2018 Fiscal Year Annual Research Report
Key diagnostic characteristics of fever of unknown origin: A prospective multicenter study
| Project/Area Number |
16K09257
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| Research Institution | Juntendo University |
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Principal Investigator |
内藤 俊夫 順天堂大学, 医学部, 教授 (10365570)
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| Co-Investigator(Kenkyū-buntansha) |
古庄 憲浩 九州大学, 医学研究院, 共同研究員 (10346786)
大塚 文男 岡山大学, 医歯薬学総合研究科, 教授 (40362967)
舛形 尚 香川大学, 医学部附属病院, 教授 (70263910)
森田 浩之 岐阜大学, 大学院医学系研究科, 教授 (90252147)
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Keywords | 不明熱 / 血沈 / 高齢化 |
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| Outline of Annual Research Achievements |
Fever of unknown origin (FUO) is a challenging problem worldwide. The diagnosis of FUO varies with age and symptoms are difficult to interpret. FUO patients with unknown causes can contribute up to 50% in all cases. With advance diagnostic tools and techniques, yet the diagnosis of FUO remained difficult, particularly in the elderly.
This multicenter prospective study was undertaken from January 2016 to December 2017. A total of 141 cases met the criteria of FUO recruited from 16 hospitals affiliated with the Japanese Society of Hospital General Medicine. The most frequent age group was 65-79 years old with a higher frequency of NIID as the cause of FUO. After a 6-month follow-up period, 21.3% of cases remained undiagnosed. Chi-square tests showed that the causative diseases for FUO were significantly correlated with age and prognosis. Between patients with and those without the final diagnosis, the performance of erythrocyte sedimentation rate test (ESR) was compared by logistic regression analysis, which revealed a significant difference (p = 0.041).
Our study identified that age may be a key factor in the differential diagnosis for FUO and ESR test may perform with a higher priority during the FUO evaluation process. These results may provide clinicians key insights in management of FUO which permits the adequate treatments according to the causes of disease and further improves the prognosis of FUO patients.
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