Invasive fungal infection in patients with systemic lupus erythematosus: experience from a single institute of Northern China.

Invasive fungal infection (IFI) is a life-threatening infection occurring most often in patients with systemic lupus erythematosus (SLE) and few data has been reported in SLE patients particularly in China. This present study was aimed to determine IFI prevalence, associated risk factors and patterns of infection in Chinese SLE patients. A retrospective study was conducted in a single institute of Northern China from July 2004 and October 2010. Demographic characteristics, clinical and laboratory data, and mycological examinations were collected. Among 1534 patients included, 20 (1.6%) were diagnosed with IFI, of whom there were 18 females and 2 males with the average age of 35.4 ± 15.1 years old. Involved sites included nine lungs, six central nervous system and five disseminated cases. 6 of 20 IFIs cases (30%) were non-survivors including 2 lungs, 2 central nervous system and 2 disseminated cases. Compared with survivors, non-survivors had significantly higher equivalent prednisone doses, elevated level of serum C reactive protein (CRP), higher erythrocyte sedimentation rate (ESR), higher thrombocytopenia rate and higher systemic lupus erythematosus disease activity index (SLEDAI) score. These results strongly demonstrated that prednisone doses, CRP, ESR, thrombocytopenia and SLEDAI could be associated risk factors in the prognosis of SLE patients with IFI.