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Fever of unknown origin (FUO) and chronic inflammatory syndrome could be seen in many affections. The diagnostic process is still a challenge and could not be specified yet after several clinical studies performed by trained teams using two levels diagnostic procedures. For this reason, the diagnosis involves many additional and expensive tests such as computed tomography (CT scan), scintigraphic imaging, endoscopy, biopsy. There is no evidence-based recommendation for the diagnostic work-up of FUO or chronic inflammatory syndrome. Positron emission tomography with 2-[18F] fluoro-2-deoxy-D-glucose combined with CT scan (FDG-PET/CT) is widely used in malignant diseases and seems to be promising for the diagnosis of inflammatory disorders. Its role has not been yet clearly defined in the investigation of FUO and chronic inflammatory syndrome.
All patients with FUO and chronic inflammatory syndrome will undergo FDG-PET/CT and conventional morphologic imaging modalities. Results of these two diagnostic procedures in identifying diagnostic clues will be compared.
We assume FDG-PET/CT could be safer and more helpful to reach early final diagnosis in patients with FUO and chronic inflammatory syndrome than conventional morphologic imaging modalities
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TEP | Procedure | Intravenous injection of glucose labeled Fluor 18. The patient remains fasted at least 6 hours before the start of the examination. The review lasted 1 hour, during wich the patient should not move. |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the contribution of FDG-PET/CT in the early diagnostic work-up of patients with FUO or chronic inflammatory syndrome | 3 month |
| Measure | Description | Time Frame |
|---|---|---|
| To establish the role of FGD PET in reaching final diagnosis compared to conventional morphologic imaging modalities including computer tomography and gallium-67 citrate scintigraphy. | 3 months | |
| To evaluate sensitivity and specificity of this diagnostic procedure |
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Inclusion Criteria:
Fever since 3 weeks, Temperature > 38.3°C, No diagnostic after 3 days of hospitalization.
Fever with criteria like FUO, Fever-free intervals, and apparent remission of the underlying disease, At least 3 febrile episodes.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kim LY, MD | University Hospital, Limoges | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Médecine Interne - CHU | Amiens | France | 80080 | France | ||
| Médecine Nucléaire - CHU |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35054081 | Result | Ly KH, Costedoat-Chalumeau N, Liozon E, Dumonteil S, Ducroix JP, Sailler L, Lidove O, Bienvenu B, Decaux O, Hatron PY, Smail A, Astudillo L, Morel N, Boutemy J, Perlat A, Denes E, Lambert M, Papo T, Cypierre A, Vidal E, Preux PM, Monteil J, Fauchais AL. Diagnostic Value of 18F-FDG PET/CT vs. Chest-Abdomen-Pelvis CT Scan in Management of Patients with Fever of Unknown Origin, Inflammation of Unknown Origin or Episodic Fever of Unknown Origin: A Comparative Multicentre Prospective Study. J Clin Med. 2022 Jan 13;11(2):386. doi: 10.3390/jcm11020386. |
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| 3 months |
| To analyse the cost effectiveness of this diagnostic approach | 3 months |
| Amiens |
| France |
| 80080 |
| France |
| Médecine Interne - CHU | Lille | France | 59037 | France |
| Médecine Nucléaire et Imagerie Fonctionnelle - CHU | Lille | France | 59037 | France |
| Médecine Interne - CHU | Limoges | France | 87042 | France |
| Médecine Nucléaire - CHU | Limoges | France | 87042 | France |
| Médecine Interne - AP-HP - Hôpital Hôtel Dieu | Paris | France | 75004 | France |
| Médecine Nucléaire - AP-HP - Hôpital Hôtel Dieu | Paris | France | 75004 | France |
| Médecine Interne - AP-HP - La Pitié Salpétrière | Paris | France | 75013 | France |
| Médecine Nucléaire - AP-HP - La Pitié Salpétrière | Paris | France | 75013 | France |
| Médecine Interne - AP-HP - Hôpital Cochin | Paris | France | 75014 | France |
| Médecine Interne - AP-HP - Hôpital Bichat | Paris | France | 75018 | France |
| Médecine Nucléaire - AP-HP - Hôpital Bichat | Paris | France | 75018 | France |
| Service des Isotopes - CRLCC Centre Eugène Marquis | Rennes | France | 35042 | France |
| Département de Médecine pour adulte - CHU | Rennes | France | 35056 | France |
| Médecine Interne - CH | Rodez | France | 12000 | France |
| Médecine Nucléaire - CH | Rodez | France | 12000 | France |
| Médecine Interne - CHU | Toulouse | France | 31059 | France |
| Médecine Nucléaire - CHU | Toulouse | France | 31059 | France |
| ID | Term |
|---|---|
| D005334 | Fever |
| D005335 | Fever of Unknown Origin |
| ID | Term |
|---|---|
| D001832 | Body Temperature Changes |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C072829 | tetraethylpyrazine |
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