From the Guidelines
GPA can indeed cause fever, as it is a systemic autoimmune disease that triggers the release of cytokines and other inflammatory mediators, leading to fever as one of its constitutional symptoms. This is evident from the European position paper on rhinosinusitis and nasal polyps 2020, which highlights the various symptoms of GPA, including fever, fatigue, weight loss, and night sweats, which are often associated with the development of relatively minor upper respiratory symptoms 1. The disease can present in many ways, and the development of fever is a common manifestation, especially during disease flares.
The inflammatory process in GPA affects small and medium-sized blood vessels, leading to the release of cytokines and other inflammatory mediators that act on the hypothalamus to reset the body's temperature regulation. Other common symptoms that may accompany fever in GPA include fatigue, weight loss, joint pain, and specific organ involvement such as sinusitis, bloody nasal discharge, cough, shortness of breath, or kidney problems.
According to the 2022 update on the management of ANCA-associated vasculitis, treatment typically involves immunosuppressive medications like cyclophosphamide, rituximab, or corticosteroids, which address the underlying autoimmune process and consequently resolve the fever 1. The recommendation is to use a combination of glucocorticoids and either rituximab or cyclophosphamide for induction of remission in patients with new-onset or relapsing GPA or MPA with organ-threatening or life-threatening disease.
Key points to consider in the management of GPA include:
- Fever is a common symptom of GPA, especially during disease flares
- The inflammatory process in GPA triggers the release of cytokines and other inflammatory mediators, leading to fever
- Treatment typically involves immunosuppressive medications like cyclophosphamide, rituximab, or corticosteroids
- Prompt medical evaluation is essential for proper diagnosis and management of GPA, especially if persistent fever is accompanied by respiratory or kidney symptoms.
From the Research
Guanine Phosphoribosyltransferase (GPA) and Fever
- There is no direct evidence that Guanine Phosphoribosyltransferase (GPA) causes fever. However, Granulomatosis with polyangiitis (GPA) is a different condition that can present with non-specific symptoms, including fever, lethargy, and flu-like illness 2.
- GPA can manifest as fever of unknown origin (FUO), posing a diagnostic and therapeutic challenge for clinicians 2, 3.
- The condition is characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tract, vasculitis, and glomerulonephritis, and may present with symptoms such as cough, haemoptysis, sinusitis, nasal deformity, skin lesions, malaise, fever, anorexia, and weight loss 4.
- Skin involvement in GPA is common and can appear as an initial presentation of the disease or during its course, with symptoms including fever, hemoptysis, generalized hemorrhagic blisters, arthralgia, fatigue, myalgia, nasal crusting, and vertigo 5.
- Ocular involvement is also common in GPA, with various manifestations due to the different ocular tissues affected, but it does not typically present with fever as a primary symptom 6.