SYSTEMIC LUPUS ERYTHEMATOSUS AND INFECTION, ANALYSIS OF 893 SLE PATIENTS IN IRAN.


Abstract: An increased rate of infection among SLE patients has long been reported from western countries. In a retrospective study in 893 patients, we analyzed 203 cases who had one or more episodes of infection between 1974 and 1992. Among them 181 were females and 22 were males (89% female) . The diagnosis of infection was established by both clinical and laboratory findings. Almost more than half of the infections were caused by gram-negative bacteria. Thirty nine episodes of infection which occurred in 30 patients were due to Salmonella: Common sites of infections were: urinary tract 58% (almost all due to E. Coli), blood 28%, respiratory system 22.6%, soft tissues 17%, joints 7.8%, bone 2.4% and CNS 1.4%. Herpes Zoster infection was in 55 cases. In most instances, infections were non-hospital acquired. Active disease (SLE) was present in almost 2/3 of the infectious events. Almost 80% of the infectious events occurred while the patients were on steroids or steroids and Cytotoxic agents. The mortality rate was significantly higher in patients with infection than in other SLE patients.