Cryptococcal meningitis in systemic lupus erythematosus patients: pooled analysis and systematic review

Wenjie Fang, Min Chen, Jia Liu, Ferry Hagen, Abdullah Ms, A M S Al-Hatmi, Peilian Zhang, Yun Guo, Teun Boekhout, Danqi Deng, Jianping Xu, Weihua Pan, Wanqing Liao

    Research output: Contribution to journal/periodicalArticleScientificpeer-review

    39 Citations (Scopus)

    Abstract

    Cryptococcal meningitis is an important fungal infection among systemic lupus erythematosus patients. We conducted a pooled analysis and systematic review to describe the epidemiological and clinical profile of cryptococcal meningitis in systemic lupus erythematosus patients. From two hospitals in China and nine literature databases, cases and prevalence data were collected for pooled analysis and meta-analysis, respectively. Categorical variables of cases were compared using a χ(2)-test on the statistical program of SAS. A multiple regression analysis was performed to ascertain independent predictors significantly correlated with prognosis. Meta-analysis was conducted by the statistical program of R. The prevalence of cryptococcal meningitis in systemic lupus erythematosus patients was 0.5%. Patients were predominantly females and adults. A prednisone equivalent of more than 30 mg/day before infection was associated with higher mortality (odds ratio (OR)=9.69 (1.54, 60.73)). In all, 36.8-38.9% patients showed low lupus activity when they developed the crytococcal infection. Moreover, 38.2% of the patients were misdiagnosed. The estimated case-fatality rate was 23.6%. Our results suggest that more emphasis should be placed to further understand lupus-related cryptococcal meningitis and to develop better prophylaxis and management strategies to combat this condition.

    Original languageEnglish
    Pages (from-to)e95
    JournalEmerging Microbes & Infections
    Volume5
    Issue number9
    DOIs
    Publication statusPublished - 07 Sept 2016

    Keywords

    • Journal Article

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