P P W Lee1, T-L Lee, M H-K Ho, W H S Wong, Y-L Lau. 1. Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong, China.
Abstract
OBJECTIVES: We postulate that patients with systemic lupus erythematosus (SLE) having recurrent infections are more likely to have poorer disease outcome. The aim of this study is to describe the pattern of infections and disease damage that occurred in a cohort of patients with juvenile-onset SLE, and to find out whether cumulative disease damage was associated with recurrent infections in these patients. METHOD: We retrospectively reviewed (1988-2004) the clinical characteristics, infective complications, and disease damage as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) in 47 juvenile-onset SLE patients. Potential risk factors for disease damage were evaluated by univariate analysis and logistic regression. The correlation between number of major infections and disease damage was determined. RESULTS: Thirty-two (68.1%) patients had lupus nephropathy and 16 patients (34%) had neuropsychiatric lupus. Sixty-one episodes of major infections, defined as infections requiring more than 1 week of antimicrobial agents, occurred in 27 patients (57.4%), and 18 patients (31.4%) had recurrent major infections (>/= 2 episodes). Organ damage (SDI >/= 1) was documented in 21 subjects (44.7%). By logistic regression, occurrence of major infections (P < 0.001) was the only significant risk factor for disease damage. There was a positive correlation between SDI score with the number of recurrent major infections (Spearman's correlation coefficient = 0.50, P < 0.001). CONCLUSION: Infections and disease damage are common co-morbidities in juvenile-onset SLE. Recurrent infections could predict poorer disease outcome and associated organ damage in SLE.
OBJECTIVES: We postulate that patients with systemic lupus erythematosus (SLE) having recurrent infections are more likely to have poorer disease outcome. The aim of this study is to describe the pattern of infections and disease damage that occurred in a cohort of patients with juvenile-onset SLE, and to find out whether cumulative disease damage was associated with recurrent infections in these patients. METHOD: We retrospectively reviewed (1988-2004) the clinical characteristics, infective complications, and disease damage as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) in 47 juvenile-onset SLEpatients. Potential risk factors for disease damage were evaluated by univariate analysis and logistic regression. The correlation between number of major infections and disease damage was determined. RESULTS: Thirty-two (68.1%) patients had lupus nephropathy and 16 patients (34%) had neuropsychiatric lupus. Sixty-one episodes of major infections, defined as infections requiring more than 1 week of antimicrobial agents, occurred in 27 patients (57.4%), and 18 patients (31.4%) had recurrent major infections (>/= 2 episodes). Organ damage (SDI >/= 1) was documented in 21 subjects (44.7%). By logistic regression, occurrence of major infections (P < 0.001) was the only significant risk factor for disease damage. There was a positive correlation between SDI score with the number of recurrent major infections (Spearman's correlation coefficient = 0.50, P < 0.001). CONCLUSION:Infections and disease damage are common co-morbidities in juvenile-onset SLE. Recurrent infections could predict poorer disease outcome and associated organ damage in SLE.
Authors: Linda T Hiraki; Candace H Feldman; Francisco M Marty; Wolfgang C Winkelmayer; Hongshu Guan; Karen H Costenbader Journal: Arthritis Care Res (Hoboken) Date: 2017-09-21 Impact factor: 4.794
Authors: May Y Choi; Kelsey Flood; Sasha Bernatsky; Rosalind Ramsey-Goldman; Ann E Clarke Journal: Best Pract Res Clin Rheumatol Date: 2017-11-10 Impact factor: 4.098
Authors: Peng Hu; Bao Yu Huang; Dong Dong Zhang; Guang Mei Jiang; Si Yan Liu; Xun Xia; Jie Cai Journal: Arch Med Sci Date: 2017-04-20 Impact factor: 3.318