Clinical Rheumatology

, Volume 37, Issue 8, pp 2095–2102 | Cite as

Tuberculosis and systemic lupus erythematosus: a case-control study in Mexico City

  • Pedro Torres-González
  • Juanita Romero-Díaz
  • Miguel Enrique Cervera-Hernández
  • Mario Ocampo-Torres
  • Luis Gerardo Chaires-Garza
  • Ernesto Alejandro Lastiri-González
  • Yemil Atisha-Fregoso
  • Miriam Bobadilla-del-Valle
  • Alfredo Ponce-de-León
  • José Sifuentes-OsornioEmail author
Original Article


To determine, among systemic lupus erythematosus patients, factors associated with active tuberculosis. We performed a case-control study, in a tertiary-care center in Mexico City. We defined cases as systemic lupus erythematosus patients with active tuberculosis and matched them 1:1 with systemic lupus erythematosus patients without tuberculosis (controls) by age, date of systemic lupus erythematosus diagnosis, and disease duration. We analyzed clinical variables, lupus disease activity (SLEDAI-2K), and accumulated damage (SLICC/ARC-DI). We performed a nonconditional logistic regression to determine factors associated with tuberculosis. We identified 72 tuberculosis cases among systemic lupus erythematosus patients, 58% were culture confirmed. Thirty-three percent (24/72) were pulmonary only, 47.2% (34/72) extrapulmonary only, and 19.4% both. After adjustment for age, gender, and socioeconomic status, SLEDAI-2K and SLICC/ARC-DI, a 1-year cumulative dose of prednisone ≥ 3 g (odds ratios (OR), 18.85; 95% confidence interval (95% CI), 6.91–51.45) was associated with tuberculosis, and the antimalarial treatment was protective (OR, 0.13; 95% CI, 0.04–0.36). Among systemic lupus erythematosus patients, cumulative dose of prednisone is associated with tuberculosis. Further research is required to elucidate the protective effect of antimalarial drugs for tuberculosis. Preventive strategies must be implemented in patients at risk.


Accumulated damage Antimalarial drugs Disease activity Prednisone Systemic lupus erythematosus Tuberculosis 



This work was supported by internal funding.

Compliance with ethical standards

Ethics statement

This study was carried out in compliance with the Helsinki Declaration. The Institutional Review Board approval for this study was obtained from the Comité Institucional de Investigación Biomédica en Humanos (reference 1534). All collected data were anonymized before analysis.




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  • Pedro Torres-González
    • 1
  • Juanita Romero-Díaz
    • 2
  • Miguel Enrique Cervera-Hernández
    • 1
  • Mario Ocampo-Torres
    • 2
  • Luis Gerardo Chaires-Garza
    • 3
  • Ernesto Alejandro Lastiri-González
    • 3
  • Yemil Atisha-Fregoso
    • 3
  • Miriam Bobadilla-del-Valle
    • 1
  • Alfredo Ponce-de-León
    • 1
  • José Sifuentes-Osornio
    • 3
    Email author
  1. 1.Department of Infectious DiseasesInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico CityMexico
  2. 2.Department of Immunology and RheumatologyInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico CityMexico
  3. 3.Department of MedicineInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico CityMexico

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