Lupus and infections: prevention and vigilance

People with lupus may have an increased risk of certain infections. This risk may be related to the disease itself, but also to certain treatments that affect the immune system, including corticosteroids and immunosuppressants.

Prevention and early detection of infections are therefore part of medical monitoring.

Why might the risk of infection be increased?

Lupus causes a dysfunction of the immune system. Furthermore, some medications used to control the disease reduce the activity of the immune defenses.

However, the level of risk is not the same for all patients. It depends in particular on the activity of the lupus, the treatments used, their doses, any combination thereof, and the person's general health.

Recognizing an infection

Fever, chills, persistent cough, shortness of breath, painful urination, severe diarrhea, or any other unusual symptoms should be reported to a doctor and prompt a consultation.

If a person with lupus is being treated with immunosuppressants, the signs of infection may sometimes be less typical. It is therefore important to promptly report any unusual or persistent symptoms to the medical team.

Do not confuse infection with a lupus flare-up

Some symptoms of an infection may resemble those of a lupus flare-up, including fever, fatigue, or pain.

Therefore, it can be difficult for the patient to make the distinction themselves.

A medical evaluation may be necessary to determine the cause and adjust the treatment plan. In particular, you should not change your lupus treatment on your own, assuming it's a flare-up or an infection.

Preventing infections on a daily basis

Simple measures help to limit the risk of infection: regular hand hygiene, proper wound care, general and oral hygiene, and adherence to medical recommendations regarding infection prevention.

It is also important to inform healthcare professionals about immunosuppressive treatments received, particularly before certain treatments or when a new medication is being considered.

Vaccination and lupus

Vaccination is one of the preventive measures that should be offered to people with lupus.

However, recommendations depend on the disease, age, treatments, and level of immune impairment. Live vaccines are contraindicated in patients receiving immunosuppressive therapies.

The vaccination schedule should therefore be checked with the doctor, ideally before starting lupus treatments.

Do not interrupt your treatment on your own

In case of infection, the treatment plan depends on the clinical situation and the medication involved. Discuss this with your doctor.

You should not stop or change your lupus treatment on your own. Your doctor will determine whether treatment should be continued, temporarily interrupted, or adjusted.

Key points to remember

Lupus and some of its treatments can increase vulnerability to infections.

Prevention, vaccination tailored to the individual situation, and the rapid reporting of unusual symptoms all contribute to reducing the risks.

If infection is suspected, particularly while undergoing immunosuppressive treatment, it is important to seek medical advice rather than modifying one's treatment oneself.

This information sheet is for general information purposes only. It does not replace a consultation or personalized medical advice for diagnosis and follow-up.

Sources: PNDS Systemic Lupus in Adults and Children (2024) — Reference Centers / RAISE / FAI²R Network; official vaccination recommendations applicable to immunocompromised individuals.

Content reviewed and validated by Professor Saïd Norou DIOP, specialist in Internal Medicine, medical advisor for TAHIRAH CARE.