Le Moing V, Leport C
Service des Maladies infectieuses et tropicales, Hôpital Bichat-Claude-Bernard, Paris.
Rev Prat. 1998 Mar 15;48(6):637-42.
Infections are one of the major causes of morbidity and mortality during the course of systemic lupus erythematosus, and are promoted by various dysfunctions of the immune system, some of which are poorly understood. Other predisposing factors have been also identified such as the presence of glomerulonephritis and a treatment with high-dose corticosteroids or immunosuppressors. These factors have been particularly associated with the occurrence of opportunistic infections such as systemic candidiasis or Pneumocystis carinii pneumonia, whose frequency has increased with the intensity of therapeutic strategies. The most frequent infections encountered are induced by community-acquired microorganisms. Thus, initiating an empirical antibiotic treatment is justified in febrile patients with lupus erythematosus. In case of marked lymphopenia, it is recommended to start cotrimoxazole as primary prophylaxis against P. carinii pneumonia.
感染是系统性红斑狼疮病程中发病和死亡的主要原因之一，免疫系统的各种功能障碍会促发感染，其中一些功能障碍尚不清楚。还确定了其他易感因素，如肾小球肾炎的存在以及大剂量皮质类固醇或免疫抑制剂的治疗。这些因素尤其与机会性感染的发生有关，如系统性念珠菌病或卡氏肺孢子虫肺炎，其发生率随着治疗策略强度的增加而上升。最常见的感染是由社区获得性微生物引起的。因此，对发热的狼疮患者开始经验性抗生素治疗是合理的。在淋巴细胞显著减少的情况下，建议开始使用复方新诺明作为预防卡氏肺孢子虫肺炎的一级预防措施。
