Oral candidiasis in systemic lupus erythematosus

被引:17
作者
Fangtham, M. [1 ]
Magder, L. S. [2 ]
Petri, M. A. [1 ]
机构
[1] Johns Hopkins Univ, Sch Med, Div Rheumatol, Baltimore, MD 21093 USA
[2] Univ Maryland, Dept Epidemiol & Publ Hlth, Baltimore, MD 21201 USA
基金
美国国家卫生研究院;
关键词
Oral candidiasis; oral thrush; systemic lupus erythematosus; SECONDARY SJOGRENS-SYNDROME; INVASIVE FUNGAL-INFECTIONS; LABORATORY PROFILES; REVISED CRITERIA; COLONIZATION; PREVALENCE; MANIFESTATIONS; CLASSIFICATION; DISEASE; INDIVIDUALS;
D O I
10.1177/0961203314525247
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: We assessed the frequency of oral candidiasis and the association between demographic variables, disease-related variables, corticosteroid treatment, other treatments and the occurrence of oral candidiasis in the Hopkins Lupus Cohort. Methods: In this large prospective cohort study of 2258 patients with systemic lupus erythematosus (SLE), demographic and clinical associates of oral candidiasis were estimated by univariate, multivariate and within-person regression models. Results: There were 53,548 cohort visits. Oral candidiasis was diagnosed at 675 visits (1.25%) in 325 (14%) of the patients. In the multivariate analyses, oral candidiasis was associated with African-American ethnicity, SELENA-SLEDAI disease activity, high white blood cell count, a history of bacterial infection, prednisone use and immunosuppressive use. The urine protein by urine dip stick was higher in SLE patients with oral candidiasis. Considering only patients who had candidiasis at some visits in a 'within-person' analysis, candidiasis was more frequent in visits with higher SELENA-SLEDAI disease activity, high white blood cell count, proteinuria by urine dip stick, a history of bacterial infection and prednisone use. The use of hydroxychloroquine was associated with a lower risk of oral candidiasis, but was not statistically significant (p = 0.50) in the within-person analysis models. Conclusion: This study identified multiple risk factors for oral candidiasis in SLE. Inspection of the oral cavity for signs of oral candidiasis is recommended especially in SLE patients with active disease, proteinuria, high white blood cell count, taking prednisone, immunosuppressive drugs or antibiotics.
引用
收藏
页码:684 / 690
页数:7
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