Table 1.
Baseline demographics, clinical features and treatments in SLE with infections vs. NPSLE
| Items | CNS infections (n = 95) | NPSLE (n = 95) | P value |
|---|---|---|---|
| Sex, female, n (%) | 81 (85.3) | 81 (85.3) | 1.000 |
| Age at SLE diagnosis, year, mean (SD) | 31.0 (13.9) | 30.8 (14.1) | 0.897 |
| Age at onset§, years, mean (SD) | 34.6 (13.7) | 32.3 (14.7) | 0.276 |
| SLE disease duration&, months, median (IQR) | 21.0 (3.0–50.0) | 1.0 (0–22.0) | < 0.001 |
| System involvement of SLE, n (%) | |||
| Lupus nephritis | 71 (74.7) | 69 (72.6) | 0.742 |
| NPSLE | 26 (27.4) | 95 (100) | < 0.001 |
| Hematological | 65 (68.4) | 62 (65.3) | 0.644 |
| Mucocutaneous | 79 (83.2) | 66 (69.5) | < 0.05 |
| Musculoskeletal | 51 (53.7) | 52 (54.7) | 0.884 |
| Cardiovascular | 12 (12.6) | 22 (23.2) | 0.058 |
| Pulmonary | 6 (6.3) | 18 (18.9) | < 0.05 |
| Medical history*, n (%) | |||
| Pulmonary tuberculosis | 5 (5.3) | 5 (5.3) | 1.000 |
| Fungal infections | 2 (2.1) | 1 (1.1) | 1.000 |
| Diabetes mellitus | 9 (9.5) | 4 (4.2) | 0.151 |
| Herpes zoster infections | 9 (9.5) | 1 (1.1) | < 0.01 |
| Previous treatment* | |||
| Pulse GCs, n (%) | 35 (36.8) | 7 (7.4) | < 0.001 |
| Average daily prednisone dose (or equivalent) in recent 6 months, mg/day, mean (SD) | 43.5 (44.2) | 21.8 (37.5) | < 0.001 |
| DMARDs in recent 6 months, n (%) | 67 (70.5) | 36 (37.9) | < 0.001 |
| CTX/MMF in recent 1 year, n (%) | 49 (51.6) | 17 (17.9) | < 0.001 |
| Neuropsychiatric symptoms§, n (%) | |||
| Fever | 92 (96.8) | 22 (23.2) | < 0.001 |
| Headache | 85 (89.5) | 42 (44.2) | < 0.001 |
| Seizure | 24 (25.3) | 35 (36.8) | 0.085 |
| Psychosis | 17 (17.9) | 31 (32.6) | < 0.05 |
| Cognitive dysfunction | 17 (17.9) | 32 (33.7) | < 0.05 |
| Acute confusional state | 49 (51.6) | 19 (20.0) | < 0.001 |
| Anxiety disorder | 2 (2.1) | 10 (10.5) | < 0.05 |
| CSF examination§ | |||
| Pressure ≥ 300 mmH2O, n (%) | 47 (51.1) | 9 (9.5) | < 0.001 |
| WBCs, 106/L, mean (SD) | 635 (1470) | 3 (12) | < 0.001 |
| PMN ratio, %, mean (SD) | 45.6 (36.0) | 0.5 (2.4) | < 0.001 |
| Protein, g/L, mean (SD) | 2.13 (3.78) | 0.64 (0.65) | < 0.001 |
| Glucose, mmol/L, mean (SD) | 2.0 (1.3) | 3.3 (0.9) | < 0.001 |
| Laboratory blood test at onset§ | |||
| WBCs, 106/L, mean (SD) | 9084 (5898) | 6497 (3508) | < 0.001 |
| PMN ratio, %, mean (SD) | 82.2 (10.3) | 75.8 (11.9) | < 0.001 |
| Lymphocytes, 106/L, mean (SD) | 923 (771) | 1032 (758) | 0.354 |
| Hypocomplementemia, n (%) | 41 (44.6) | 72 (77.4) | < 0.001 |
| IgG, g/L, mean (SD) | 13.6 (7.6) | 12.2 (7.4) | 0.236 |
| ESR, mm/h, mean (SD) | 54.8 (39.5) | 48.2 (31.8) | 0.215 |
| SLEDAI-2K score, mean (SD) | 7.5 (7.3) | 18.4 (5.6) | < 0.001 |
| SLICC/ACR Damage Index, mean (SD) | 1.03 (1.04) | 1.01 (0.88) | 0.151 |
| Morality rate#, n (%) | 26 (27.4) | 13 (13.7) | < 0.05 |
Pulse GCs are defined as equal to or greater than 500 mg/day methylprednisolone infusion for consecutive 3~5 days; DMARDs, including cyclophosphamide, mycophenolate mofetil, methotrexate, cyclosporin, tacrolimus, azathioprine, hydroxychloroquine, leflunomide
CNS central nervous system, GCs glucocorticoids, NPSLE neuropsychiatric lupus erythematosus, DMARDs disease-modifying antirheumatic drugs, CTX cyclophosphamide, MMF mycophenolate mofetil, CSF cerebrospinal fluid, ESR erythrocyte sedimentation rate, WBCs white blood cells, PMN polymorphonuclear leukocyte, IgG immunoglobulin G, SLEDAI-2K systemic lupus erythematosus disease activity index 2000. SLICC/ACR Systemic Lupus International Collaborating Clinics/American College of Rheumatology
§Evaluated within 2 weeks of CNS infection or NPSLE onset
&Disease duration from SLE diagnosis to CNS infections or NPSLE onset
*Evaluated history before the diagnosis of CNS infection or NPSLE
#Evaluated within 1 year of diagnosis of CNS infection or NPSLE
Significant p values are shown in bold typeface