title: Distinguishing infections vs flares in patients with systemic lupus erythematosus.
abstract: SLE is a chronic autoimmune disease involving multiple systems. Patients with SLE are highly susceptible to infections due to the combined effects of their immunosuppressive therapy and the abnormalities of the immune system that the disease itself causes, which can increase mortality in these patients. The differentiation of SLE activity and infection in a febrile patient with SLE is extremely difficult. Activity indexes are useful to identify patients with lupus flares but some clinical and biological abnormalities may, however, make it difficult to differentiate flares from infection. Several biological markers are now recognized as potential tools to establish the difference between SLE activity and infection, including CRP and procalcitonin. It is possible, however, that the use of only one biomarker is not sufficient to confirm or discard infection. This means that new scores, which include different biomarkers, might represent a better solution for differentiating these two clinical pictures. This review article describes several markers that are currently used, or have the potential, to differentiate infection from SLE flares.
authors.affiliation: Rheumatology Unit, Fundación Valle del Lili, ICESI University.|Clinical Investigation InstituteFundación Valle del Lili.
authors.forename: Fabio E
authors.initials: FE
authors.lastname: Ospina
authors.affiliation: Rheumatology Unit, Fundación Valle del Lili, ICESI University.
authors.forename: Alex
authors.initials: A
authors.lastname: Echeverri
authors.affiliation: Internal Medicine, Fundación Valle del Lili, ICESI University.
authors.forename: Diana
authors.initials: D
authors.lastname: Zambrano
authors.affiliation: Rheumatology Unit, Fundación Valle del Lili, ICESI University.|Clinical Investigation InstituteFundación Valle del Lili.
authors.forename: Juan-Pablo
authors.initials: JP
authors.lastname: Suso
authors.affiliation: Immunology Laboratory, Fundación Valle del Lili, Cali, Colombia.
authors.forename: Javier
authors.initials: J
authors.lastname: Martínez-Blanco
authors.affiliation: Rheumatology Unit, Fundación Valle del Lili, ICESI University.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Cañas
authors.affiliation: Rheumatology Unit, Fundación Valle del Lili, ICESI University.|Internal Medicine, Fundación Valle del Lili, ICESI University.
authors.forename: Gabriel J
authors.initials: GJ
authors.lastname: Tobón
mesh_terms: D015088:2',5'-Oligoadenylate Synthetase / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism; D003937:Diagnosis, Differential; D018450:Disease Progression; D024243:HMGB1 Protein / Q000378:metabolism; D006801:Humans; D007239:Infections / Q000175:diagnosis* / Q000378:metabolism; D007958:Leukocyte Count; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D037601:Mannose-Binding Lectin / Q000378:metabolism; D008562:Membrane Glycoproteins / Q000378:metabolism; D009504:Neutrophils; D017452:Receptors, IgG / Q000378:metabolism; D011971:Receptors, Immunologic / Q000378:metabolism; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7 / Q000378:metabolism
chemical_list: D015415:Biomarkers; D024243:HMGB1 Protein; C585491:HMGB1 protein, human; D037601:Mannose-Binding Lectin; D008562:Membrane Glycoproteins; D017452:Receptors, IgG; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7; D002116:Calcitonin; D002097:C-Reactive Protein; D015088:2',5'-Oligoadenylate Synthetase
keywords: biomarkers; infections; lupus flares; scores; systemic lupus erythematosus