Systemic lupus erythematosus and tuberculosis

Prabu, Vnn; Agrawal, Shruti

doi:10.4103/0022-3859.68653

Cited by 43 publications

(12 citation statements)

References 32 publications

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“…Meanwhile, infectious agents, including viruses, bacteria, parasites, and fungus, are a pivotal factor for induction of autoimmunity [22], which could lead to SLE flare. Infection also could result in organ damage in SLE patients, and its risk and prevalence are much higher because of the combined with a defective immune system and use of immunosuppressive drugs [3,22,23]. Therefore, infection is always a vulnerable point in SLE patients.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for the flare of systemic lupus erythematosus and its influence on prognosis: a single-center retrospective analysis

et al. 2021

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Objectives To explore the risk factors for systemic lupus erythematosus (SLE) flare and their impact on prognosis. Methods The clinical characteristics, laboratory results, and treatment plans of 121 patients with SLE flare were retrospectively analyzed. Ninety-eight SLE outpatients with sustained remission during the same period were selected as controls. Logistic multivariate regression analysis was employed to screen for risk factors for SLE flare. Results Infection, thrombocytopenia, arthritis, anti-nucleosome antibodies positive, anti-β2-glycoprotein I (IgG) antibodies positive, and patient’s self-discontinuation of medicine maintenance therapy might be risk factors for SLE flare. Patients who discontinued medicine maintenance therapy by themselves had a significantly higher rate of severe SLE flare than patients with regular medicine maintenance therapy (P = 0.033). The incidence of anemia associated with SLE (P = 0.001), serositis (P = 0.005), and pulmonary hypertension (P = 0.003) in patients who discontinued medicine maintenance therapy were significantly higher than patients with regular medicine maintenance therapy. SLE patients with regular medicine maintenance therapy for less than 3 years had a higher risk of pulmonary hypertension than those with regular medicine maintenance therapy longer than 3 years (P = 0.034). Conclusions The accompanying thrombocytopenia, arthritis, anti-nucleosome antibodies positive and anti-β2-glycoprotein I (IgG) antibodies positive at the onset of SLE may affect the prognosis of SLE. Patient’s self-discontinuation of medicine maintenance therapy is the main cause of SLE flare, which may induce severe flare in SLE patients and lead to a significantly higher incidence of pulmonary hypertension.

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Section: Discussionmentioning

confidence: 99%

Risk factors for the flare of systemic lupus erythematosus and its influence on prognosis: a single-center retrospective analysis

et al. 2021

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“…Use of glucocorticoids, arthritis, pleuritis, vasculitis, nephritis, organic brain syndrome, previous TB, and duration of SLE have been shown to be factors associated with TB in SLE [61,62]. Incidences of TB, extrapulmonary TB rates, and relapse rates were higher in Korean patients with SLE than in Korean patients with rheumatoid arthritis [63].…”

Section: Infection As a Vulnerable Point In Slementioning

confidence: 99%

Infection in systemic lupus erythematosus, similarities, and differences with lupus flare

Jung

Suh

2017

Korean J Intern Med

109

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse manifestations, and its pathogenesis is unclear and complicated. Infection and SLE are similar in that they both cause inf lammatory reactions in the immune system; however, one functions to protect the body, whereas the other is activated to damage the body. Infection is known as one of the common trigger factors for SLE; there are a number of reports on infectious agents that provoke autoimmune response. Several viruses, bacteria, and protozoa were revealed to cause immune dysfunction by molecular mimicry, epitope spreading, and bystander activation. In contrast, certain pathogens were revealed to protect from immune dysregulation. Infection can be threatening to patients with SLE who have a compromised immune system, and it is regarded as one of the common causes of mortality in SLE. A clinical distinction between infection and lupus f lare up is required when patients with SLE present fevers. With a close-up assessment of symptoms and physical examination, C-reactive protein and disease activity markers play a major role in differentiating the different disease conditions. Vaccination is necessary because protection against infection is important in patients with SLE.

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“…However, other reports suggest that the disease itself might contribute to the increased risk [ 5 ]. Studies have documented increased susceptibility for TB among SLE patients; however, these revolved around endemic countries [ 6 , 7 ]. Patients with SLE are prone to infections owing to abnormality in their immune system: immunoglobulin deficiency, complement deficiencies, defects in chemotaxis, phagocytosis, delayed hypersensitivity, and abnormalities of cellular immunity [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Combined Diagnosis of Systemic Lupus Erythematosus and Tuberculosis in an Irish Adolescent Female

Maduemem

Adedokun

Vatca

2018

Case Reports in Pediatrics

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Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown aetiology, which can affect any organ system. Tuberculosis (TB) is a common infection in SLE because of immune dysregulation associated with the latter. We report a case of an adolescent female who presented with a year's history of polyarticular arthralgia and fever. Physical examination revealed a large left effusion that needed drainage. Investigations revealed a combined diagnosis of SLE and TB. Management comprised quadruple anti-TB therapy and SLE treatment. She made a steady recovery and has maintained a stable state from the lupus perspective.

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Systemic lupus erythematosus and tuberculosis

Cited by 43 publications

References 32 publications

Risk factors for the flare of systemic lupus erythematosus and its influence on prognosis: a single-center retrospective analysis

Risk factors for the flare of systemic lupus erythematosus and its influence on prognosis: a single-center retrospective analysis

Infection in systemic lupus erythematosus, similarities, and differences with lupus flare

Combined Diagnosis of Systemic Lupus Erythematosus and Tuberculosis in an Irish Adolescent Female

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