Author:
Martinez-Martinez Marco Ulises,Sturbaum Anne K.,Alcocer-Varela Jorge,Merayo-Chalico Javier,Gómez-Martin Diana,Gómez-Bañuelos José de Jesús Eduardo,Saavedra Miguel Ángel,Enciso-Peláez Sandra,Faugier-Fuentes Enrique,Maldonado-Velázquez Rocío,Suárez-Larios Luz María,Vega-Morales David,Casasola-Vargas Julio César,Carrillo Pérez Diego Luis,Abril Andy,Butendieck Ronald,Irazoque-Palazuelos Fedra,Abud-Mendoza Carlos
Abstract
Objective.To evaluate factors associated with mortality and infections in patients with systemic lupus erythematosus (SLE) and diffuse alveolar hemorrhage (DAH).Methods.A retrospective chart review was carried out for medical admissions of patients with a diagnosis of SLE and DAH in 9 hospitals. Clinical and laboratory data were recorded for each patient at DAH diagnosis.Results.We included 57 episodes of DAH of 50 patients (7 recurrences), 49 women (86%), 14 juvenile SLE (24.6%); 24 had died (42.1%). In the chart review we detected infection in 22 episodes (38.6%): 8 invasive fungal infections, 16 bacterial infections, and 2 patients had both types. In the bivariate analysis, factors associated with mortality were high Acute Physiology and Chronic Health Evaluation II scores, requirement of mechanical ventilation (OR 15.0, 95% CI 1.9 to 662.2), infections (fungal or bacterial; OR 3.2, CI 0.9 to 11.1), renal failure (OR 4.9, CI 1.4 to 18.0), and thrombocytopenia (OR 4.3, CI 1.2 to 15.6). We found similar mortality between children and adults. Infections were associated with treatment for SLE, requirement of mechanical ventilation, hypocomplementemia, and high levels of C-reactive protein.Conclusion.Infection is a frequent finding in patients with DAH and SLE; we found similar mortality between adult SLE and juvenile SLE. Factors that we describe associated with infections may influence the therapeutic selection for these patients.
Publisher
The Journal of Rheumatology
Subject
Immunology,Immunology and Allergy,Rheumatology
Cited by
42 articles.
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