Recurrent urinary tract infections and bladder dysfunction in systemic lupus erythematosus

Pelvic floor dysfunctions in women with systemic lupus erythematosus: A cross-sectional study

INTRODUCTION AND HYPOTHESIS

As a result of the impairment of the musculoskeletal system, the pelvic floor muscles are likely compromised in women with systemic lupus erythematosus (SLE). We hypothesized that women with SLE would report more symptoms of pelvic floor dysfunction (PFD) and there will be an association between SLE and PFD.

METHODS

An online cross-sectional survey was conducted. Data were collected on demographic and anthropometric characteristics, PFD (urinary incontinence, nocturia, anal incontinence, genital-pelvic pain/penetration disorder and pelvic organ prolapse) and obstetric history using a web-based questionnaire. The groups were compared using the Mann-Whitney test for quantitative variables and the chi-squared test for categorical variables. The association between SLE and PFD was tested using logistic regression analysis.

RESULTS

A total of 196 women answered the questionnaire (102 with SLE and 94 healthy controls). Women with SLE reported significantly more urinary incontinence, nocturia, anal incontinence, pelvic organ prolapse and genital-pelvic pain/penetration disorder than the healthy controls (p ≤ 0.05). Women with SLE were 2.8- to 3.0-fold more likely to report genital-pelvic pain/penetration disorder than healthy women.

CONCLUSIONS

The prevalence of PFD was significantly higher in women with SLE compared to healthy women. Thus, PFD seems to be an important problem in women with this disease. An in-depth investigation of these disorders could contribute to the understanding of how SLE impacts pelvic floor function.

Infections and systemic lupus erythematosus

OBJECTIVE

To determine the incidence of infections in a population of systemic lupus erythematosus individuals and the characteristics of infections regarding original site, as well as to study the possible associations between infections and treatment.

METHODS

An analytical retrospective study using data from medical charts of systemic lupus erythematosus patients from a single university hospital. A total of 144 patients followed up for five years were included. Data collected comprised age of patients and age at onset of lupus, sex and ethnicity, disease duration before the study period, medications, cumulative dose of prednisone, occurrence of infections and their original site.

RESULTS

The most frequent infections were urinary tract infections (correlated to use of prednisone - p<0.0001 and cyclophosphamide - p=0.045), upper airways infections (correlated to use of prednisone - p=0.0004, mycophenolate mofetil - p=0.0005, and cyclosporine - p=0.025), and pneumonia (associated to prednisone - p=0.017).

CONCLUSION

Prednisone was the drug more often associated with presence of infections, pointing to the need for a more judicious management of this drug.

Study on clinical features and complications with systemic lupus erythematosus (SLE) activity in Chinese Han population

Systemic lupus erythematosus (SLE) is a complex autoimmune disease affecting multiple organs/systems with variable activities. We performed a retrospective study to investigate the relationship of clinical characteristics and complications with SLE activity in Chinese Han population. A cohort of 1,490 SLE inpatients was evaluated for disease activity using the systemic lupus erythematosus disease activity index (SLEDAI). Chi-square test or Fisher's exact test was used to compare differences of clinical and laboratory features between active and inactive SLE patients. Logistic regression was chosen to explore the pattern of risk factors for disease activity. We found that neuropsychiatric involvement, nephritis, arthralgia, anti-dsDNA, serositis, hypocomplementemia, oral ulcerations, erythrocyte sedimentation rate, low C3, hematological abnormalities, and systolic pressure (1.010 < odds ratio < 10.568, 1.002 < 95% confidence interval < 31.599, 0.000 < P < 0.026) were major factors associated with disease activity, but not headaches, anti-ribonucleoprotein or anti-Sm, C-reactive protein, and anemia (P > 0.05, respectively). The involvements of urinary system, respiratory system, and central nervous system were significantly more frequent in active SLE than inactive SLE (0.000 < P < 0.014), except for alimentary system (P = 0.399). Our study has comprehensively evaluated the relationship of clinical characteristics and organs/systems involvement of SLE with SLEDAI in Chinese Han population and presented a compendium of factors affecting SLE, which should be useful for better evaluating disease activity and predicting organs/systems damage in SLE for clinical assessments and managements.