Factors associated with active tuberculosis in Colombian patients with systemic lupus erythematosus: a case-control study

González, Luis Alonso; Coral-Enríquez, Jaime Alberto; Restrepo-Escobar, Mauricio; Muñoz-Vahos, Carlos Horacio; Jaramillo-Arroyave, Daniel; Vanegas-García, Adriana L.; Eraso, Ruth; Vásquez, Gloría; Jaimes, Fabián

doi:10.1007/s10067-020-05225-x

Cited by 19 publications

(24 citation statements)

References 39 publications

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“…SLE can increase the risk of infection for many reasons. 29 In our study, many patients did not receive a high dose of glucocorticoid or immunosuppressive therapy because of their reduced renal function or low SLEDAI, and thus, their prognosis was slightly better than that in patients who received high-dose glucocorticoids. Therefore, balancing the application course and dosage of glucocorticoids and immunosuppressants in patients with SLE remains a major challenge to solve.…”

Section: Discussionmentioning

confidence: 58%

Infection profile and risk factors for mortality in patients with end-stage renal disease attributable to systemic lupus erythematosus: a two-center integrated study

et al. 2022

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Objective Renal impairment is a significant complication of systemic lupus erythematosus (SLE). Additionally, infection in patients with end-stage renal disease (ESRD) attributable to SLE is common, and it increases the risk of mortality. This study explored the infection profile and risk factors for mortality in patients with ESRD attributable to SLE. Methods In this retrospective, observational study of 125 hospitalized patients, demographic, clinical, laboratory, treatment, and prognosis data were retrieved and analyzed. Results The 125 cases included 98 pulmonary infections (78.4%), 14 urinary infections (11.2%), and 13 intestinal infections (10.4%). Twenty-six patients died within 1 month after enrollment. Univariate Cox regression and Kaplan–Meier analyses revealed several possible indicators potentially influencing patient survival. Furthermore, multivariate Cox regression analysis identified a higher SLE Disease Activity Index-2000 score, recent higher-dose glucocorticoid use, hypertension, and catheter indwelling as risk factors for higher mortality. Conclusions Infections were common in patients with advanced SLE and ESRD, and several risk factors might increase the risk of mortality. Once infection is identified, empiric antibiotics should be initiated immediately, and subsequent antibiotics should be applied per the results of drug sensitivity testing to clear the infection.

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Section: Discussionmentioning

confidence: 58%

Infection profile and risk factors for mortality in patients with end-stage renal disease attributable to systemic lupus erythematosus: a two-center integrated study

et al. 2022

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“…Corticosteroid and immunosuppressive agents are the mainstay treatment in SLE. A retrospective case-control study in Colombia showed that 12 months of cumulative steroid dose ≥1830 mg almost tripled the risk of TB [ 13 ]. A 13-year cohort study of SLE patients in Taiwan has shown that corticosteroid treatment was associated with a more than 10-fold increased risk of TB [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis Among Patients With Systemic Lupus Erythematosus in Indonesia: A Cohort Study

Hamijoyo

Sahiratmadja

Ghassani

et al. 2022

Open Forum Infectious Diseases

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Background Previous studies have identified systemic lupus erythematosus (SLE) as a risk factor for tuberculosis (TB), but data from TB endemic countries are still relatively scarce. We examined TB in a large cohort of SLE patients in Indonesia. Methods All patients registered in a lupus registry of the top-referral hospital for West-Java between 2008 and 2020 were included. Data on SLE characteristics and treatment were retrieved from the registry, and data on TB diagnosis, localization and outcome were extracted from medical records. Cox-proportional hazard model was used to examine risk factors for development of TB. Results Among 1278 SLE patients followed over a total of 4804 patient years, 131 patients experienced 138 episodes of TB, a median 2 years (IQR 0.6–5.4) after diagnosis of SLE. A total of 113 patients (81.9%) had pulmonary and 61 (44.2%) had extra-pulmonary involvement, with disseminated disease in 26 of 138 episodes (18.8%), and 13 of 131 patients (9.9%) died from TB. The estimated TB incidence was 2,873 cases per 100,000 person years. In multivariate cox regression analysis, development of TB was associated with household TB contact (HR 7.20; 95%CI 4.05-12.80), pulse methylprednisolone therapy (HR 1.64; 95%CI 1.01-2.67) and age ≤ 25 years old at SLE diagnosis (HR 1.54; 95%CI 1.00-2.35). Conclusion There is a high burden of TB in SLE patients in this TB endemic setting, underlining the need for evaluation or implementation of TB preventive strategies.

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“…One-year cumulative doses of 1830 mg or more of GCs has been associated with TB infection in patients with systemic lupus erythematosus (OR= 2.74, 95% CI 1.26-5.98; P = 0.011) [88] that may be true for SOT patients as well.…”

Section: Side Effects 1infectionsmentioning

confidence: 93%

Current Status of Glucocorticoid Usage in Solid Organ Transplantation

Dashti‐Khavidaki¹,

Saidi²,

Lü³

2021

Preprint

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Glucocorticoids (GCs) have been the mainstay of immunosuppressive therapy in solid organ transplantation (SOT) for decades due to their potent effects on the innate immunity and tissue protective effects. But, some SOT centers are reluctant to administer GCs for long-time due to the various side effects. This review summarizes advantages and disadvantages of GCs in SOT. PubMed and Scopus databases were searched from 2011 to April 2021 using search syntaxes cover “transplantation” and “glucocorticoids”.GCs are used in transplant recipients, transplant donors, and organ perfusate solution to improve transplant outcomes. In SOT recipients GCs are administered as induction and maintenance immunosuppressive therapy. GCs are also the cornerstone to treat acute anti-body- and T-cell-mediated rejections. Addition of GCs to organ perfusate solution and pretreatment of transplant donors with GCs are recommended by some guidelines and protocols to reduce ischemia-reperfusion injury peri-transplant. GCs with low bioavailability and high potency for GC receptors such as budesonide, nanoparticle-mediated targeted delivery of GCs to specific organs, and combination use of dexamethasone with inducers of immune-regulatory cells are new methods of GC usage in SOT patients to reduce side effects or induce immune-tolerance instead of immunosuppression. Various side effects on different non-targeted organs/tissues such as bone, cardiovascular, neuromuscular, skin, and gastrointestinal tract have been noted for GCs. There are also potential drug-drug interactions for GCs in SOT patients.

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Factors associated with active tuberculosis in Colombian patients with systemic lupus erythematosus: a case-control study

Cited by 19 publications

References 39 publications

Infection profile and risk factors for mortality in patients with end-stage renal disease attributable to systemic lupus erythematosus: a two-center integrated study

Infection profile and risk factors for mortality in patients with end-stage renal disease attributable to systemic lupus erythematosus: a two-center integrated study

Tuberculosis Among Patients With Systemic Lupus Erythematosus in Indonesia: A Cohort Study

Current Status of Glucocorticoid Usage in Solid Organ Transplantation

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