Background it's known that infection could complicate the course of systemic lupus erythematosus (SLE) because of the immune status or the long term steroids and immunosuppressors.
Objectives This study was aiming at determining the prevalence of infectious complications during SLE and their predictive factors.
Methods A retrospective bi-centric analyzes of 289 patients diagnosed as SLE between January 2004 and December 2016 according to the ARA criteria of 1997 was conducted. A descriptive analysis of infectious complications was first made, then a comparative study between patients with (group 1) and without (group 2) infectious complications was performed to detect predictive factors.
Results Mean age was 84.6±13 years (14–72 years) with a sex ratio F/M=6. Cardiac involvement and lupus nephritis (LN) were developed in 20% of patients. About 13.75% of patients had neurological manifestations, 26.5% articular complications, 16% vascular involvement and 10% of them developed infectious complications. Eight percent of these infections were diagnosed concomitantly with the diagnosis of SLE and 92% of them after the diagnosis of lupus with an average of 25 months. About 52.9% of the patients developed more than 2 episodes of infection. The spectrum of infectious complications was: pulmonary in 33.3%, urinary in 22.2% and cutaneous in 13.9%. Tuberculosis was the most frequent infection 12.5%. Lupus flare complicated the infection in 28.6% of patients with mean SLEDAI score at 10. Comparative study between group 1 and group 2 revealed that LN, corticosteroids and immunosuppressors were associated with a high risk of infection (p=0.002, p=0.017 and p=0.034 respectively). In multivariate analysis only LN was an independent predictive factor (OR=3.5, 95% CI=1.06- 12.87, p=0.049).
Conclusions Infections may complicate the course of SLE with flares presenting in 1/3 of cases. Half of the patients had more than 2 episodes of infection during their follow up. The presence of LN represents a predictive factor of such complication.
Disclosure of Interest None declared