Tuberculosis in Patients with Systemic Lupus Erythematosus: Five Year Experience of a Single Center in Northern Taiwan

Abstract

Objective: Tuberculosis (TB) is one of the most severe infectious diseases worldwide. Previous studies have shown a higher prevalence of TB infection in patients with systemic lupus erythematosus (SLE) in South-East Asia, including Taiwan. This study aimed to analyze cases of TB in patients with SLE in a single center from 2008 to 2013. Methods: We retrospectively reviewed the medical records of patients with SLE who were followed up at National Taiwan University Hospital from May, 2008 to April, 2013, including both inpatient and outpatient departments. Age, gender, disease duration, medications, cause of death, and treatment response to TB were documented and analyzed. Results: A total of 1615 patients with SLE were enrolled in this study. TB was diagnosed in 18 patients, with a prevalence rate of 1.11%. The average age of the patients with SLE and TB was 50 ± 14.4 years, with a female to male ratio of 13:5, and 56% of the patients had extrapulmonary involvement. The patients with SLE and TB were significantly older than the non-TB group (p=0.027). The prevalence of TB was also higher in the male and patients with late-onset SLE. The TB-related mortality rate was 5.5%. Most patients received glucocorticoids, and the mean daily dosage was 12.1 ± 8.7 mg prednisolone or equivalent. Conclusion: The average age of the patients with SLE and TB was older than that of those without TB. In patients with SLE, TB may be a particularly important issue in males, patients with late-onset SLE, and in older patients with concomitant steroid use.