Different causes of mortality have been described over different decades followed by description of pathogens identified from infective episodes that led to death. A retrospective review was performed in 3,831 hospitalized systemic lupus erythematosus (SLE) patients in Peking Union Medical College Hospital from January 1986 to April 2012. The primary causes of death were identified, and the constituent ratio of specific death causes during different periods was compared. Among 3,831 hospitalized SLE patients, 268 patients died, accounting for 7.0 %. No significant difference of death rate was found between men and women, P = 0.404. The three most frequent death causes according to decade were as follows: for 1986-1995, renal involvement, lupus encephalopathy, and infections; for 1996-2005, infections, lupus encephalopathy, and renal involvement; and for 2006-2012, infections, lupus encephalopathy, and pulmonary hypertension. Certain types of deaths, primarily related to lupus activity, have decreased over time, whereas infections, often attributed to the use of corticosteroid and immunosuppressant medications, have increased gradually and changed to the most frequent death causes of SLE. Early mortality (<3 years) occurred more commonly in lupus encephalopathy, while late death (>3 years) happened more frequently in renal involvement, pulmonary artery hypertension, cardiovascular events, and cancer. In SLE death cases mainly dying from infection, mixed infections were more frequent than single pathogen infection (60.5 vs. 39.5 %), including common bacteria, fungal infection, and cytomegalovirus. Aspergillus fumigatus and Pneumocystis carinii were the two most commonly infected pathogens, and Cytomegalovirus was a frequent pathogen of mixed infection. Aggressive therapy has effectively reduced the mortality related to disease activity but also was associated with life-threatening infections. Mixed and fungal infection should be considered when SLE patients have severe infection.

Both ankylosing spondylitis (AS) and Takayasu's arteritis (TA) are infrequent, and their association is even more rare. Our objective was to assess their association and characteristics in our patients. We conducted retrospective analysis of our hospital inpatients from June 2000 to July 2011 who had both AS and TA. We used modified New York criteria for ankylosing spondylitis (1984) as AS diagnosis criterion and American College of Rheumatology Classification Criteria for Takayasu's Arteritis as TA diagnosis criterion. All clinical data, lab data, and radiological data were collected. Six patients were included in our study because they fulfilled our AS and TA criteria, four males and 2 females, aged from 18 to 35 years old. Four patients were HLA-B27 positive and 2 were negative. All patients' inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein were high. The clinical characteristics of patients with both diseases did not seem to be different from that of patients with AS or TA alone in China. All patients were first diagnosed as AS, then found TA 3-20 years later. After diagnosed those patients having AS and TA, patients were given prednisone and cyclophosphamide and their symptoms improved gradually. Our study provides further evidence of the association of TA with AS. We should know that some AS patients can do have TA. To AS patients who have fever, bruit, or pulselessness, we should suspect that they have TA.