Predictive potential of the disease activity index and C-reactive protein for infection in systemic lupus erythematosus patients (original) (raw)
Related papers
Predictors of major infections in systemic lupus erythematosus
Arthritis Research & Therapy, 2009
Methods A nested case-control study design was used within the prospective Lupus-Cruces cohort. The endpoints of the study were major infections. Cases were defined as patients with a major infection. Two controls (SLE patients without major infections), matched for time of follow-up until the event and age at diagnosis, were selected for each case. Univariate analysis and logistic regression models were used for the analysis of data.
Factors Related to Infection in Systemic Lupus Erythematosus Patients Admitted to the Hospital
Indonesian Journal of Rheumatology
Background: One of the causes of the increase in hospitalized SLE patients is infection, and it is an important factor in morbidity and mortality, so it is necessary to conduct a research to identify factors related to infection and the type of infection caused in hospitalized SLE patients. Methods: This study is a retrospective, categorical descriptive study utilizing medical records of SLE patients diagnosed with and treated for infection both on admission and during their stay in Hasan Sadikin General Hospital between January 2016 to June 2018. Results: Seventy- four patients were involved into this study. Female were 70 (94.6%), aged <40 years were 69 (93.2%) patients, and all 74 (100%) were entirely in an active disease condition with a mean Mexican systemic lupus erythematosus disease activity (Mex-SLEDAI) score of 9 ± 5.2. Fifty-three (71.6%) subjects experienced major infections. Mucocutaneous and kidney were the most organs involvement found in SLE patients during infect...
Lupus, 2020
Prospective data on infections in systemic lupus erythematosus (SLE) from India are scarce. We studied the frequency and predictors of infections in hospitalized SLE patients. All data on infections were prospectively recorded. During the study period, 212 SLE patients (91% women) were hospitalised. Sixty-three (29.7%) had infections. The most common infections were pneumonia, skin and soft-tissue infections and urinary-tract infections. Mortality was higher in the infection group compared to the no infection group (11.1% vs. 0.7%; p=0.01). At three months, 10/63 developed another episode of infection. On logistic regression, the predictors of infection were fever [odds ratio (OR) = 4.17], vasculitis (OR = 2.64), thrombocytopaenia (OR = 3.59), presence of co-morbidities (OR = 3.59) and duration of hospital stay >11 days (OR = 3.55); p<0.001 for all. High-sensitivity CRP (hsCRP) and procalcitonin were measured in 95 patients. hsCRP was significantly higher in the infection grou...
A study on steroids and immunosuppressants as risk factors for infections in SLE patients
IP innovative publication pvt. ltd, 2019
Introduction: Systemic lupus Erythematosus (SLE) patients are inherently at risk for infections. Steroids and other immunosuppressants used for treating SLE patients further increase the chances of infections. This study was done to find the association of immunosuppressants with the risk of development of infections in patients with SLE. Materials and Methods: Appropriate samples were collected from 110 SLE patients with various infections and processed in Microbiology laboratory. Treatment history was also collected from the patients and analysis was done on infections in these patients. Results: Daily prednisolone dosage 20 mg was associated with increased risk of infection with p value of < 0.05 and in patients receiving Cyclophosphamide with steroids also risk of infection was higher with p value <0.05 which is also statistically significant. Conclusion: Since there is strong association between higher dose of steroids and Cyclophosphamide therapy with risk of infections in SLE patients, judicious use of these drugs is recommended.
Annals of the Rheumatic Diseases, 1980
The concentration of C-reactive protein (CRP) in the sera of patients with systemic lupus erythematosus (SLE) was higher when the disease was active than when it was inactive, but was only markedly raised in patients suffering from identifiable microbial infection. CRP levels greater than 60 mg/i suggest the presence of intercurrent infection and may therefore be a valuable aid to the differential diagnosis of pyrexia in SLE. Pyrexia in systemic lupus erythematosus SLE is a common and important clinical problem (Hughes, 1977), particularly in patients who are being treated with anti-inflammatory or immunosuppressive drugs. The differential diagnosis, which usually lies between intercurrent infection and simple exacerbation of the underlying disease, may often be difficult to resolve rapidly. The erythrocyte sedimentation rate (ESR) is not a good index of disease activity in SLE (Hughes, 1977). Although the ESR does tend to rise with intercurrent infection, this does not differentiate it from active SLE alone with high ESR. Furthermore plasma viscosity and to an even greater extent ESR are determined by many variables and respond rather slowly and very variably to alterations in disease activity and other stimuli (Pepys, 1979a). Patients and methods Forty-one patients fulfilling the American Rheumatology Association criteria for the classification of SLE were studied longitudinally with a total of 214 sera collected over the 24-month period prior to June 1978. Their disease was regarded as active if vasculitis, serositis, arthritis, cerebral lupus, or severe glomerulonephritis was present. Infection was diagnosed only when clinical evidence was supported by microbiological studies. Patients with mild
Distinguishing infectionsvsflares in patients with systemic lupus erythematosus: Table 1
Rheumatology, 2016
SLE is a chronic autoimmune disease involving multiple systems. Patients with SLE are highly susceptible to infections due to the combined effects of their immunosuppressive therapy and the abnormalities of the immune system that the disease itself causes, which can increase mortality in these patients. The differentiation of SLE activity and infection in a febrile patient with SLE is extremely difficult. Activity indexes are useful to identify patients with lupus flares but some clinical and biological abnormalities may, however, make it difficult to differentiate flares from infection. Several biological markers are now recognized as potential tools to establish the difference between SLE activity and infection, including CRP and procalcitonin. It is possible, however, that the use of only one biomarker is not sufficient to confirm or discard infection. This means that new scores, which include different biomarkers, might represent a better solution for differentiating these two clinical pictures. This review article describes several markers that are currently used, or have the potential, to differentiate infection from SLE flares.
Seminars in arthritis and rheumatism, 2017
To estimate the incidence of severe infection and investigate the associated factors and clinical impact in a large systemic lupus erythematosus (SLE) retrospective cohort. All patients in the Spanish Rheumatology Society Lupus Registry (RELESSER) who meet ≥4 ACR-97 SLE criteria were retrospectively investigated for severe infections. Patients with and without infections were compared in terms of SLE severity, damage, comorbidities, and demographic characteristics. A multivariable Cox regression model was built to calculate hazard ratios (HRs) for the first infection. A total of 3658 SLE patients were included: 90% female, median age 32.9 years (DQ 9.7), and mean follow-up (months) 120.2 (±87.6). A total of 705 (19.3%) patients suffered ≥1 severe infection. Total severe infections recorded in these patients numbered 1227. The incidence rate was 29.2 (95% CI: 27.6-30.9) infections per 1000 patient years. Time from first infection to second infection was significantly shorter than tim...
Risk factors for infection in Malaysian patients with systemic lupus erythematosus
QJM, 1996
To determine the incidence, types and risk factors for infection in systemic lupus erythematosus (SLE) patients in Kuala Lumpur, Malaysia, we retrospectively reviewed the medical records of 102 patients with definite SLE attending a specialist clinic. Details of major infections (pneumonia or severe infection requiring intravenous therapy) and minor infections, and their time of onset in relation to immunosuppressive therapy and disease flares were recorded. There were 77 major and 163 minor infections during 564 patient-years of follow-up. In the month following a course of pulse methylpredniso-lone, the incidence of major infection was 20 times higher and the incidence of minor infection was 10 times higher than at other periods (p < 0.0001). In the month after disease flare, the incidence of major infection was 10 times higher and the incidence of minor infection six times higher than at other times (p < 0.0001). After allowing for methylprednisolone therapy and disease flares, there was no increase in the rate of infections during treatment with azathioprine, oral or intravenous cyclophosphamide. There was no effect of renal involvement on infection rate.