Distinguishing infectionsvsflares in patients with systemic lupus erythematosus: Table 1

Abstract

SLE is a chronic autoimmune disease involving multiple systems. Patients with SLE are highly susceptible to infections due to the combined effects of their immunosuppressive therapy and the abnormalities of the immune system that the disease itself causes, which can increase mortality in these patients. The differentiation of SLE activity and infection in a febrile patient with SLE is extremely difficult. Activity indexes are useful to identify patients with lupus flares but some clinical and biological abnormalities may, however, make it difficult to differentiate flares from infection. Several biological markers are now recognized as potential tools to establish the difference between SLE activity and infection, including CRP and procalcitonin. It is possible, however, that the use of only one biomarker is not sufficient to confirm or discard infection. This means that new scores, which include different biomarkers, might represent a better solution for differentiating these two clinical pictures. This review article describes several markers that are currently used, or have the potential, to differentiate infection from SLE flares.

The CD38/NAD/SIRTUIN1/EZH2 Axis Mitigates Cytotoxic CD8 T Cell Function and Identifies Patients with SLE Prone to Infections

“…In our cohort, the CD8CD38 high T cell population was found expanded in patients with SLE who experienced a higher incidence of infections independently of disease activity. Previous reports have pointed to indicators of susceptibility to infections including serum levels of C reactive protein, procalcitonin (Ospina et al, 2017), T cell surface expression of CD64 (Feng et al, 2019), or deletion of Deltex1 (Leu et al, 2019), but they have fallen short in defining correctable molecular pathways.…”

Differential Parameters between Activity Flare and Acute Infection in Pediatric Patients with Systemic Lupus Erythematosus

“…There have been a number of studies on the predictive biological markers of SLE ares, including antidouble-stranded DNA antibodies (anti-dsDNA Ab), the complement system, anti-extractable nuclear antigen antibodies (anti-ENA Ab), cytokines, and chemokines [12,13]. For the prediction of infection in SLE patients, conventional biomarkers (C-reactive protein [CRP], erythrocyte sedimentation rate (ESR), procalcitonin [PCT]) [14][15][16][17][18] and new markers have been developed [19]. Several recent studies have focused on markers for differentiating between disease are and infection in febrile SLE patients [20][21][22].…”

“…However, most physicians agreed that no single biomarker had su cient predictive value for both events [8,19]. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were signi cantly higher in SLE patients compared with healthy controls and were positively correlated with SLEDAI score [23].…”

Causes of fever in adults patients of systemic lupus erythematosus

“…El 36,36% de estos pacientes con enfermedad activa presentaban concomitantemente un cuadro infeccioso. Al analizar la relación entre pacientes con puntaje alto de MEX-SLEDAI y VSG acelerada no se halló una relación estadísticamente (5,26) significativa como lo fue con complemento consumido y ANA positivo .…”

“…Las infecciones son consideradas causa importante de morbilidad y mortalidad en pacientes con (5) LES, reportándose dentro de las primeras dos causas de muerte más comunes en estos pacientes . Las (6) infecciones en LES son responsables del 40-50% de la morbilidad y mortalidad .…”