Risk factors for infection in patients with systemic lupus erythematosus

Risk factors for infection were evaluated in patients with active SLE. The active SLE patients complicated by infection within one year after initiation of steroid therapy for SLE (n=19) were compared with those not complicated by infection (n=71) with regard to age, disease duration, laboratory findings, disease activity (SLE Disease Activity Index), and treatment. There was a significant difference in levels of serum albumin, urine protein, serum creatinine, blood urea nitrogen, serum IgA, IgG, and prednisolone dose between the two groups. By using logistic regression analysis, the dependence of infection on the above variables was investigated. The incidence of infection was significantly related to serum albumin level, the severity of SLE (the Healht and Welfare Ministry criteria) and initial prednisolone dose. The severity of SLE, urine protein level, pleural or pericardial effusion, age, and CH 50 were found to contribute in the decreasing order to serum albumin level. We conclude that hypoalbuminemia not only from proteinuria but also from other causes, such as the severity of SLE, may increase the risk of infection in patients with active SLE.