Enberg G Margarita, Kahn Ch Mariana, Goity F Cecilia, Villalón S María Valentina, Zamorano R Juanita, Figueroa E Fernando
Unidad de Infectología, Facultad de Medicina, Universidad de los Andes, Santiago de Chile.
Rev Med Chil. 2009 Oct;137(10):1367-74.
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.
尽管有了更新的治疗干预措施来改善系统性红斑狼疮（SLE）患者的临床结局，但在过去30年里，作为发病和死亡原因的感染发生率并未改变。SLE本身会增加感染风险，这是由于遗传因素（补体缺陷）以及后天因素，如功能性无脾（体液免疫抑制）和使用免疫抑制药物。这些药物会增加与细胞免疫反应改变相关的机会性感染风险。SLE患者主要的病原性感染病原体是常见的细菌病原体，尤其是有荚膜的细菌。最常见的感染部位是肺部、皮肤、膀胱、脑部和全身性感染。感染的主要危险因素是既往有感染史。对于疑似感染性疾病的SLE患者，临床处理必须考虑到基础疾病发作的可能性，这给临床医生带来了额外的问题。
