Clinical Analysis Of Central Nervous System Infection In Systemic Lupus Erythematosus

Objective: To investigate the clinic features and risk factors forCNS (central nervous system) infection in patients with systemic lupuserythematosus.Methods: 18 cases of hospitalized lupus patients with CNS infectionfrom Jan 2002 to May 2007 were analyzed retrospectively. 36 lupuspatients without CNS infection were selected as control. Disease duration,disease activity index, corticosteroid therapy, applying ofcyclophosphamide (CTX) and clinic laboratory findings were recorded indetail.Results: During the period there were 727 SLE patients in all. 18subjects were complicated with CNS infection (2.48%). Of the 18 cases,10 were tuberculous meningitis (55.6%), 6 were cryptococcal meningitis(33.3%), 2 were brain abscess (11.1%). 11 (61.1%) presented with feveron first episode, 12(66.7%) were manifested with neck rigidity todifferent extent. 1 subject was cured (5.6%), 13 were relieved (72.2%), 4died (22.2%). There were significant differences in large-dosagecorticosteroid hormone therapy (Methylprednisolone≥500 mg/day),average dosage of corticosteroid applied, and count of lymphocytes andleukocytes of peripheral blood between the CNS infection group andcontrol group. No significant difference was found in disease duration,cumulative dosage of cyclophosphamide applied in one year, level of C₃,albumin, globin in serum or systemic lupus erythematosus diseaseactivity index (SLEDAI) between two groups.Conclusion: The clinical manifestation of CNS infection may beatypical. Large-dosage corticosteroid hormone therapy, higher dosage ofcorticosteroid applied everyday, decreased count of lymphocytes and leucocytes in peripheral blood are risk factors of CNS infection in SLEpatients. Repeated examination of cerebral spinal fluid (CSF) is critical toelevate the percentage of definite diagnosis.