Microbiological and immunological profile of patients with severe lupus flares related to bloodstream infections: a retrospective cohort study

What is it about?

In epidemiological studies, viral and bacterial infections have been shown to be a risk factor for the development of autoimmune diseases including systemic lupus erythematosus (SLE). Until now, the relationship between infectious agents and the development of severe SLE flares has not been fully addressed. In this paper we describe the results of a retrospective cohort study in which we demonstrated that bloodstream infections, especially those caused by S. pneumoniae and accompanied by low C4 levels, are an independent risk factor for the development of a severe SLE flare defined by the SELENA/SLEDAI scale and adjusted for the basal level of disease activity and immunosuppressive treatment. As far as we know, this is the first clinical study to evaluate whether a serious infection (bloodstream) is capable of increasing the risk of a severe SLE flare, with emphasis on the immunological and microbiological features of patients who developed severe lupus flare.

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Why is it important?

Among autoimmune diseases, patients with SLE have a unique predisposition to the development of infections and theoretically serious infections can trigger severe disease activity. Because severe infections and SLE flares are the main causes of morbidity and mortality in such patients, confirming that severe infections can trigger a severe SLE flare is essential to closely follow up such patients in order to provide timely treatment of the severe flare and avoid irreversible damage or death

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