Infection in systemic lupus erythematosus patients

Dorgham, Dalia; Anwar, Somaya; Khaled, Al Shimaa

doi:10.1016/j.ejr.2020.12.007

Cited by 6 publications

(3 citation statements)

References 33 publications

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“…Riley and George [5] describe herpes zoster, mycobacterial tuberculosis, and fungal infection as the most common infections observed among patients with rheumatoid arthritis on disease-modifying agents or biological agents or steroids. Dorgham et al [6] also observed a similar pattern of infection that was mostly bacterially followed by fungal and viral infection among systemic lupus erythematosus (SLE) patients who were on DMARD or steroids. According to Germano et al [7] most commonly observed infections were bacterial, followed by viral and fungal in both rheumatoid arthritis and spondyloarthropathy.…”

Section: Discussionmentioning

confidence: 83%

Pattern and Predictors of Infection Among Patients With Rheumatological Disease on Immunosuppressive Medications: A Retrospective Study in a Tertiary Care Hospital in Bangladesh

Been Sayeed,

Moniruzzaman,

Kabir

et al. 2024

Cureus

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BackgroundImmunomodulatory therapy for chronic rheumatic disease carries a risk for infectious complications. In Bangladesh, there is limited information regarding patterns and factors associated with infections among patients receiving immunosuppressive medications. ObjectiveThe present study aimed to find out patterns and predictors associated with infection among patients who were on different immunosuppressive medications due to chronic rheumatological disease. MethodologyThis was a retrospective study; all confirmed cases of (new and old) different rheumatological diseases on disease-modifying agents attended at the rheumatology clinic of Dhaka Medical College Hospital from January 2019 to December 2021 were enrolled. ResultAmong 489 cases, 90 (18.4%) patients had documented infections. The most common rheumatological diseases were systemic lupus erythematosus (28, 31.1%), ankylosing spondylitis (26, 28.8%), and rheumatoid arthritis (20, 22.2%). 31.1%) was the most commonly occurring infection followed by urinary tract infection (14, 15.6%), fungal infection (12, 13.3%), herpes zoster (10, 11.1%), pulmonary tuberculosis (TB) (eight, 8.8%), latent TB (seven, 7.7%), community-acquired pneumonia (six, 6.6%), and sepsis (three, 3.3%). Infection was most prevalent among patients who received steroids of more than 10 mg per day (17, 18.8%) than those less than 10 mg steroid per day (six, 6.7%), Factors associated with infections were (odds ratio, 95% CI, p-value) underweight (2.

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Section: Discussionmentioning

confidence: 83%

Pattern and Predictors of Infection Among Patients With Rheumatological Disease on Immunosuppressive Medications: A Retrospective Study in a Tertiary Care Hospital in Bangladesh

Been Sayeed,

Moniruzzaman,

Kabir

et al. 2024

Cureus

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“…Возникают опасения по поводу связи между инфекцией COVID-19 и аутоиммунными заболеваниями [4]. Известно, что пациенты с тяжело протекающим COVID-19 имеют повышенный уровень провоспалительных цитокинов и биомаркеров [5], что вызывает вторичные кожные проявления инфекции как результат иммунного ответа [6].…”

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Impact of COVID-19 on the occurrence and exacerbation of cutaneous forms of lupus erythematosus: A review

et al. 2023

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The article addresses the impact of the new coronavirus infection on the occurrence of cutaneous forms of lupus erythematosus (LE). Since the beginning of the COVID-19 pandemic, there has been an increase in the incidence of cutaneous LE worldwide, the emergence of new cases, and exacerbation and aggravation of the severity of existing ones. The pathogenesis of cutaneous LE, and the role of viral infections in its occurrence, mainly COVID-19, is reviewed. The need for the SARS-CoV-2 vaccination and its potential as a possible trigger is described. It is necessary to note the importance of clinicians in diagnosing LE since it is essential for the dermatologist to know the features of its course and be able to suspect and diagnose even the rarest forms of this disease. Proper awareness and correct diagnosis determine the optimal drug therapy and patient health in the future.

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“…Серьезной проблемой, с которой сталкиваются лечащие врачи, является разграничение проявлений инфекции и обострения СКВ, поскольку инфекции могут имитировать активность заболевания, а проведение активной иммуносупрессивной терапии для лечения тяжелых обострений СКВ может иметь катастрофические осложнения у пациентов с активной инфекцией [2][3][4][5].…”

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Vaccination of pneumococcal infection in patients with systemic lupus erythe matosus and antiphospholipid syndrome: experience of 6 years of use

Тарасова¹,

Белов²,

Reshetnyak³

et al. 2023

Naučno-praktičeskaâ revmatologiâ

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Infections remain one of the main causes of morbidity and mortality in patients with immuno-inflammatory rheumatic diseases. Objective – to study the efficacy, immunogenicity and safety of the 23-valent polysaccharide pneumococcal vaccine (PPV-23) in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (AРS). Materials and methods. 91 patients were included in the study: 78 with SLE, of which 18 (23 %) – with secondary AРS, 13 – with primary AРS. 85 patients received immunosuppressive therapy, including 30 – genetically engineered biological drugs (bDMARD); 23 – anticoagulants. PPV-23 was administered subcutaneously, patients were observed for a year after vaccination. Results. Local reactions were observed in 49% of patients with SLE and secondary AРS, in 23% of patients with primary AРS. General reactions were noted in isolated cases, were short-term and did not require additional prescriptions. During the follow-up period, no exacerbations of SLE, relapses of thrombosis and thromboembolism associated with vaccination were detected; no development of new autoimmune diseases was registered. 10 (13%) patients with SLE were immunized against the background of high activity of the disease, no adverse reactions were recorded. In some patients, a transient increase in a-DNA and ANF was observed during the year without signs of exacerbation of the disease. 56% of patients with SLE and secondary AРS, 15.4% with primary AРS were “responders” to the vaccine. There was no negative effect on the immune response of the dose of GC >10 mg/day, age, duration and activity of the disease. With the treatment of bDMARD, a full-fledged vaccine response was recorded much less frequently than with standard therapy (38% and 67.4%, respectively; p=0.01). After vaccination, there was a significant decrease in the number of lower respiratory tract infections (LRTI) (p=0.0001), including community-acquired pneumonia (PN) (p=0.03) and acute bronchitis (p=0.04), ENT infections (p=0.001). In the treatment of rituximab (RTM), compared with belimumab (BLM), a greater number of LRTI was observed, mainly due to PN. After vaccination on RTM therapy, the number of INDP in general (p=0.008) and PN in particular (p=0.03) decreased, isolated cases of LRTI and ENT organs were recorded on BLM therapy. Within 4–6 years after vaccination, 30 patients with SLE retained the clinical effect of vaccination, while immunogenicity decreased to 18%. Conclusion. Safety, sufficient immunogenicity, and clinical efficacy of PPV-23 in patients with SLE and AРS have been shown. The use of bDMARD reduces the vaccine response. Immunization performed prior to or during treatment with bDMARD lasting <1 year increases the number of vaccine responders.

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Infection in systemic lupus erythematosus patients

Cited by 6 publications

References 33 publications

Pattern and Predictors of Infection Among Patients With Rheumatological Disease on Immunosuppressive Medications: A Retrospective Study in a Tertiary Care Hospital in Bangladesh

Pattern and Predictors of Infection Among Patients With Rheumatological Disease on Immunosuppressive Medications: A Retrospective Study in a Tertiary Care Hospital in Bangladesh

Impact of COVID-19 on the occurrence and exacerbation of cutaneous forms of lupus erythematosus: A review

Vaccination of pneumococcal infection in patients with systemic lupus erythe matosus and antiphospholipid syndrome: experience of 6 years of use

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