gms | German Medical Science

47. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 33. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 29. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

04.09. - 07.09.2019, Dresden

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The association between lymphopenia and serious infection risk in rheumatoid arthritis

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  • Sujith Subesinghe - King’s College London, London, United Kingdom
  • James Galloway - King’s College London, London, United Kingdom
  • Alexander Kleymann - Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Medizinische Klinik III, Dresden
  • Andrew Ian Rutherford - King’s College Hospital NHS, London, United Kingdom
  • Katie Bechman - King’s College London, London, United Kingdom
  • Sam Norton - Academic Department of Rheumatology, Weston Education Centre, King’s College London, London, United Kingdom

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 47. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 33. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 29. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Dresden, 04.-07.09.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocEV.01

doi: 10.3205/19dgrh084, urn:nbn:de:0183-19dgrh0840

Veröffentlicht: 8. Oktober 2019

© 2019 Subesinghe et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

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Objectives: To investigate the relationship between occurrence of serious infection (SI) and lymphocyte counts in patients with rheumatoid arthritis (RA) using data from single centre.

Methods: We used routinely captured data from a single tertiary rheumatology centre to explore the relationship between lymphopenia and SI risk. Adult RA patients were included over a 5-year follow-up period. Admissions due to SI were classified by infection organ-class. SI rate with 95% confidence intervals were calculated. The association between SI with baseline lymphocyte counts, time averaged lymphocyte counts throughout all follow up, and a nadir lymphocyte count were assed using Cox proportional hazards regression. The relationship between lymphopenia over time and SI was analysed using a mixed-effect model of lymphocyte counts prior to SI.

Results: This analysis included 1095 patients with 205 SIs during 2016 person-years of follow-up. The SI rate was 4.61/100 patient years (95% CI 3.76 to 5.65). Compared to patients with nadir lymphocyte counts >1.5 × 109 cells/L, nadir lymphopenia <1 × 109 cells/L were significantly associated with higher SI risk (HR 3.28, 95%CI 1.59 to 6.76), increasing to 8.08 (95%CI 3.74 to 17.44) in patients with lymphopenia <0.5 × 109 cells/L. Lymphocyte counts were observed to be reduced in the 30-day period prior to SI.

Conclusion: Lymphocyte counts below <1.0 x 109 cells/L were associated with higher SI risk in RA patients, the strongest association between lymphopenia and SI was observed when lymphocyte counts were below <0.5x 109 cells/L. Lymphopenia may be used as a measure to stratify patients at risk of SI.