The review analysis of Chinese systemic lupus erythematosus patients complicated with tuberculosis infection / 中华风湿病学杂志

ABSTRACT

Objective To investigate the prevalence and clinical features of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE). Methods All articles published in Chinese between 1998-2008 were searched by using "systemic lupus erythematosus (SLE)" and "tuberculosis infection" as the keywords.Data were extracted and then Meta-analysis was done. Results Four hundred and twenty-four patients with the age(32±9) years from 30 studies were available for analysis, in which 45 were males and 379 were females. The duration of SLE when TB infection was diagnosed was (26±19) months.TB was found in 2.3%～19.6% of patients and 15.6% of them died. 73.0% of patients of SLE were in stable phase when infected with TB.7.50% of patients had a history of TB infection years ago. The common manifestations observed were fever (95.2%), weight loss (63.1%), cough and expectoration (60.2%), night-sweat (47.8%), chest pain (44.7%), chest distress and dyspnea (41.1%). 35.0% of patients had hematogenous disseminated pulmonary tuberculosis and 15.1% of patients had tuberculous meningitis. 45.3% of patients had extra-pulmonary TB. The focus of infection could not be identified in 2.8% of patients. Both ESR and CRP were elevated in patients(93.9%, 77.1%), but the positive rate of tuberculin test, anti-TB antibody and sputum smear posivity was low (19.3%, 41.8%, 14.3%). Conclusion TB incidence in patients with SLE is evidently high and the clinical mani-festation is not typical. Extra-pulmonary TB and serious infection are more frequently. Severe TB infection and extra-pulmonary TB are frequent. More patients with SLE are in stable phase when infected with TB. Early diagnosis of TB infection is important.