TY - JOUR 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 DO - 10.3899/jrheum.130927 SP - jrheum.130927 AU - Marco Ulises Martinez-Martinez AU - Anne K. Sturbaum AU - Jorge Alcocer-Varela AU - Javier Merayo-Chalico AU - Diana Gómez-Martin AU - José de Jesús Eduardo Gómez-Bañuelos AU - Miguel Ángel Saavedra AU - Sandra Enciso-Peláez AU - Enrique Faugier-Fuentes AU - Rocío Maldonado-Velázquez AU - Luz María Suárez-Larios AU - David Vega-Morales AU - Julio César Casasola-Vargas AU - Diego Luis Carrillo Pérez AU - Andy Abril AU - Ronald Butendieck AU - Fedra Irazoque-Palazuelos AU - Carlos Abud-Mendoza Y1 - 2014/07/01 UR - http://www.jrheum.org/content/early/2014/06/25/jrheum.130927.abstract N2 - 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. ER -