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The risk of tuberculosis in SLE patients from an Asian tertiary hospital

  • Observational Research
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Abstract

Systemic lupus erythematosus (SLE) has been associated with increased risk of tuberculosis (TB). However, little is known about the extent and risk factors for TB among Asian patient with SLE. We aimed to assess the rate of TB in patients with SLE, and investigate the risk of SLE on TB development using hospital administrative database. This is an historical cohort study of hospital discharge database from 2004 to 2011 to identify cases with SLE and TB using International Statistical Classification of Diseases and Related Health Problems, 9th Revision, Australian Modification (ICD-9-AM) codes. Of 301568 hospitalized patients, 841 (0.3%) patients had SLE, 1843 (0.6%) patients had TB, including 17 SLE patients (2.0%). SLE patients had a significantly higher rate of TB (2.0 vs. 0.6%, p < 0.001) compared to that of patients without SLE. The differences in the higher rate after breaking down was in the pulmonary TB group (1.7 vs. 0.5%, p < 0.00) but not in extrapulmonary TB group (0.4 vs. 0.1%, p = 0.060). Logistic regression analyses showed that SLE was a significant and independent predictor of TB (odds ratio 4.6, 95% CI 2.8–7.5, p < 0.001) after adjustment for factors such as age group, gender, ethnicity, admission class, nutritional deficiency, organ transplantation, and Charlson comorbidity index. SLE patients were found to experience higher rates of tuberculosis in this group of Asian patient population. Patients with SLE should be considered as a high-risk group for TB, active screening for latent patients and treatment for positive TB patients is needed.

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Acknowledgements

We acknowledge Mr Benedict Tan and Mrs Bessie Ang for their contribution with the database preparation. We also thank all other staff of the Department of Epidemiology at for logistical support and the patients, who all made the study possible.

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Authors and Affiliations

  1. Department of Epidemiology, Medical Board, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Yong Yang

  2. Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore

    Yong Yang, Julian Thumboo, Ban Hock Tan, Thuan Tong Tan & Kok Yong Fong

  3. Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Julian Thumboo & Kok Yong Fong

  4. Department of Infectious Disease, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Ban Hock Tan & Thuan Tong Tan

  5. Healthcare Analytics, Integrated Health Information Systems (IHIS), SingHealth Corporate Office, 6 Serangoon North Ave 5, Singapore, 554910, Singapore

    Chern Hui Jeffrey Fong

  6. CEO’s Office, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Han Seong Ng

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  1. Yong Yang
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Correspondence to Yong Yang.

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The authors declare that no financial or other relationships exist that might lead to a conflict of interest.

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The protocol for this study was approved by the Institutional Review Board of our hospital with waive of informed consent, as only database review was used in the study.

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Yang, Y., Thumboo, J., Tan, B.H. et al. The risk of tuberculosis in SLE patients from an Asian tertiary hospital. Rheumatol Int 37, 1027–1033 (2017). https://doi.org/10.1007/s00296-017-3696-3

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