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Clin Immunol. 2013 Dec;149(3):442-9. doi: 10.1016/j.clim.2013.08.009. Epub 2013 Sep 2.

Major infections in a cohort of 120 patients with juvenile-onset systemic lupus erythematosus.

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Division of Pediatric Rheumatology, Morgan Stanley Children's Hospital, New York Presbyterian Hospital, Columbia University Medical Center, NY, USA; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal. Electronic address:


In order to describe the incidence and characteristics of major infections in juvenile-onset systemic lupus erythematosus (jSLE), we studied a cohort of 120 patients (51% Hispanic and 28% African American, 49% with renal involvement and 12% with neuropsychiatric manifestations). There were 101 major infections affecting 44 patients (37%) for an incidence of 169/1000 patient-years of follow-up. Active disease at jSLE diagnosis, renal involvement, neuropsychiatric manifestations, higher cumulative dose of prednisone, and treatment with cyclophosphamide or mycophenolate mofetil were all associated with major infection (p<0.05). By logistic regression, the combined effect of treatment with cyclophosphamide and cumulative dose of prednisone was associated with major infection (p=0.04). Two patients died, one due to cytomegalovirus infection. Major infection was associated with damage (p=0.004). In conclusion, in a large cohort of jSLE patients, major infections were common, were associated with active disease and its treatment, and resulted in noteworthy morbidity.


Infections; Lupus;; SLE;; Systemic lupus erythematosus;

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