RT Journal Article
SR Electronic
T1 Factors Associated with Mortality and Infections in Patients with Systemic Lupus Erythematosus with Diffuse Alveolar Hemorrhage
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1656
OP 1661
DO 10.3899/jrheum.130927
VO 41
IS 8
A1 Marco Ulises Martinez-Martinez
A1 Anne K. Sturbaum
A1 Jorge Alcocer-Varela
A1 Javier Merayo-Chalico
A1 Diana Gómez-Martin
A1 José de Jesús Eduardo Gómez-Bañuelos
A1 Miguel Ángel Saavedra
A1 Sandra Enciso-Peláez
A1 Enrique Faugier-Fuentes
A1 Rocío Maldonado-Velázquez
A1 Luz María Suárez-Larios
A1 David Vega-Morales
A1 Julio César Casasola-Vargas
A1 Diego Luis Carrillo Pérez
A1 Andy Abril
A1 Ronald Butendieck
A1 Fedra Irazoque-Palazuelos
A1 Carlos Abud-Mendoza
YR 2014
UL http://www.jrheum.org/content/41/8/1656.abstract
AB Objective. To evaluate factors associated with mortality and infections in patients with systemic lupus erythematosus (SLE) and diffuse alveolar hemorrhage (DAH). Methods. A retrospective chart review was carried out for medical admissions of patients with a diagnosis of SLE and DAH in 9 hospitals. Clinical and laboratory data were recorded for each patient at DAH diagnosis. Results. We included 57 episodes of DAH of 50 patients (7 recurrences), 49 women (86%), 14 juvenile SLE (24.6%); 24 had died (42.1%). In the chart review we detected infection in 22 episodes (38.6%): 8 invasive fungal infections, 16 bacterial infections, and 2 patients had both types. In the bivariate analysis, factors associated with mortality were high Acute Physiology and Chronic Health Evaluation II scores, requirement of mechanical ventilation (OR 15.0, 95% CI 1.9 to 662.2), infections (fungal or bacterial; OR 3.2, CI 0.9 to 11.1), renal failure (OR 4.9, CI 1.4 to 18.0), and thrombocytopenia (OR 4.3, CI 1.2 to 15.6). We found similar mortality between children and adults. Infections were associated with treatment for SLE, requirement of mechanical ventilation, hypocomplementemia, and high levels of C-reactive protein. Conclusion. Infection is a frequent finding in patients with DAH and SLE; we found similar mortality between adult SLE and juvenile SLE. Factors that we describe associated with infections may influence the therapeutic selection for these patients.