A Retrospective Study Of Systemic Lupus Erythematosus Associated With Tuberculosis Infection In Northeastern Sichuan

Objective:The research isto investigate the clinical characteristics and related factors of patients with systemic lupus erythematosus(SLE)with mycobacterium tuberculosis infection in the northeast of Sichuan.Method:A retrospective study of 3053 SLE patients between January 2010 and November 2019 recorded demographic and clinical characteristics,laboratory data and imaging findings.A total of 59(1.93%)patients with active tuberculosis diagnosed with lupus were included in the observation group,of which 27 were in the observation group of Mianyang 404 Hospital,of which 32 were in theNanchongobservation group of Affiliated Hospital of North Sichuan Medical College.According to the ratio of 1:2,we randomly selected patients who were hospitalized in the Affiliated Hospital of North Sichuan Medical College and did not have infection at the same time.Sixty-four patients with SLE were in the control group.Clinical data such as lupus activity,autoantibodies,blood glucose,anemia,inflammation indicators,liver function,kidney function,and stool characteristics were observed for statistical analysis in theboth groups.Result:1.The incidence and mortality of SLE-associated tuberculosis in Northeast Sichuan were lower than the national average,and the incidence was mainly tuberculosis(47 cases,2.18%).2.The main clinical symptoms are fever,fatigue,and cough.The imaging characteristics of the lungs of the patient are not typical,including miliary nodules,patches,and cord-like manifestations,and so on.Involvement in more than two leaves is the main manifestation.The positive rate of the Interferon Gamma Release Assay(IGRA)in the observation group is greater than the tuberculin skin test(TST).3.25 cases were combined with other infections,which are mainly bacteria with 22 cases(88%).The site was mainly lungwith 15 cases(60%).4.Some patients had different degrees of liver damage due to the diagnosis of tuberculosis in external hospitals and the use of anti-tuberculosis drugs.There were 3 drug rashes in the observation group,compared with the control group.The total bilirubin(TBIL)in the Nanchong observation group was greater than that in the control group.There was statistical significance(P<0.05).5.In the observation group,1 mother had tuberculosis and 10(16.95%)had previous tuberculosis.6.Compared with the control group,the red blood cell(RBC),Hemoglobin(HGB),Albumin(ALB),and Blood glucose(GLU)of the Nanchong observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).7.The positive rates of Red blood cell sedimentation rate(ESR),high-sensitivity C-reactive protein(hsCRP),24-hour urine protein,and fecal occult blood were higher in the Nanchong observation group thanthose in the control group.The differences were statistically significant(P<0.05).8.Compared with the control group in Nanchong,the daily average amount of hormones used alone within 6 months and the combined use of immunosuppressants and hormones within 6 months were higher in the Nanchong observation groupthan those in the control group.The difference was statistically significant(P<0.05).9.Compared with the control group in Nanchong,Age,Sex,Disease course,Disease activity(SLEDAI),White blood cells(WBC),Platelets(PLT),Aspartate aminotransferase(AST),Alkaline phosphatase(ALP),Urea((BUN),Creatinine(Cre),Complement,Autoantibodies,and whether or not hormone shock treatment within 1 year was not statistically significant.Conclusion:1.The incidence and mortality of SLE with tuberculosis infection in the northeastern Sichuan are lower than the national level.The incidence of tuberculosis is mainly manifested by tuberculosis.2.The clinical manifestations of SLE-associated tuberculosis are often fever,cough,fatigue,and lack of specificity.The imaging findings are not typical,and test results in the laboratoryare partially asymmetric with the clinical ones.Comprehensive clinical and examination,and even diagnostic treatment are needed to confirm the diagnosis of tuberculosis infection.3.If SLE patients suffer from the fever and one or more of the following indicators change:reduced RBC,reduced HGB,increased ESR,reduced GLU,increased hsCRP,reduced ALB,bloody stool,and increased 24-hour urine protein,they should be alert to the presence of Tuberculosis.If you have a previous history of tuberculosis,you should be highly suspicious of recurrence.4.The amount of hormones used alone or in combination with immunosuppressants within 6 months,and the average daily amount of hormones>10 mg/d(methylprednisolone)may be a risk factor for tuberculosis infection.Reasonable use of hormones to treat SLE can reduce SLE risk of TB infection.