Risk factors for infection in Malaysian patients with systemic lupus erythematosus

To determine the incidence, types and risk factors for infection insystemic lupus erythematosus (SLE) patients in Kuala Lumpur, Malaysia, weretrospectively reviewed the medical records of 102 patients with definiteSLE attending a specialist clinic. Details of major infections (pneumoniaor severe infection requiring intravenous therapy) and minor infections,and their time of onset in relation to immunosuppressive therapy anddisease flares were recorded. There were 77 major and 163 minor infectionsduring 564 patient-years of follow-up. In the month following a course ofpulse methylprednisolone, the incidence of major infection was 20 timeshigher and the incidence of minor infection was 10 times higher than atother periods (p<0.0001). In the month after disease flare, theincidence of major infection was 10 times higher and the incidence of minorinfection six times higher than at other times (p<0.0001). Afterallowing for methylprednisolone therapy and disease flares, there was noincrease in the rate of infections during treatment with azathioprine, oralor intravenous cyclophosphamide. There was no effect of renal involvementon infection rate.