Distinguishing infections vs flares in patients with systemic lupus erythematosus

SLE is a chronic autoimmune disease involving multiple systems. Patients with SLE are highly susceptible to infections due to the combined effects of their immunosuppressive therapy and the abnormalities of the immune system that the disease itself causes, which can increase mortality in these patie...

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Bibliographic Details
Published in:Rheumatology (Oxford, England) England), 2017-04, Vol.56 (suppl_1), p.i46-i54
Main Authors: Ospina, Fabio E, Echeverri, Alex, Zambrano, Diana, Suso, Juan-Pablo, Martínez-Blanco, Javier, Cañas, Carlos A, Tobón, Gabriel J
Format: Article
Language:English
Subjects:
2',5'-Oligoadenylate Synthetase - metabolism
Biomarkers - metabolism
C-Reactive Protein - metabolism
Calcitonin - metabolism
Diagnosis, Differential
Disease Progression
HMGB1 Protein - metabolism
Humans
Infection - diagnosis
Infection - metabolism
Leukocyte Count
Lupus Erythematosus, Systemic - diagnosis
Lupus Erythematosus, Systemic - metabolism
Lupus Erythematosus, Systemic - physiopathology
Mannose-Binding Lectin - metabolism
Membrane Glycoproteins - metabolism
Neutrophils
Receptors, IgG - metabolism
Receptors, Immunologic - metabolism
Triggering Receptor Expressed on Myeloid Cells-1
Tumor Necrosis Factor Receptor Superfamily, Member 7 - metabolism
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Summary:SLE is a chronic autoimmune disease involving multiple systems. Patients with SLE are highly susceptible to infections due to the combined effects of their immunosuppressive therapy and the abnormalities of the immune system that the disease itself causes, which can increase mortality in these patients. The differentiation of SLE activity and infection in a febrile patient with SLE is extremely difficult. Activity indexes are useful to identify patients with lupus flares but some clinical and biological abnormalities may, however, make it difficult to differentiate flares from infection. Several biological markers are now recognized as potential tools to establish the difference between SLE activity and infection, including CRP and procalcitonin. It is possible, however, that the use of only one biomarker is not sufficient to confirm or discard infection. This means that new scores, which include different biomarkers, might represent a better solution for differentiating these two clinical pictures. This review article describes several markers that are currently used, or have the potential, to differentiate infection from SLE flares.
ISSN:1462-0332
DOI:10.1093/rheumatology/kew340