TUBERCULOSIS AMONG FILIPINO PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

A retrospective review of the clinical records of 54 patients with sys temic lupus erythematosus (SLE) and documented tuberculosis (TB) infec tion seen at the University of Santo Tomas Hospital was accomplished. There were 53 women and one man, with a mean age of 32.2+/-10 years an d a total of 57 TB occurrences. Pulmonary involvement was recorded in 42 (74%): upper lungfietd in 25, mid to lower lungfield in 7, and mili ary pattern or diffuse infiltrates in 10. TB arthritis was noted in 8, osteomyelitis in 4, and soft tissue abscesses in 4. Central nervous s ystem involvement consisted of brain abscesses (tuberculomas) in two a nd meningitis in one. Two patients each had TB lymphadenitis, genitour inary TB, ileocecal TB, and TB peritonitis. Hepatobiliary and cutaneou s TB occurred in one patient each. Eight of 10 patients with dissemina ted or miliary TB died primarily of respiratory failure; six of these eight patients also had some form of extrapulmonary involvement. Using the Wilcoxon rank-sum test, there were significant differences in the mean SLE Disease Activity Index (SLEDAI) and Severity of Disease Inde x (SDI) scores between those with limited TB (SLEDAI 24+/-7 SD; SDI 19 +/-18 SD) versus those with extensive TB (SLEDAI 41+/-16 SD; SDI 36+/- 21 SD). P <.05. There was no significant difference in the average dai ly prednisone dose (mg) between those with limited TB (25+/-17 SD) ver sus those with extensive TB (31+/-16 SD). The contributory role of tub erculous infection in the morbidity and mortality of patients with SLE must be emphasized, especially in areas endemic for TB. Copyright (C) 1996 by W.B. Saunders Company.