Clinical characteristics and outcomes of the meningitides in systemic lupus erythematosus.

BACKGROUND

The meningitides are rare but well-identified complications in patients with systemic lupus erythematosus (SLE).

AIMS

To determine the clinical characteristics, risk factors, prevalence and outcomes of the meningitides (septic and aseptic) in patients with SLE.

PATIENTS AND METHODS

From January 1988 to December 2006, we identified patients with SLE and septic or aseptic meningitis.

RESULTS

We identified 25 episodes of meningitis in 23 patients with SLE, from a total of 1,411 SLE patients (1.63%); in 15 out of 25 episodes, a microorganism was identified. Mycobacterium tuberculosis, Listeria monocytogenes and Criptococcus neoformans represented the main microorganisms. In 10 episodes, aseptic meningitis was diagnosed. Lymphopenia, steroid use, chronic damage and systemic activity of SLE were frequent in both kinds of meningitis. Although the clinical presentation did not differ significantly, patients with septic meningitis had more residual neurological deficits (p = 0.04).

CONCLUSIONS

Meningitis was observed in about 1.6% of the patients with SLE; in 40% of the cases, no microorganism could be isolated. A residual neurological deficit was more common in patients with septic meningitis.