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SLE and infections.

Gisele Zandman-Goddard1, Yehuda Shoenfeld

  • 1Center for Autoimmune Diseases and Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel 52621.

Clinical Reviews in Allergy & Immunology
|June 10, 2003
PubMed
Summary

Systemic lupus erythematosus (SLE) patients frequently experience infections, a major cause of mortality. Differentiating infections from lupus flares and managing risk factors are crucial for better patient outcomes.

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Immunology

Background:

  • Infections are a significant cause of mortality in patients with systemic lupus erythematosus (SLE).
  • SLE patients face risks for common and opportunistic infections, particularly when on immunosuppressive therapy.
  • Distinguishing between an infection and a lupus flare is a critical clinical challenge.

Purpose of the Study:

  • To review the epidemiology, risk factors, and management of infections in SLE patients.
  • To highlight the importance of identifying and treating chronic infections before immunosuppression.
  • To discuss factors aiding in the differentiation of infection from disease flares.

Main Methods:

  • Review of existing literature on infections in SLE.
  • Analysis of common pathogens and opportunistic infections in SLE.
  • Discussion of risk factors, including genetic predispositions and treatment modalities.

Main Results:

  • Infections in SLE patients involve similar pathogens to the general population but carry higher mortality risk.
  • Immunosuppressive agents and disease activity (e.g., renal disease, severe flares) increase infection susceptibility.
  • Genetic factors and biomarkers like C-reactive protein (CRP) may influence infection risk and differentiation from flares.

Conclusions:

  • Proactive screening for chronic infections (e.g., tuberculosis, hepatitis B, HIV) is essential before initiating immunosuppression.
  • Careful management of corticosteroids and immunosuppressants is vital to minimize infectious complications.
  • Understanding risk factors and utilizing diagnostic parameters can improve the management of infections in SLE.

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