Fever and Lupus
Fevers are often one of the early signs of lupus (SLE). Fevers are generally caused by infections that occur as a complication the disease. Urinary tract and respiratory infections are very common, but fevers can also be a result of more serious infections of the heart (pericarditis) or the lungs (pleurisy).
Episodic fever (>100 degrees F) is experienced by more than 80 percent of lupus patients, and there is no particular fever pattern. Although high fevers can occur during a lupus flare, low-grade fevers are more frequently seen. A complicating infection is often the cause of an elevated temperature in a patient with SLE.
The patient’s WBC 28 count may be normal to elevated with an infection, but low with SLE alone. However, certain medications, such as immunosuppressives, will suppress the WBC count even in the presence of fever. Therefore, it is important to rule out other causes of a fever, including an infection or a drug reaction.
For some people with lupus, an intermittent (coming and going) or continuous low-grade fever may be normal. Other people, especially those taking large doses of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or corticosteroids, may not have fever at all because these drugs may mask a fever.
If you have lupus, you may be more vulnerable to certain infections than other people who don’t have lupus. In addition, you may be more prone to infection if you are taking any immunosuppressive drugs for your lupus. Urinary and respiratory infections are common in SLE patients. Be alert to a temperature that is new or higher than normal for you, because it could be a sign of a developing infection or a lupus flare.
Caring for Yourself
- Take your temperature at least once a day (or more often if needed) to determine what a “normal” temperature is for you.
- Take your temperature and watch for a fever any time you feel chills or do not feel well.
- Call your doctor immediately if you have a new or higher-than normal temperature.
- Even if you don’t have a fever, don’t hesitate to call your doctor if you do not feel well in any way, particularly if you are taking aspirin, NSAIDs, or a corticosteroid. Signs of infection other than a fever include unusual pain, cramping or swelling, a headache with neck stiffness, cold or flu symptoms, trouble breathing, nausea, vomiting, diarrhea, or changes in urine or stool.
- Talk to your doctor about immunization against pneumococcal pneumonia and the flu.
- Practice good personal hygiene.
- Avoid large crowds and people who are sick.