[Pregnancy and systemic lupus erythematosus]. / Embarazo y lupus eritematoso sistémico.

BACKGROUND: The interrelations between systemic lupus erythematosus (SLE) and pregnancy are reason for debate. Patients with SLE may present antiphospholipid antibodies (APL), anti-Ro (a-Ro) or anti-La (a-La) with their influence in pregnancy not being well defined. METHODS: The pregnancies in a series of 96 fertile age women with SLE, followed during the period of 1975-1991 with a mean follow up of 6.2 years were studied. The spontaneous or provoked abortions, prematurity and the number of flares of the disease during pregnancy and during the year after birth were analyzed. The number of flares was compared with that presented by a control group of women with SLE of similar clinical features followed over the same time period. RESULTS: Twenty-seven patients had 35 pregnancies with 23 full term pregnancies, 5 spontaneous abortions and 7 provoked abortions. Twenty-six percent of the deliveries were premature. One or two flares related with 43% of the pregnancies with viable fetus (11 flares in total) were registered. The number of flares in the control group was 6%. The difference was not statistically significant (p = 0.55) but the relative risk was of 1.6. No relation was found between the presence of APL, a-Ro and a-La and the course of the pregnancy. No case of lupus neonatorum was observed. CONCLUSIONS: Pregnancy is not advised in patients with systemic lupus erythematosus in remission. Patients should be more frequently controlled during pregnancy and post partum. The presence of antiphospholipid antibodies or anti-Ro does not modifies the prognosis.

[Infection and systemic lupus erythematosus: analysis of a series of 145 patients]. / Infección y lupus eritematoso sistémico: análisis de una serie de 145 pacientes.

Systemic lupus erythematosus (SEL) is a chronic inflammatory disease, which often requires corticosteroid treatment, being infection a common cause of both morbidity and mortality. We report the infectious episodes from 145 SLE patients revisited through 1975-1991, with a 6.8 years mean follow-up period. The relationship between each episode and several variables, especially corticosteroid treatment a month before the infectious episode, was analyzed. Forty two infections were diagnosed in 32 patients (22.06%). A significant increase in the number of infections among SLE patients with daily corticosteroids treatment was observed with respect to that of SLE patients with alternate day treatment (p < 0.001). The administration corticosteroids in alternate day form, if possible, can decrease the infection incidence in SLE patients.