Department of Internal Medicine, Division of Rheumatology, , Ankara Training and Research Hospital, Ankara, Turkey ; Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey.
Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey.
Turk J Med Sci. 2022 Dec;52(6):1881-1888. doi: 10.55730/1300-0144.5535. Epub 2022 Dec 21.
Systemic sclerosis (SSc) is a chronic systemic disease characterized by vascular damage, autoimmunity, and fibrosis in the skin and internal organs. In this study, we tried to determine the causes of severe infection in patients with SSc and to reveal the factors associated with severe infection.
We retrospectively examined 214 SSc patients between January 2010 and August 2020. Forty-seven patients with at least one severe infection and 167 patients without severe infection were compared.
A total of 76 episodes of severe infections were detected in 47 (22%) patients. Common infections included pneumonia, infected digital ulcer, urinary tract infections, and osteomyelitis. Female patients had a higher frequency in the group without severe infection (91.6% vs. 80.9%, p = 0.035). Patients with severe infections had a higher frequency of digital ulcers (p < 0.001), cardiac (p = 0.002), and GIS involvement (p < 0.001). In multivariable analysis, digital ulcer presence (OR: 2.849 [1.356-5.898] (p = 0.006) and cardiac involvement (OR: 2.801 [1.248-6.285]) were associated with severe infection. Of the patients with severe infections, 34% had recurrent severe infections. There was no difference in demographic and clinical characteristics between patients with recurrent and nonrecurrent severe infections.
The presence of digital ulcer and cardiac involvement seem to be associated with a severe infection in patients with systemic sclerosis. In patients with cardiac involvement and digital ulcers, more careful attention may be required for the development of severe infections.
系统性硬化症（SSc）是一种慢性全身性疾病，其特征为皮肤和内脏器官的血管损伤、自身免疫和纤维化。在本研究中，我们试图确定 SSc 患者严重感染的原因，并揭示与严重感染相关的因素。
我们回顾性检查了 2010 年 1 月至 2020 年 8 月期间的 214 例 SSc 患者。将至少有一次严重感染的 47 例患者与 167 例无严重感染的患者进行比较。
在 47 例（22%）患者中发现了 76 例严重感染。常见感染包括肺炎、感染性指溃疡、尿路感染和骨髓炎。在无严重感染组中，女性患者的比例更高（91.6% vs. 80.9%，p = 0.035）。有严重感染的患者更常出现指溃疡（p < 0.001）、心脏（p = 0.002）和 GIS 受累（p < 0.001）。多变量分析显示，指溃疡存在（OR：2.849[1.356-5.898]（p = 0.006））和心脏受累（OR：2.801[1.248-6.285]）与严重感染相关。在有严重感染的患者中，34%有反复发生的严重感染。反复发生和非反复发生严重感染的患者在人口统计学和临床特征方面无差异。
指溃疡和心脏受累的存在似乎与系统性硬化症患者的严重感染相关。在有心脏受累和指溃疡的患者中，可能需要更密切关注严重感染的发生。
