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Lupus Foundation of America, Inc.
2000 L Street, N.W., Suite 410
Washington, DC 20036
Phone: 202-349-1155
Fax: 202-349-1156

Words of Caution

Infections and Immunizations

Why Do People With Lupus Get Infections So Easily?

An individual with lupus is more susceptible to infection than most people for two reasons:

1. Lupus directly affects a person's immune system and reduces his or her ability to prevent and fight infection.
2. Many of the drugs used to treat lupus suppress the function of the immune system and leave the body more prone to infection.

Effects Of Medications Used In The Treatment Of Lupus

Cortisone-like drugs (prednisone) and cytotoxic drugs such as azathioprine (Imuran) and cyclophosphamide (Cytoxan) increase a person's susceptibility to infections because they suppress both normal and abnormal immune system function.

However, controlling lupus is usually more important than the danger posed by a possible infection due to the use of immunosuppressive medications.

The risk of infection parallels the dose and the duration of treatment with steroids:

• a daily dose of 20 mg. of prednisone is enough to impose a significant risk of infection
• taking steroids every other day ("alternate day" treatment) decreases the risk and incidence of infections

Direct Effects of Lupus On The Immune System

People with lupus have abnormalities in their immune systems, so they are more likely to develop infections. They are more susceptible to infection even if they do not take corticosteroids. Lupus experts such as Dr. Marian Ropes sparingly used steroids in treating her patients in the 1940s and 1950s. Yet, the data she published showed that the majority of her patients developed serious infections, even on low-dose steroids.

Types Of Infection In SLE

Infections in people with lupus fall into two categories.

1. The first category includes infections with organisms that can affect persons with lupus and the general population:
   • streptococcus (which causes strep throat)
   • staphylococcus (which causes staph infections).
2. The second category consists of "opportunistic" infections, which are caused by organisms that bring about disease only when the immune system is weakened. Most opportunistic infections are one of three kinds:
   • fungal
   • parasitic
   • protozoan.

 

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