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Aspergillosis in systemic lupus erythematosus
A Katz1, M Ehrenfeld, A Livneh
1Rheumatology Unit, Sheba Medical Center, Tel-Hashomer, Israel.
Seminars in Arthritis and Rheumatism
|December 1, 1996
Summary
Invasive aspergillosis is a rare but serious fungal infection in systemic lupus erythematosus (SLE) patients. Early suspicion and aggressive treatment are crucial for improving outcomes in these immunocompromised individuals.
Area of Science:
- Infectious Diseases
- Rheumatology
- Mycology
Background:
- Infection is a primary cause of death in systemic lupus erythematosus (SLE).
- Aspergillosis, a fungal infection, is an uncommon but severe opportunistic infection in immunocompromised patients, including those with SLE.
- Few cases of invasive aspergillosis in SLE patients have been documented in medical literature.
Observation:
- This study presents three cases of invasive aspergillosis in SLE patients.
- Patients presented with active SLE, often treated with high-dose corticosteroids and immunosuppressants.
- Risk factors included high disease activity, granulocytopenia, concurrent bacterial infections, and steroid use.
Findings:
- Two patients had systemic invasive aspergillosis, diagnosed post-mortem, with leukopenia and concurrent bacterial infections.
- One patient had localized aspergillosis in a transplanted kidney, successfully treated with nephrectomy.
- Diagnosis was frequently delayed, contributing to poor outcomes.
Implications:
- Aspergillosis should be suspected in SLE patients with active disease, immunosuppression, and bacterial coinfections.
- Prompt and aggressive diagnostic workup and treatment are essential to improve the currently poor prognosis.
- Increased awareness and vigilance can potentially enhance survival rates for SLE patients with invasive fungal infections.