title: [Prevention of infections in adults and adolescents with systemic lupus erythematosus: Guidelines for the clinical practice based on the literature and expert opinion].
abstract: OBJECTIVE
  To develop French recommendations about the management of vaccinations, the screening of cervical cancer and the prevention of pneumocystis pneumonia in systemic lupus erythematosus (SLE).
  
  
  METHODS
  Thirty-seven experts qualified in internal medicine, rheumatology, dermatology, nephrology and pediatrics have selected recommendations from a list of proposition based on available data from the literature. For each recommendation, the level of evidence and the level of agreement among the experts were specified.
  
  
  RESULTS
  Inactivated vaccines do not cause significant harm in SLE patients. Experts recommend that lupus patient should receive vaccinations accordingly to the recommendations and the schedules for the general public. Pneumococcal vaccination is recommended for all SLE patients. Influenza vaccination is recommended for immunosuppressed SLE patients. Live attenuated vaccines should be avoided in immunosuppressed patients. Yet, recent works suggest that they can be considered in mildly immunosuppressed patients. Experts have recommended a cervical cytology every year for immunosuppressed patients. No consensus was obtained for the prevention of pneumocystis pneumonia.
  
  
  CONCLUSIONS
  These recommendations can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of SLE patients.
authors.affiliation: Service de médecine interne 2, centre de référence national pour le lupus et le syndrome des antiphospholipides, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France. Electronic address: alexis.mathian@aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Mathian
authors.affiliation: Service de médecine interne 2, centre de référence national pour le lupus et le syndrome des antiphospholipides, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Arnaud
authors.affiliation: Service de médecine interne et d'immunopathologie clinique, hôpital Purpan, 31059 Toulouse, France.
authors.forename: D
authors.initials: D
authors.lastname: Adoue
authors.affiliation: Service de médecine interne, Hôtel-Dieu, CHU de Nantes, 44000 Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Agard
authors.affiliation: Service d'immunologie et de rhumatologie pédiatrique, centre de référence des maladies rares rhumatologiques et inflammatoires pédiatriques (CERHUMIP), institut Imagine, hôpital Necker, 75015 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Bader-Meunier
authors.affiliation: Service de néphrologie pédiatrique, hôpital universitaire Robert-Debré, 75019 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Baudouin
authors.affiliation: Service de médecine interne, CHU d'Angers, 49100 Angers, France.
authors.forename: C
authors.initials: C
authors.lastname: Belizna
authors.affiliation: Service de médecine interne et d'immunologie clinique, CHU François-Mitterrand, 21079 Dijon, France.
authors.forename: B
authors.initials: B
authors.lastname: Bonnotte
authors.affiliation: Service de médecine interne 2, centre de référence national pour le lupus et le syndrome des antiphospholipides, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Boumedine
authors.affiliation: Service de médecine interne 2, centre de référence national pour le lupus et le syndrome des antiphospholipides, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Chaib
authors.affiliation: Service de médecine interne, hôpital Saint-Antoine, 75012 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Chauchard
authors.affiliation: Département de médecine interne, hôpital européen, 6, rue Désirée-Clary, 13003 Marseille, France.
authors.forename: L
authors.initials: L
authors.lastname: Chiche
authors.affiliation: Service de néphrologie, hôpital Bichat, 75018 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Daugas
authors.affiliation: Service de médecine interne, CHU d'Angers, 49100 Angers, France.
authors.forename: A
authors.initials: A
authors.lastname: Ghali
authors.affiliation: Service de médecine interne et néphrologie, centre hospitalier d'Avignon, 84000 Avignon, France.
authors.forename: P
authors.initials: P
authors.lastname: Gobert
authors.affiliation: Service de médecine interne A, hôpital Dupuytren, CHU de Limoges, 87000 Limoges, France.
authors.forename: G
authors.initials: G
authors.lastname: Gondran
authors.affiliation: Service de médecine interne, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
authors.forename: G
authors.initials: G
authors.lastname: Guettrot-Imbert
authors.affiliation: Service de médecine interne, centre de référence des maladies auto-immunes et systémiques rares, sclérodermie systémique, hôpital Claude-Huriez, CHRU de Lille, université de Lille, 59000 Lille, France.
authors.forename: E
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: Service de médecine interne, Hôtel-Dieu, CHU de Nantes, 44000 Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Hamidou
authors.affiliation: Service de médecine interne 2, centre de référence national pour le lupus et le syndrome des antiphospholipides, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Haroche
authors.affiliation: Service de médecine interne 2, centre de référence national pour le lupus et le syndrome des antiphospholipides, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Hervier
authors.affiliation: Service de néphrologie adulte, hôpital Necker, 75015 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Hummel
authors.affiliation: Service de néphrologie, CHU La Conception, Aix-Marseille université, 13005 Marseille, France.
authors.forename: N
authors.initials: N
authors.lastname: Jourde-Chiche
authors.affiliation: Service d'immunologie clinique, centre de référence des maladies auto-immunes rares, hôpital Civil, CHU de Strasbourg, 67000 Strasbourg, France.
authors.forename: A-S
authors.initials: AS
authors.lastname: Korganow
authors.affiliation: Service de néphrologie pédiatrique, hôpital universitaire Robert-Debré, 75019 Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Kwon
authors.affiliation: Service de médecine interne, centre de référence maladies systémiques et auto-immunes rares, sclérodermies, vascularites, groupe hospitalier Cochin, 75014 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Le Guern
authors.affiliation: Département de médecine interne, hôpital Saint-Éloi, 34090 Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Le Quellec
authors.affiliation: Service de médecine interne, CHU Henri-Mondor, 94010 Créteil, France.
authors.forename: N
authors.initials: N
authors.lastname: Limal
authors.affiliation: Service de médecine interne, CHU Jean-Minjoz, 25030 Besançon, France.
authors.forename: N
authors.initials: N
authors.lastname: Magy-Bertrand
authors.affiliation: Service de médecine interne, hôpital Robert-Debré, CHU de Reims, 51092 Reims cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Marianetti-Guingel
authors.affiliation: Service d'immunologie clinique, centre de référence des maladies auto-immunes rares, hôpital Civil, CHU de Strasbourg, 67000 Strasbourg, France.
authors.forename: T
authors.initials: T
authors.lastname: Martin
authors.affiliation: Service de médecine interne, CHU de Caen, 14003 Caen, France.
authors.forename: N
authors.initials: N
authors.lastname: Martin Silva
authors.affiliation: Service de rhumatologie, hôpital Bichat - Claude-Bernard, 75018 Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Meyer
authors.affiliation: Service de médecine interne 2, centre de référence national pour le lupus et le syndrome des antiphospholipides, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Miyara
authors.affiliation: Service de médecine interne, centre de référence des maladies auto-immunes et systémiques rares, sclérodermie systémique, hôpital Claude-Huriez, CHRU de Lille, université de Lille, 59000 Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Morell-Dubois
authors.affiliation: Service de médecine interne, hôpital Édouard-Herriot, CHRU de Lyon, 69003 Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Ninet
authors.affiliation: Service de médecine interne, hôpital Robert-Debré, CHU de Reims, 51092 Reims cedex, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Pennaforte
authors.affiliation: Service de médecine interne 5D, CHU de Martinique, 97261 Fort-de-France, Martinique.
authors.forename: K
authors.initials: K
authors.lastname: Polomat
authors.affiliation: Service de néphrologie, CHU-hôpital Rangueil, 31403 Toulouse, France.
authors.forename: J
authors.initials: J
authors.lastname: Pourrat
authors.affiliation: Service de médecine interne, hôpital de l'Archet, 06200 Nice, France.
authors.forename: V
authors.initials: V
authors.lastname: Queyrel
authors.affiliation: Service de médecine interne et des maladies infectieuses, centre français Magendie, hôpital Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France.
authors.forename: I
authors.initials: I
authors.lastname: Raymond
authors.affiliation: Service de néphrologie, CHU Henri-Mondor, 94010 Créteil, France.
authors.forename: P
authors.initials: P
authors.lastname: Remy
authors.affiliation: Service de médecine interne, hôpital Saint-Antoine, 75012 Paris, France.
authors.forename: K
authors.initials: K
authors.lastname: Sacre
authors.affiliation: Service de rhumatologie, centre de référence des maladies auto-immunes rares, hôpital de Hautepierre, UMR 1109 Inserm - fédération de medecine translationnelle de Strasbourg (FMTS) et hôpital universitaire de Strasbourg, 67200 Strasbourg, France.
authors.forename: J
authors.initials: J
authors.lastname: Sibilia
authors.affiliation: Service de médecine interne et des maladies infectieuses, centre français Magendie, hôpital Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Viallard
authors.affiliation: Service de médecine interne, hôpital Robert-Debré, CHU de Reims, 51092 Reims cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Viau Brabant
authors.affiliation: Service de médecine interne, CHU Ambroise-Paré, 92100 Boulogne-Billancourt, France.
authors.forename: T
authors.initials: T
authors.lastname: Hanslik
authors.affiliation: Service de médecine interne 2, centre de référence national pour le lupus et le syndrome des antiphospholipides, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
authors.forename: Z
authors.initials: Z
authors.lastname: Amoura
mesh_terms: D000293:Adolescent; D000328:Adult; D005602:France; D006801:Humans; D016867:Immunocompromised Host; D017053:Infection Control / Q000379:methods / Q000592:standards*; D007239:Infections / Q000175:diagnosis; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012196:Review Literature as Topic; D014611:Vaccination / Q000592:standards; D055815:Young Adult
keywords: Guidelines; Infection; Lupus systémique; Recommandations; Systemic lupus erythematosus; Vaccination