Necrotizing Fasciitis in Systemic Lupus Erythematosus

Mohammad Kamran, Jane Wachs, Chaim Putterman

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives: Necrotizing fasciitis (NF) is an uncommon infection of the subcutaneous tissue and superficial fascia. Any delay in treatment can lead to catastrophic results with high mortality. It is well known that patients with systemic lupus erythematosus (SLE) are at increased risk of infection, from the disease and/or its treatment. The objective of our study was to evaluate the presenting features of NF in SLE patients and to identify possible risk factors for this severe complication. Methods: We searched for patients with diagnoses of SLE and NF using a computerized patient database at Montefiore Medical Center (MMC), from 1996 to present. We also included patients from the MMC Lupus Clinic with these diagnoses (identified from paper records) from 1994 to present. Of a total of 449 patients with SLE that were followed during this time, 8 patients with NF were identified, and their records were reviewed. Results: Two of the 8 patients (25%) died during hospitalization. A third patient died within 2 months of hospital discharge. All 8 patients were receiving steroids at the time of diagnosis, and 7 of 8 had hypoalbuminemia and lymphopenia. Both patients who died in the hospital and the one patient who died within 2 months of her discharge had lupus nephritis. Conclusions: NF is an uncommon infection, but one that must be recognized early if the outcome is to be favorable. This series of 8 cases of NF in SLE from a single institution suggests that heightened awareness is warranted, particularly among SLE patients who are immunosuppressed by virtue of their underlying disease, the therapy they require, or both.

Original languageEnglish (US)
Pages (from-to)236-242
Number of pages7
JournalSeminars in Arthritis and Rheumatism
Volume37
Issue number4
DOIs
StatePublished - Feb 2008
Externally publishedYes

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Necrotizing Fasciitis
Systemic Lupus Erythematosus
Subcutaneous Tissue
Infection
Hypoalbuminemia
Lymphopenia
Lupus Nephritis

Keywords

  • infection
  • lupus nephritis
  • necrotizing fascitis
  • SLE

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Orthopedics and Sports Medicine
  • Rheumatology

Cite this

Necrotizing Fasciitis in Systemic Lupus Erythematosus. / Kamran, Mohammad; Wachs, Jane; Putterman, Chaim.

In: Seminars in Arthritis and Rheumatism, Vol. 37, No. 4, 02.2008, p. 236-242.

Research output: Contribution to journalArticle

Kamran, Mohammad ; Wachs, Jane ; Putterman, Chaim. / Necrotizing Fasciitis in Systemic Lupus Erythematosus. In: Seminars in Arthritis and Rheumatism. 2008 ; Vol. 37, No. 4. pp. 236-242.
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