was observed in 16 (11.8%) out of 135 febrile children while no subject in the control group had positive results. One out of the 16 positive cases showed persistent elevated levels after fever disappearance. On biopsy examination, this child was confirmed to have celiac disease. Conclusions.We showed that fever can trigger the production of anti-tTG IgA autoantibody in children. It is recommended for pediatricians to be vigilant in interpreting anti-tTG IgA results during fever episodes and repeat positive cases after the cease of fever. It is also recommended to reassess anti-tTG IgA seropositivity in other clinical settings in future studies.

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