Clinical analysis of 30 patients with systemic lupus erythematosus complicated with central nervous system infectious / 中华风湿病学杂志

ABSTRACT

Objective To investigate the characteristics of clinical manifestations,treatment and prognosis of patients with systemic lupus erythematosus (SLE) complicated with central nervous system (CNS) infoction.Methods The medical records of 30 patients with SLE complicated with CNS infeetion were retrospectively reviewed.Results In the cohort of 3039 SLE patients admitted during last 20-year8,30 patients (1%) were identified with CNS infection.The mean age of patients with CNS infection was (34±11) years.Twenty-seven (90%) out of the 30 patients were fomale.Patients could be divided into 3 groups based on the offending microorganismsmycobacterium tuberculosis (TB),non-TB bacterial and fungal infection groups respectively.TB infection was identified in 11 patients (37%),non-TB bacterial infections could be confirmed in 11 (37%),and fungal infection in 8 (26%).The most common presentations of CNS infeetion were fever,headache,and conscious level changes.There was no difierence among the three groups in morta-lity rate.Conclusion The clinical presentations of SLE patients complicated with CNS are generally atypical.Tubereulosis meningitis is the most prevalent CNS infection in patients with SLE.CSF analysis should be done as soon as possible for establishing early diagnosis.A lOW sernm albumin level,low C3 level and a low intracranial pressure predicts for unfavorable outcomes.