Abstract
Despite the availability of newer therapeutic interventions to improve clinical outcome in patients with Systemic Lupus Erythematosus (SLE), the incidence of infections as a cause of morbidity and mortality has not changed over the past 30 years. SLE itself increases the risk of infection, due to genetic (complement deficiencies) and acquired factors such as functional asplenia (humoral immunodepression) and the use of immunosuppressive drugs. These medications increase the risk of opportunistic infections that are associated with an altered cellular immune response. The main etiologic infectious agents in SLE patients are common bacterial pathogens, especially capsulated ones. The most common sites are lung, skin, bladder, brain and systemic infections. The main risk factor for infection is the history of a previous one. The clinical approach to SLE patients with suspected infectious diseases must consider the possibility of a flare up of the underlying disease, posing an additional problem to the clinician.
Highlights
Despite the availability of newer therapeutic interventions to improve clinical outcome in patients with Systemic Lupus Erythematosus (SLE), the incidence of infections as a cause of morbidity and mortality has not changed over the past 30 years
SLE itself increases the risk of infection
These medications increase the risk of opportunistic infections that are associated with an altered cellular immune response
Summary
Despite the availability of newer therapeutic interventions to improve clinical outcome in patients with Systemic Lupus Erythematosus (SLE), the incidence of infections as a cause of morbidity and mortality has not changed over the past 30 years. SLE itself increases the risk of infection, due to genetic (complement deficiencies) and acquired factors such as functional asplenia (humoral immunodepression) and the use of immunosuppressive drugs. These medications increase the risk of opportunistic infections that are associated with an altered cellular immune response. Otro problema adicional en los pacientes con lupus es la distinción entre una infección aguda y exacerbación de la enfermedad, lo cual constituye un desafío diagnóstico y terapéutico para el médico, dado que ambas pueden coexistir. El objetivo del presente trabajo es presentar una revisión actualizada de las características de las infecciones en los pacientes con LES, para así poder prevenirlas y tratarlas oportunamente, con el propósito de controlar uno de los factores de mayor impacto en la morbimortalidad y pronóstico de esta enfermedad
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