Infectious complications in systemic lupus erythematosus:: A series of 146 patients

Purpose. - The objective of this Study was to analyse the incidence and characteristics of infection in systemic lupus erythematosus (SLE) and to determine the related risk factors. Methods. - A retrospective review of a well documented population of 146 Tunisian patients with SLE was undertaken. All patients fulfilled four or more criteria defined by the American College of Rheumatology. Results. - Sixty-five patients (44.5%) suffered at least one infection. Skin, urinary tract and lung were the most affected localizations. Bacterial infections (67.5%) were the most common. In the univariate analysis, nephritis, neuropsychiatric, leucopenia, lymphopenia, decreased complement (CH50, C3 and C4), SLE activity, ever use of steroids and cyclophosphamide were significantly associated with infection. In the multivariate analysis, nephritis, neuropsychiatric and lymphopenia were found to be significant. Conclusion. - SLE has an increased overall risk for infection and they are especially prone to develop urinary, cutaneous and pulmonary infections. Infectious complications seem to be more associated with major organ damage than with steroid or immunosuppressive therapy. (C) 2008 Elsevier Masson SAS. Tous droits reserves.