Active tuberculosis in patients with systemic lupus erythematosus from Southern China: a retrospective study

Lao, Minxi; Chen, Dongying; Wu, Xingcheng; Chen, Haihong; Qiu, Qian; Yang, Xia; Zhan, Zhi-Hui

doi:10.1007/s10067-018-4303-z

Cited by 23 publications

(27 citation statements)

References 36 publications

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“…These figures are higher compared to those in Western countries (187/100 000 patient‐years), 42 and the risk of TB infection in SLE patients is higher than in the general population 45 . Risk factors for TB infection in SLE patients include high disease activity (SLE Disease Activity Index score >12), 39 renal involvement, 40 high cumulative doses of glucocorticoids, 39,40,46 lymphopenia, 46 longer disease duration of SLE and a past history of TB 41…”

Section: Resultsmentioning

confidence: 99%

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

et al. 2021

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Systemic lupus erythematosus (SLE) is a more common autoimmune rheumatic disease in the Asia‐Pacific region. The prognosis of SLE remains unsatisfactory in some Asian countries because of delayed diagnosis, limited access to medications, increased complications and issues of tolerability and adherence to treatment. The Asia‐Pacific League of Associations for Rheumatology SLE special interest group has recently published a set of consensus recommendations on the management of SLE for specialists, family physicians, specialty nurses, and other healthcare professionals in the Asia‐Pacific region. This article reports a systematic literature review of the infective complications of SLE in Asia and evidence for prevention of these infections by pre‐emptive antimicrobial therapy and vaccination.

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Section: Resultsmentioning

confidence: 99%

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

et al. 2021

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“…29 Therefore, we speculated that the extent of decline of CD4+ T cells in SLE patients determines immunity. At present, several centres have confirmed that lymphocytopaenia is the independent risk factor for infection in lupus, 15,30,31 but there is no research about CD4+ T cells and infection.…”

Section: Discussionmentioning

confidence: 99%

Severe pneumonia in Chinese patients with systemic lupus erythematosus

Peng

Wang

Zhao

et al. 2020

Lupus

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Objective This study aimed to investigate the clinical characteristics and risk factors associated with severe pneumonia in systemic lupus erythematosus (SLE) patients from China. Method We performed a retrospective study in 112 hospitalized SLE patients who had had pneumonia for 8 years. The primary outcome was severe pneumonia, followed by descriptive analysis, group comparison and bivariate analysis. Results A total of 28 SLE patients were diagnosed with severe pneumonia, with a ratio of 5:23 between men and women. The mean age at diagnosis was 44.36 ± 12.389 years. The median disease duration was 72 months, and the median SLE Disease Activity Index 2000 (SLEDAI 2K) score was 8. The haematological system was the most affected, with an incidence of anaemia in 85.7% of cases and thrombocytopenia in 75% of cases, followed by lupus nephritis in 50% of cases and central nervous system involvement in 10.71% of cases. Cultured sputum specimens were positive in 17 (68%) SLE patients with severe pneumonia, of whom nine (36%) were cases of fungal infection, five (20%) were cases of bacterial infection and three (12%) were cases of mixed infection. Using multivariate logistic regression analysis, we concluded that a daily dosage of prednisone (>10 mg; odds ratio (OR) = 3.193, p = 0.005), a low percentage of CD4+ T lymphocytes (OR = 0.909, p = 0.000), a high SLEDAI 2K score (OR = 1.182, p = 0.001) and anaemia (OR = 1.182, p = 0.001) were all independent risk factors for pneumonia in SLE patients, while a low percentage of CD4+ T lymphocytes (OR = 0.908, p = 0.033), a daily dose of prednisone of >10 mg (OR = 35.67, p = 0.001) were independent risk factors for severe pneumonia in SLE patients. Conclusion Severe pneumonia is not rare in lupus, and is associated with high mortality and poor prognosis. Monitoring CD4+ T-cell counts and giving a small dose of glucocorticoids can reduce the occurrence of severe pneumonia and improve the prognosis of patients with lupus.

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“…Tuberculosis (TB) remains one of the most common formidable infections in China and globally [6]. As an immunocompromised population, SLE patients have a higher risk of TB infection than the general population [7][8][9][10][11][12][13]. Precise incidence reports of TB in lupus patients are lacking to date.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis in patients with systemic lupus erythematosus–a 37‐year longitudinal survey‐based study

Xiao

Xie

et al. 2020

J Intern Med

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Background. Infections are one of the most common causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). SLE patients have a higher risk of tuberculosis (TB) infection due to impaired immune defence.Objectives. To investigate the demographics, clinical characteristics and outcomes of patients with SLE and concomitant TB.Methods. Medical records of SLE patients with TB who were admitted to Peking Union Medical College (PUMC) Hospital in 1983-2019 were retrospectively reviewed. Age-and sex-matched SLE inpatients without TB were randomly selected as controls. Clinical and laboratory features and treatment were analysed and compared, and subjects were followed up to assess their outcome. Results. Of the 10 469 SLE inpatients, 249 (2.4%) were diagnosed with TB. Compared with controls, SLE/ TB + patients exhibited higher frequency of prior haematologic, mucocutaneous and muscu-loskeletal system involvement, and prior treatment with potent glucocorticoid/immunosuppressive agents (GC/ISA). Arthritis and alopecia, positive T-SPOT.TB test and lymphocytopenia were more common in SLE/TB + patients. SLE/TB + patients with lupus before TB (SLE ? TB) had higher risk of miliary TB (22.8%) and intracranial TB (16.5%) than SLE/TB + patients with lupus after TB (TB ? SLE). SLE/TB + patients exhibited shorter long-term survival than SLE/TB-patients; those with poorer inhospital outcomes had more severe lymphocytopenia and had received less treatment with ISAs. Conclusion. Systemic lupus erythematosus patients treated vigorously with GC/ISA should be alerted of increased risk of TB infection, especially miliary and intracranial TB. Positive T-SPOT.TB and lymphocytopenia served as discriminatory variables between SLE/TB + and SLE/TB-patients. Lymphocytopenia was associated with poorer outcomes in SLE/TB + patients.

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Active tuberculosis in patients with systemic lupus erythematosus from Southern China: a retrospective study

Cited by 23 publications

References 36 publications

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

Prevention of infective complications in systemic lupus erythematosus: A systematic literature review for the APLAR consensus statements

Severe pneumonia in Chinese patients with systemic lupus erythematosus

Tuberculosis in patients with systemic lupus erythematosus–a 37‐year longitudinal survey‐based study

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