Associated factors to serious infections in a large cohort of juvenile-onset systemic lupus erythematosus from Lupus Registry (RELESSER)
Por:
Torrente-Segarra, V, Salman-Monte, T, Rua-Figueroa, I, del Campo, V, Lopez-Longo, F, Galindo-Izquierdo, M, Calvo-Alen, J, Olive-Marques, A, Mourino-Rodriguez, C, Horcada, L, Bohorquez, C, Montilla, C, Salgado, E, Diez-Alvarez, E, Blanco, R, Andreu, J, Fernandez-Berrizbeitia, O, Exposito, L, Gantes, M, Hernandez-Cruz, B, Pecondon-Espanol, A, Lozano-Rivas, N, Bonilla, G, Iglesias, A, Rubio-Munoz, P, Ovalles, J, Tomero, E, Boteanu, A, Narvaez, J, Freire, M, Vela, P, Quevedo-Vila, V, Mas, A, Munoz-Fernandez, S, Raya, E, Moreno, M, Velloso-Feijoo, M, Soler, G, Vazquez-Rodriguez, T, Pego-Reigosa, J, RELESSER Study Grp Spanish Soc Rhe and Study Grp Syst Autoimmune Dis SER
Publicada:
1 ago 2020
Resumen:
Objective: To assess the incidence of serious infection (SI) and associated factors in a large juvenile-onset systemic lupus erythematosus (jSLE) retrospective cohort.
Methods: All patients in the Spanish Rheumatology Society Lupus Registry (RELESSER) who meet >= 4 ACR-97 SLE criteria and disease onset <18 years old (jSLE), were retrospectively investigated for SI (defined as either the need for hospitalization with antibacterial therapy for a potentially fatal infection or death caused by the infection). Standardized SI rate was calculated per 100 patient years. Patients with and without SI were compared. Bivariate and multivariate logistic and Cox regression models were built to calculate associated factors to SI and relative risks.
Results: A total of 353 jSLE patients were included: 88.7% female, 14.3 years (+/- 2.9) of age at diagnosis, 16.0 years (+/- 9.3) of disease duration and 31.5 years (+/- 10.5) at end of follow-up. A total of 104 (29.5%) patients suffered 205 SI (1, 55.8%; 2-5, 38.4%; and >= 6, 5.8%). Incidence rate was 3.7 (95%CI: 3.2-4.2) SI per 100 patient years. Respiratory location and bacterial infections were the most frequent. Higher number of SLE classification criteria, SLICC/ACR DI score and immunosuppressants use were associated to the presence of SI. Associated factors to shorter time to first infection were higher number of SLE criteria, splenectomy and immunosuppressants use.
Conclusions: The risk of SI in jSLE patients is significant and higher than aSLE. It is associated to higher number of SLE criteria, damage accrual, some immunosuppressants and splenectomy. (C) 2020 Elsevier Inc. All rights reserved.
Filiaciones:
Torrente-Segarra, V:
Hosp Comarcal Alt Penedes Garraf, Dept Rheumatol, C Espirall S-N, Vilafranca Del Penedes 08720, Spain
Salman-Monte, T:
Parc Salut Mar IMIM, Rheumatol Dept, Barcelona, Spain
Rua-Figueroa, I:
Doctor Negrin Univ Hosp Gran Canaria, Rheumatol Dept, Las Palmas Gran Canaria, Spain
del Campo, V:
Vigo Univ, Dept Stat & OR, Vigo, Spain
Lopez-Longo, F:
Gregorio Maranon Univ Hosp, Rheumatol Dept, Madrid, Spain
Galindo-Izquierdo, M:
Doce Octubre Univ Hosp, Rheumatol Dept, Madrid, Spain
Calvo-Alen, J:
Hosp Araba, Rheumatol Dept, Araba, Spain
Olive-Marques, A:
Germans Trias & Pujol Univ Hosp, Rheumatol Dept, Badalona, Spain
Mourino-Rodriguez, C:
Complexo Hosp Univ Vigo Spain, Rheumatol Dept, IRIDIS Grp, Inst Invest Sanitaria Galicia Sur IISGS, Vigo, Spain
Horcada, L:
Navarra Hosp, Rheumatol Dept, Pamplona, Spain
Bohorquez, C:
Hosp Principe Asturias, Rheumatol Dept, Madrid, Spain
Montilla, C:
Salamanca Clin Univ Hosp, Rheumatol Dept, Salamanca, Spain
Salgado, E:
Hosp Complex Ourense, Rheumatol Dept, Orense, Spain
Diez-Alvarez, E:
Leon Hosp, Rheumatol Dept, Leon, Spain
Blanco, R:
Marques Valdecilla Univ Hosp, Rheumatol Dept, Santander, Spain
Andreu, J:
Puerta Hierro Majadahonda Hosp, Rheumatol Dept, Madrid, Spain
Fernandez-Berrizbeitia, O:
Basurto Hosp, Rheumatol Dept, Pais Vasco, Basurto, Spain
Exposito, L:
Hosp Univ Canarias, Rheumatol Dept, Tenerife, Spain
Gantes, M:
Tenerife Clin Hosp, Rheumatol Dept, Islas Canarias, Santa Cruz De T, Spain
Hernandez-Cruz, B:
Virgen Macarena Hosp, Rheumatol Dept, Seville, Spain
Pecondon-Espanol, A:
Miguel Servet Univ Hosp, Rheumatol Dept, Zaragoza, Spain
Lozano-Rivas, N:
Virgen Arrixaca Univ Hosp, Rheumatol Dept, Murcia, Spain
Bonilla, G:
La Paz Univ Hosp, Rheumatol Dept, Madrid, Spain
Iglesias, A:
Complexo Hosp Univ A Coruna, Rheumatol Dept, La Coruna, Spain
Rubio-Munoz, P:
Germans Trias & Pujol Univ Hosp, Rheumatol Dept, Badalona, Spain
Ovalles, J:
Hosp Gregorio Maranon, Rheumatol Dept, Madrid, Spain
Tomero, E:
Hosp la Princesa, Rheumatol Dept, Madrid, Spain
Boteanu, A:
Hosp Ramon & Cajal, Rheumatol Dept, Madrid, Spain
Narvaez, J:
Hosp Bellvitge Princeps Espanya, Rheumatol Dept, Lhospitalet De Llobregat, Spain
Freire, M:
Complexo Hosp Univ A Coruna, Rheumatol Dept, La Coruna, Spain
:
Hosp Univ Alicante, Rheumatol Dept, Alicante, Spain
Quevedo-Vila, V:
Hosp Monforte, Rheumatol Dept, Monforte, Spain
Mas, A:
Hosp Son Llatzer Mallorca, Rheumatol Dept, Mallorca, Spain
Munoz-Fernandez, S:
Hosp Infanta Sofia Madrid, Rheumatol Dept, Madrid, Spain
Raya, E:
Hosp Clin San Cecilio Granada, Rheumatol Dept, Granada, Spain
Moreno, M:
Parc Tauli Sabadell, Rheumatol Dept, Sabadell, Spain
Velloso-Feijoo, M:
Hosp Univ Valme, Rheumatol Dept, Seville, Spain
Soler, G:
Hosp Marinabaixa, Rheumatol Dept, Villajoyosa, Spain
Vazquez-Rodriguez, T:
Hosp Univ Lugo, Rheumatol Dept, Lugo, Spain
Pego-Reigosa, J:
Univ Hosp Complex, Rheumatol Dept, IRIDIS Grp, Inst Invest Sanitaria Galicia IISGS, Vigo, Spain
Green Accepted
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