Adjusted neutropenia is associated with early serious infection in systemic lupus erythematosus.
OBJECTIVE
The susceptibility to infection increases in systemic lupus erythematosus (SLE) patients with neutropenia, but the link between infection risk and the cutoff neutrophil count still remains controversial. In this study, we investigated a valuable parameter associated with early serious infection in SLE patients during the first follow-up year.


METHODS
We reviewed the medical records of 160 patients with SLE. The initial levels were defined as the mean of the results of the first two consecutive tests. The adjusted levels were defined as the results of the accumulated area under the curve divided by interval follow-up days. Patients were divided into two groups according to early serious infection and initial and adjusted neutropenia and were then compared.


RESULTS
Immunosuppressive-naïve SLE patients with early serious infection more frequently had initial, latest, and adjusted leukopenia and neutropenia (<2,500/mm(3)) and hypocomplementemia than those without. Adjusted neutropenia was the only independent predictive value for early serious infection [odds ratio (OR 11.366)]. Initial neutropenia was the independent predictive value for adjusted neutropenia (OR 6.504).


CONCLUSIONS
We suggest that adjusted neutropenia is useful for predicting early serious infection in SLE patients during the first follow-up year.
Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.
Sang-Won
SW
Lee
Min-Chan
MC
Park
Soo-Kon
SK
Lee
Yong-Beom
YB
Park
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D005260:Female; D006801:Humans; D007239:Infections / Q000097:blood / Q000150:complications* / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood / Q000150:complications* / Q000276:immunology; D012307:Risk Factors; D012720:Severity of Illness Index
D000888:Antibodies, Anti-Idiotypic; D001323:Autoantibodies