Prevalence of progressive multifocal leukoencephalopathy (PML) in adults and children with systemic lupus erythematosus.
Adult
Arthritis, Rheumatoid
/ complications
Case-Control Studies
Central Nervous System Viral Diseases
/ epidemiology
Child
Electronic Health Records
Female
HIV
/ isolation & purification
HIV Infections
/ complications
Hospitalization
Humans
Immunosuppressive Agents
/ adverse effects
JC Virus
/ isolation & purification
Kidney Transplantation
/ adverse effects
Leukoencephalopathy, Progressive Multifocal
/ cerebrospinal fluid
Lupus Erythematosus, Systemic
/ complications
Lymphopenia
/ complications
Middle Aged
Prevalence
Retrospective Studies
Risk Assessment
autoimmune diseases
infections
systemic lupus erythematosus
Journal
Lupus science & medicine
ISSN: 2053-8790
Titre abrégé: Lupus Sci Med
Pays: England
ID NLM: 101633705
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
31
01
2020
revised:
06
05
2020
accepted:
20
05
2020
entrez:
10
6
2020
pubmed:
10
6
2020
medline:
11
5
2021
Statut:
ppublish
Résumé
To define the risk of progressive multifocal leukoencephalopathy (PML) in SLE. This is a retrospective observational study to evaluate PML cases in patients with SLE admitted to two large academic hospitals. Using electronic medical record (EMR) data, International Classification of Diseases (ICD) codes identified PML cases among patients with SLE, rheumatoid arthritis (RA) (controls), had renal transplant and with HIV. Medication exposure was reviewed. A total of 5409 Columbia University Medical Center (CUMC) patients and 2046 Northwell Health patients were identified using one ICD code for SLE. Of 7455 patients, three had an ICD code for PML. On EMR review, however, PML was substantiated in only one fatal SLE case with significant immunosuppressant use and severe lymphopenia (<0.5 cells x 10 Among 7455 adult patients with SLE ICD codes, there were two PML cases, with only one confirmed case associated with severe lymphopenia and immunosuppressants, corresponding to a prevalence of 13-27 per 100 000 patients. No PML cases in pSLE were found. A high index of suspicion in patients with SLE and CNS manifestations is required for the prompt diagnosis of PML.
Identifiants
pubmed: 32513809
pii: 7/1/e000388
doi: 10.1136/lupus-2020-000388
pmc: PMC7282388
pii:
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIGMS NIH HHS
ID : R35 GM131905
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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