title: Major infections in a cohort of 120 patients with juvenile-onset systemic lupus erythematosus.
abstract: In order to describe the incidence and characteristics of major infections in juvenile-onset systemic lupus erythematosus (jSLE), we studied a cohort of 120 patients (51% Hispanic and 28% African American, 49% with renal involvement and 12% with neuropsychiatric manifestations). There were 101 major infections affecting 44 patients (37%) for an incidence of 169/1000 patient-years of follow-up. Active disease at jSLE diagnosis, renal involvement, neuropsychiatric manifestations, higher cumulative dose of prednisone, and treatment with cyclophosphamide or mycophenolate mofetil were all associated with major infection (p<0.05). By logistic regression, the combined effect of treatment with cyclophosphamide and cumulative dose of prednisone was associated with major infection (p=0.04). Two patients died, one due to cytomegalovirus infection. Major infection was associated with damage (p=0.004). In conclusion, in a large cohort of jSLE patients, major infections were common, were associated with active disease and its treatment, and resulted in noteworthy morbidity.
authors.affiliation: Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital, New York Presbyterian Hospital, Columbia University Medical Center, NY, USA; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal. Electronic address: pcr.patricia@gmail.com.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Costa-Reis
authors.forename: Simona
authors.initials: S
authors.lastname: Nativ
authors.forename: Josephine
authors.initials: J
authors.lastname: Isgro
authors.forename: Teresa
authors.initials: T
authors.lastname: Rodrigues
authors.forename: Cagri
authors.initials: C
authors.lastname: Yildirim-Toruner
authors.forename: Amy
authors.initials: A
authors.lastname: Starr
authors.forename: Lisa
authors.initials: L
authors.lastname: Saiman
authors.forename: Lisa
authors.initials: L
authors.lastname: Imundo
authors.forename: Andrew
authors.initials: A
authors.lastname: Eichenfield
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001424:Bacterial Infections / Q000150:complications / Q000382:microbiology / Q000401:mortality / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007668:Kidney / Q000276:immunology / Q000382:microbiology / Q000473:pathology / Q000821:virology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000821:virology; D008297:Male; D011618:Psychotic Disorders / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000821:virology; D012720:Severity of Illness Index; D016019:Survival Analysis; D014777:Virus Diseases / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000821:virology; D055815:Young Adult
keywords: Infections; Lupus;; SLE;; Systemic lupus erythematosus;