Risk factors and clinical features for tuberculosis among patients with systemic lupus erythematosus in Hong Kong

Objective: To determine the risk factors associated with and to describe the clinical course of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE). Methods: Clinical features of patients with TB during the 1-year period prior to the diagnosis of TB were compared with controls. Results: Of the 526 SLE patients, 57 (11%) had TB. Extra-pulmonary or miliary TB occurred in 67%. Patients with TB were more likely to have organic brain syndrome, vasculitis, and nephritis; and they were also more likely to have received intravenous 'pulse' methylprednisolone or high cumulative dose of prednisolone. The cumulative dose of prednisolone and presence of nephritis were independent risk factors for the development of TB using multivariate regression analysis. Conclusions: There is a high prevalence of TB, especially extra-pulmonary diseases, among SLE patients in Hong Kong. High cumulative dose of corticosteroid and lupus nephritis are important risk factors for the development of TB.