Summary
Infection has now become the most frequent cause of death in systemic lupus erythematosus. Seven patients were seen in a 4 year period who developed infections requiring admission to hospital. Severe infections generally occurred early in the course of the disease. Despite intensive antibiotic therapy only 3 patients survived. Death was associated with corticosteroid dosage, azathioprine therapy, the severity of anaemia, and with the occurrence of septicaemia. In this study neither the occurrence of infection nor a fatal outcome were associated with features of active disease. It is concluded that patients with systemic lupus need regular monitoring, even when disease is well controlled, so as to minimise dosages of corticosteroids and immunosuppressive drugs and prevent the occurrence of fatal infections.
Similar content being viewed by others
References
Brandt, L., Hedberg, M. 1969. Impaired phagocycytosis by peripheral blood granulocytes in systemic lupus erythematosus. Scand. J. Haemat. 6, 348–353.
Bresnihan, B., Jasin, H. E. 1977. Suppressor function of peripheral blood mononuclear cells in normal individuals and in patients with systemic lupus erythematosus. J. Clin. Invest. 59, 106–116.
Bresnihan, B. 1982. CNS lupus. Clin. Rheum. Dis. 8, 183–195.
Cameron, J. S. 1979. The nephritis of systemic lupus erythematosus. In Progress in Glomerulonephritis. P. Kincaid-Smith, A. J. K. d’Apice, R. C. Atkins. 387–423. John Wiley, New York.
Cohen, A. S., Reynolds, W. E., Franklin, E. C., Kulka, J. P., Ropes, M. W., Shulman, L. E. and Wallace, S. L. 1971. Preliminary criteria for the classification of systemic lupus erythematosus. Bull. Rheum. Dis. 21, 643–648.
Dubois, E. L., Wierzchowiecki, M., Cox, M. and Weiner, J. M. 1974. Duration’ and death in systemic lupus erythematosus. An analysis of 249 cases. J.A.M.A. 227, 1399–1402.
Fauci, A. S., Steinberg, A. D., Haynes, B. F. and Whalen, G. 1978. Immunoregulatory aberrations in systemic lupus erythematosus. J. Immunol. 121, 1473–1478.
Ginzler, E., Diamond, H., Kaplan, D., Weiner, M., Schlesinger, M. and Selenznick, M. 1978. Computer analysis of factors influencing frequency of infection in systemic lupus erythematosus. Arthritis Rheum. 21, 37–44.
Ginzler, E., Diamond, H., Weiner, M., Schlesinger, M., Fries, J. K., Wasner, C., Medsger, T. A., Ziegler, G., Klippel, J. H., Hadler, M. N., Albert, D. A., Hess, E. V., Spencer-Green, G., Grayzel, A., Worth, D., Hahn, B. H. and Barnett, E. V. 1982. A Multi-Centre study of outcome in systemic lupus erythematosis. 1. Entry variables as predictors of prognosis. Arthritis Rheum. 25, 601–611.
Grigor, R., Edmonds, J., Leukonia, R., Bresnihan, B. and Hughes, G. R. V. 1978. Systemic lupus erythematosus. Am. J. Med. 58, 829–835.
Karsh, J. Klippel, J. H., Balow, J. E. and Decker, J. L. 1979. Mortality in lupus nephritis. Arthritis Rheum. 22, 764–769.
Lee, P., Urowitz, B. M., Bookman, A. A. M., Koehler, B. E., Smythe, H. A., Gordon, D. A. and Ogryzlo, M. A. 1977. A review of 110 cases with reference to nephritis, the nervous system, infections, aseptic necrosis and prognosis. Quart. J. Med. 46, 1–32.
Paty, J. G., Sienknecht, C. W., Townes, A. S., Hanissuian, A. S., Miller, J. B. and Masi, T. 1975. Impaired cell-mediated immunity in systemic lupus erythematosus. Am. J. Med. 59, 769–778.
Rosner, S., Ginzler, E., Diamond, H. S., Weiner, M., Schlesinger, M., Fries, J. F., Wasner, C., Medsger, T. A., Ziegler, G., Klippel, J. H., Hadler, A. M., Albert, D. A., Hess, E. V., Spencer-Green, G., Grayzel, A., Worth, D., Hahn, B. H. and Barnett, E. V. 1982. A Multi-Centre study of outcome in systemilc lupus erythematosus. II. Causes of death. Arthritis Rheum. 25, 612- 617.
Shingu, M., Todoroki, T., Sakal, K. and Nobunaga, M. 1981. Suppression of Fc receptor and C4.C3 receptors of the granulocytes from patients with systemic lupus erythematosus. J. Rheumatology. 8, 910–916.
Staples, P. H., Gerding, D. N., Decke, J. L. and Gordon, R. S. 1974. Incidence of infection in systemic lupus erythematosus. Arthritis Rheum. 17, 1–10.
Urowitz, B. M., Bookman, A. A. M., Koehler, B. E., Gordon, D. A., Smythe, H. A. and Ogryzlo, M. A. 1976. The bimodal mortality pattern of systemic lupus erythematosus. Am. J. Med. 60, 221–225.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kiernan, M., Bresnihan, B. Clinical features and outcome of infection in systemic lupus erythematosus. I.J.M.S. 152, 382–386 (1983). https://doi.org/10.1007/BF02960749
Issue Date:
DOI: https://doi.org/10.1007/BF02960749