Major infections in a cohort of 120 patients with juvenile-onset systemic lupus erythematosus

Clin Immunol. 2013 Dec;149(3):442-9. doi: 10.1016/j.clim.2013.08.009. Epub 2013 Sep 2.

Abstract

In order to describe the incidence and characteristics of major infections in juvenile-onset systemic lupus erythematosus (jSLE), we studied a cohort of 120 patients (51% Hispanic and 28% African American, 49% with renal involvement and 12% with neuropsychiatric manifestations). There were 101 major infections affecting 44 patients (37%) for an incidence of 169/1000 patient-years of follow-up. Active disease at jSLE diagnosis, renal involvement, neuropsychiatric manifestations, higher cumulative dose of prednisone, and treatment with cyclophosphamide or mycophenolate mofetil were all associated with major infection (p<0.05). By logistic regression, the combined effect of treatment with cyclophosphamide and cumulative dose of prednisone was associated with major infection (p=0.04). Two patients died, one due to cytomegalovirus infection. Major infection was associated with damage (p=0.004). In conclusion, in a large cohort of jSLE patients, major infections were common, were associated with active disease and its treatment, and resulted in noteworthy morbidity.

Keywords: Infections; Lupus;; SLE;; Systemic lupus erythematosus;.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Bacterial Infections / complications
  • Bacterial Infections / microbiology
  • Bacterial Infections / mortality
  • Bacterial Infections / pathology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Kidney / immunology
  • Kidney / microbiology
  • Kidney / pathology
  • Kidney / virology
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / mortality
  • Lupus Erythematosus, Systemic / pathology*
  • Lupus Erythematosus, Systemic / virology
  • Male
  • Psychotic Disorders / complications
  • Psychotic Disorders / mortality
  • Psychotic Disorders / pathology*
  • Psychotic Disorders / virology
  • Severity of Illness Index
  • Survival Analysis
  • Virus Diseases / complications
  • Virus Diseases / mortality
  • Virus Diseases / pathology*
  • Virus Diseases / virology
  • Young Adult