Lupus en el varón e infección dermatológica: a propósito de un caso

Authors

  • Dianayis Hortelas Sánchez Centro de referencia para las enfermedades reumáticas. Hospital Docente Clínico Quirúrgico Diez de Octubre. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba. https://orcid.org/0000-0002-5199-7213
  • Thuyen Fong Fernández 2Hospital Docente Clínico Quirúrgico Diez de Octubre. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba. https://orcid.org/0000-0002-5199-7213
  • Ana María Gutiérrez Guadarrama Centro de referencias para las enfermedades reumáticas. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba. https://orcid.org/0009-0008-4616-8358
  • Gretchen Garrido Muñoz Centro de referencias para las enfermedades reumáticas. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba. https://orcid.org/0009-0004-8953-5403
  • Katiuska Rodríguez Pérez Centro de referencia para las enfermedades reumáticas. Hospital Docente Clínico Quirúrgico Diez de Octubre. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba. https://orcid.org/0009-0003-8363-6732
  • Yaliana Frómeta Barrera Centro de referencia para las enfermedades reumáticas. Hospital Docente Clínico Quirúrgico Diez de Octubre. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba. https://orcid.org/0000-0002-9485-0385

Keywords:

lupus, male, infection

Abstract

Introduction: systemic lupus erythematosus is a chronic, potentially fatal autoimmune disease that is frequently associated with infections.

Objective: to describe the case of a male patient with a dermatologic infection and subsequent disease activity after discontinuation of treatment.

Case presentation: 50-year-old male patient, mestizo race with a history of systemic lupus erythematosus of 20 years of evolution, lupus nephritis, suspended immunosuppressive treatment about 3 months for dermatological infection that was complicated evolving to a Pyodermitis, is hospitalized and receives broad-spectrum antibiotic treatment and Intacglobin; his dermatological condition improves but begins with elements of activity: fever, genital ulcer, pleural effusion, hypocomplementemia, proteinuria it is decided to maintain antibiotic coverage and treatment with Methylprednisolone 0. 5 gr/ 5 days and later Prednisone 60 mg/6 weeks and treatment with Mycophenolate Mofetil 2gr/day was resumed.

Conclusions: it is essential to know the infections that occur most frequently in patients with lupus, in order to achieve their prevention, diagnosis and treatment, which would have a significant impact on their survival.

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Author Biographies

Dianayis Hortelas Sánchez, Centro de referencia para las enfermedades reumáticas. Hospital Docente Clínico Quirúrgico Diez de Octubre. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba.

Médico. Especialista de primer grado en Reumatología. Profesora Asistente.

Thuyen Fong Fernández, 2Hospital Docente Clínico Quirúrgico Diez de Octubre. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba.

Médico. Especialista de segundo grado en Dermatología. Profesora e investigadora Auxiliar. Máster en Atención integral al paciente reumático.

Ana María Gutiérrez Guadarrama, Centro de referencias para las enfermedades reumáticas. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba.

Especialista de primer grado en Reumatología.

Profesora Instructora.

Gretchen Garrido Muñoz, Centro de referencias para las enfermedades reumáticas. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba.

No existe.

Katiuska Rodríguez Pérez, Centro de referencia para las enfermedades reumáticas. Hospital Docente Clínico Quirúrgico Diez de Octubre. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba.

No existe.

Yaliana Frómeta Barrera, Centro de referencia para las enfermedades reumáticas. Hospital Docente Clínico Quirúrgico Diez de Octubre. Universidad de Ciencias Médicas de La Habana. La Habana, Cuba.

No existe.

References

1-Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum [Internet]. 2012 [citado 16 Mar 2025];64(8):2677-86. Disponible en: https://pubmed.ncbi.nlm.nih.gov/22553077/

2-Pons-Estel GJ, Alarcón GS, Scofield L, Reinlib L, Cooper GS. Understanding the epidemiology and progession of systemic lupus erythematosus. Semin Arthritis [Internet]. 2010 [citado 16 Mar 2025];39(4):257-68. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27821390/

3-Zonana-Nacach A, Camargo-Coronel A, Yañez P, Sánchez L, Jiménez-Balderas FJ, Fraga A. Infections in outpatients with systemic lupus erythematosus: a prospective study. Lupus [Internet]. 2001 [citado 16 Mar 2025];10(7):505-10. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11480850/

4-Gladman DD, Hussain F, Ibañez D, Urowitz MB. The nature and outcome of infection in systemic lupus erythematosus. Lupus [Internet]. 2002 [citado 16 Mar 2025];11(4):234-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/12043887/

5-Nived O, Sturfelt G, Wollheim F. Systemic lupus erythematosus and infections. A controlled prospective study including an epidemiological group. Q J Med [Internet]. 1985 [citado 16 Mar 2025];55(218):271-87. Disponible en: https://pubmed.ncbi.nlm.nih.gov/4023171/

6-Kim J-W, Kim H-A, Suh C-H, Jung J-Y. Sex hormones affect the pathogenesis and clinical characteristics of systemic lupus erythematosus. Front Med (Lausanne). 2022;9:906475. http://dx.doi.org/10.3389/fmed.2022.906475

7-Alarcón-Segovia D, Alarcón-Riquelme ME, Cardiel MH, Caeiro F, Massardo L, et al. Familial aggregation of systemic lupus erythematosus, rheumatoid arthritis, and other autoinmune diseases in 1,177 lupus patients from the GLADEL cohort. Arthritis Rheum [Internet]. 2005 [citado 16 Mar 2025];52(4):1138-47. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15818688/

8-Kanda N, Tsuchida T, Watanabe T, Tamaki K. Clinical features of systemic lupus erythematosus in men. Characteristics of the cutaneous manifestations. Dermatology [Internet]. 1996 [citado 16 Mar 2025];193(1):6-10. Disponible en: https://pubmed.ncbi.nlm.nih.gov/8864610/

9-Font J, Cervera R, Navarro M, Pallarés L, López-Soto A, et al. Systemic lupus erythematosus in men: clinical and immunological characteristics. Ann Rheum Dis [Internet]. 1992 [citado 16 Mar 2025];51(9):1050-2. Disponible en: https://pubmed.ncbi.nlm.nih.gov/1417135/

10-Varaganti V, Vadakedath S, Ca J, Kandi V, B PV, Hussain MH, et al. Mechanisms underlying gender influence on the clinical course and immunopathogenesis of systemic lupus erythematosus: An explorative review. Cureus [Internet]. 2024 [citado 16 Mar 2025];16(11):e73646. Disponible en: https://pubmed.ncbi.nlm.nih.gov/39677179/

11-Mok CC, Lau CS, Chan TM, Wng RW. Clinical characteristics and outcome of southern Chinese males with systemic lupus erythematosus. Lupus [Internet]. 1999 [citado 16 Mar 2025];8(3):188-96. Disponible en: https://pubmed.ncbi.nlm.nih.gov/10342711/

12-Pande N, Malaviya N, Sekharan S. SLE in Indian men: analysis of the clinical and laboratory features with a review of the literature. Lupus [Internet]. 1994 [citado 16 Mar 2025];3(3):181-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/7951303/

13-Jones JM, Smith F, Littlejohn E, Jorgensen TN. Lack of Association Between Sex Hormones, MDSCs, LDGs and pDCs in Males and Females With Systemic Lupus Erythematosus. Front Immunol [Internet]. 2022 [citado 16 Mar 2025];13:888501. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35833144/

14-Costallat L, Coimbra A. Systemic lupus erythematosus in 18 Brazilian males: clinical and laboratory analysis. Clin Rheumatol [Internet]. 1993 [citado 16 Mar 2025];12(4):522-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/8124916/

15-Barber MRW, Drenkard C, Falasinnu T, Hoi A, Mak A, Kow NY, et al. Global epidemiology of systemic lupus erythematosus. Nat Rev Rheumatol [Internet]. 2021 [citado 16 Mar 2025];17(9):515-32. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34345022/

16-Han JY, Cho SK, Sung YK. Epidemiology of systemic lupus erythematosus in Korea. J Rheum Dis [Internet]. 2023 [citado 16 Mar 2025];30(4):211-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37736591/

17-Bouza E, Moya JG, Muñoz P. Infections in systemic lupus erythematosus and rheumatoid arthritis. Infect Dis Clin North Am [Internet]. 2001 [citado 16 Mar 2025];15(2):335-61,vii. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11447699/

18-Kavrul Kayaalp G, Esencan D, Guliyeva V, Arık SD, Türkmen Ş, Şahin S, et al. Childhood-onset systemic lupus erythematosus: A descriptive and comparative study of clinical, laboratory, and treatment characteristics in two populations. Lupus [Internet]. 2024 [citado 16 Mar 2025];33(10):1130-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/39037381/

19-Massardo Vega L, Martínez Re ME, Baro AM, Figueroa EF, Rivero Díaz S, Jacobelli S. Infecciones en lupus eritematoso generalizado. Rev Méd Chile. 1991;119:1115-22.

20-Yuhara T, Takemura H, Akama T, Suzuki H, Yamane K, Kashiwagi H. Predicting infection in hospitalized patients with systemic lupus erythematosus. Intern Med [Internet]. 1996 [citado 16 Mar 2025];35(8):629-36. Disponible en: https://pubmed.ncbi.nlm.nih.gov/8894737/

21-Karim MY, Alba P, Cuadrado MJ, Abbs IC, D’Cruz DP, Khamashta MA, et al. Mycophenolate mofetil for systemic lupus erythematosus refractory to other immunosuppressive agents. Rheumatology (Oxford) [Internet]. 2002 [citado 16 Mar 2025];41(8):876-82. Disponible en: https://pubmed.ncbi.nlm.nih.gov/12154204/

22-Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P et al. Morbidity and mortality in systemic lupus erythematosus during 5-year period. A multicenter prospective study of 1,000 patients. European Working Party on Systemic Lupus Erythematosus. Medicine (Baltimore) [Internet]. 1999 [citado 16 Mar 2025];78(8):167-75. Disponible en: https://pubmed.ncbi.nlm.nih.gov/10352648/

23-Pons-Estel BA, Catoggio LJ, Cardiel MH, Soriano ER, Gentiletti S, Villa AR, et al. The GLADEL multinational Latin American prospective inception cohort of 1,214 patients with systemic lupus erythematosus: ethnic and disease heterogeneity among “Hispanics”. Medicine (Baltimore) [Internet]. 2004 [citado 16 Mar 2025];83(1):1-17. Disponible en: https://pubmed.ncbi.nlm.nih.gov/14747764/

24-Fessler BJ. Infectious diseases in systemic lupus erythematosus: risk factors, management and prophylaxis. Best Pract Res Clin Rheumatol [Internet]. 2002 [citado 16 Mar 2025];16(2):181-91. Disponible en: https://pubmed.ncbi.nlm.nih.gov/12041954/

25-Bunkhorst R, Eberhardt OK, Haubitz M, Brunkhorst FM. Procalcitonin for discrimination between activity of systemic autoimmune disease and systemic bacterial infection. Intensive Care Med [Internet]. 2000 [citado 16 Mar 2025];26(Suppl2):S199-201. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18470720/

26-Shin KC, Lee YJ, Kang SW, Baek HJ, Lee EB, Kim HA et al. Serum procalcitonin measurement for detection of intercurrent infection in febrile patients with SLE. Ann Rheum Dis [Internet]. 2001 [citado 16 Mar 2025];60(10):988-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11589181/

Published

2025-07-01

How to Cite

1.
Hortelas Sánchez D, Fong Fernández T, Gutiérrez Guadarrama AM, Garrido Muñoz G, Rodríguez Pérez K, Frómeta Barrera Y. Lupus en el varón e infección dermatológica: a propósito de un caso. Rev. cuba. de Reumatol. [Internet]. 2025 Jul. 1 [cited 2025 Dec. 5];27:e1452. Available from: https://revreumatologia.sld.cu/index.php/reumatologia/article/view/1452

Issue

Section

Studies of cases