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Co-morbidities in SLE (systemic lupus erythematosus)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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co-morbidities in SLE

Patients with SLE are at an increase risk of several co-morbidities when compared with the general population.

  • can be either disease related morbidity or treatment related morbidity
  • the following co-morbidities have been identified in lupus patients
    • cardiovascular diseases
      • e.g. - hypertension, dyslipidaemia
      • the risk is 5-6 times higher when compared to healthy controls
      • additionally lupus patients have a predisposition to premature atherosclerosis due to lupus-specific factors such as disease activity, renal disease and corticosteroid use.
    • osteoporosis
      • risk factors for reduced bone mineral density (BMD) include age, low body weight, inflammatory markers (ESR and CRP) and pre-existing organ damage
      • corticosteroid doses of >7.5 mg in particular are associated with a greater risk of osteoporosis
    • infection
      • remains the primary cause of mortality in approximately 25% patients with SLE
      • bacterial infections (specially pneumonia) are the most common reason for hospitalisation due to infection
      • most common
        • viral pathogen - herpes zoster
        • bacterial pathogen - S. pneumoniae, E. coli and S. aureus
      • both disease-related factors (lung involvement, renal disease, lymphopenia, complement consumption and functional hyposplenism) and drug-related effects (cumulative steroid exposure and immunosuppressant use) may increase the risk of infection (1)
    • certain types of cancer (non-Hodgkin's lymphoma, lung cancer, hepatobiliary cancer)
    • thromboembolic disease (1,2,3)


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