Objective: To investigate the characteristics and related risk factors associated with Tuberculosis(TB) in patients with systemic lupus erythematosus (SLE) who received glucocorticoid and immunosuppressive therapy.
Methods: Among the 452 SLE patients underwent the treatment of glucocorticoid and immunosuppressive agent, the clinical data was reviewed and summarized retrospectively.
Results: 42 of 452 (9.29%) patients were diagnosed as TB infection.11 patients (23.81%) had exudative pulmonary tuberculosis and 31 patients (73.81%) had extra-pulmonary TB. Statistics of the 31 patients showed that 8 patients (19.05%) had hematogenous disseminated pulmonary tuberculosis; 6 (14.29%) had tuberculo-meningitis; 2 (4.76%) had thoracic cavity TB; 2 (4.76%) had abdominal cavity TB; 1 (2.38%) had crewels; 1 (2.38%) had bone tuberculosis and 1 (2.38%) had nephronophthisis. The focus of infection was not found in 10 patients. Of all 42 patients with TB infection, 38 cases suffered form lupus nephritis, 40 with hypoalbuminosis, 10 with TB history, 14 had leucocytopenia or hyperglycaemia, respectively. The effect of antiTB therapy started up at least 7 days, or in 4 weeks as longest. 2 patients died of hematogenous disseminated pulmonary tuberculosis.
Conclusion: Under the treatment of glucocorticoid and immunosuppressive agent, TB incidence in patients with SLE is obviously higher than that of common people. Extra-pulmonary TB and serious infection are more frequently. It is shown that those who had lupus nephritis or TB history are more susceptible to TB.