Isolated pyuria in systemic lupus erythematosus
Isolated pyuria in systemic lupus erythematosus
复制标题
DOI：
10.1177/0961203309358901
复制
发表时间：
2010-06-01
期刊：
影响因子：
2.6
通讯作者：
Bernatsky, S.
中科院分区：
文献类型：
--
作者：
Appenzeller, S.;Clark, A.;Bernatsky, S.
本研究的目的是评估单纯性脓尿在系统性红斑狼疮样本，并确定可能与这种表现相关的因素。我们研究了在狼疮门诊随访的患者，将孤立性脓尿定义为每个高倍视野中有超过10个白色血细胞，且无血尿、蛋白尿、管型或菌尿。我们采用单变量logistic回归分析评估了各种人口统计学和临床因素对孤立性脓尿发生的影响。我们还进行了多变量模型，包括性别，年龄，种族/民族，系统性红斑狼疮病程，非肾系统性红斑狼疮疾病活动，系统性红斑狼疮损害，非肾和肾美国流变学学会标准的数量，既存高血压和当前药物暴露。在264名受试者中，66名被排除（43名患有菌尿或尿培养物污染，23名没有伴随尿培养）;其余198名受试者中有27名（13.6%）患有孤立性脓尿。27例无菌性脓尿患者中有16例既往符合美国风湿病学会肾脏受累标准（血尿、管型和/或蛋白尿），而171例无菌性脓尿患者中有62例（未校正比值比2.55; 95%置信区间= 1.11-5.85）。我们的单变量分析也提示单纯性脓尿患者非肾脏疾病活动性更高的趋势。在调整后的分析中，独立关联不明显。在我们的系统性红斑狼疮样本中观察到大量的孤立性脓尿。虽然孤立性脓尿的鉴别诊断是广泛的，这种表现可能与狼疮活动相关，即使没有血尿或蛋白尿。Lupus（2010）19，793-796.
The objective of this study was to assess isolated pyuria in an unselected systemic lupus erythematosus sample, and to determine factors potentially associated with this manifestation. We studied patients followed in our lupus clinic, defining isolated pyuria as more than 10 white blood cells per high power field in the absence of hematuria, proteinuria, casts, or bacteriuria. We assessed the effects of various demographic and clinical factors on the occurrence of isolated pyuria, using univariate logistic regression analyses. We also performed multivariate models which included sex, age, race/ethnicity, systemic lupus erythematosus duration, non-renal systemic lupus erythematosus disease activity, systemic lupus erythematosus damage, number of non-renal and renal American College of Rheumatology criteria ever present, pre-existing hypertension, and current drug exposures. Of 264 subjects, 66 were excluded (43 had bacteriuria or a contaminated urine culture and 23 had no concomitant urine culture); 27 of the remaining 198 (13.6%) had isolated pyuria. Sixteen of 27 patients with sterile pyuria had previous American College of Rheumatology criteria for renal involvement (hematuria, casts, and/or proteinuria) compared to 62/171 patients without sterile pyuria (unadjusted odds ratio 2.55; 95% confidence interval = 1.11-5.85). Our univariate analyses also suggested a trend towards higher non-renal disease activity in patients with isolated pyuria. Independent associations were not evident in adjusted analyses. Isolated pyuria was observed in a significant number of our systemic lupus erythematosus sample. Although the differential diagnosis for isolated pyuria is broad, this manifestation may be correlated with lupus activity even in the absence of hematuria or proteinuria. Lupus (2010) 19, 793-796.