CLINICAL PROFILE AND RISK FACTORS OF MAJOR INFECTIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS

BACKGROUND Infection is a major source of morbidity and mortality in patients with Systemic Lupus Erythematosus (SLE). Prevalence of infections in SLE is much higher than in general population. Infection remains the most important practical problem while managing lupus patients, especially in developing countries. There are only few studies on clinical profile and risk factors of infections in SLE. MATERIALS AND METHODS This is a descriptive study. Hospitalised SLE patients with infections were examined for pattern of infections in SLE and they were compared with SLE patients without infections for demographic and the lupus related variables. RESULTS 105 infection related admissions were compared with 118 infection unrelated admissions. A causative organism was identified in 79.6%. The pattern of infections was as follows: Gram negative infections (54.4%), fungal infections (24.4%), tuberculosis (8.8%) and gram-positive infections in 12.2%. Higher disease activity was seen in the infected group. The duration of prednisolone intake and hence the cumulative prednisolone dose prior to infection was significantly higher in infected group. Infection rate was not higher in the subgroup, which received other immunosuppressive drugs. The incidence of leukopenia and lupus nephritis was same in both groups. CONCLUSION Infections were common in SLE patients, especially in younger age and early part of the illness. Infections were associated with prolonged use of steroids and higher disease activity.