Correspondence

One Foot Away

N Engl J Med 2002; 347:1805November 28, 2002

Article

To the Editor:

The patient with systemic lupus erythematosus and tuberculosis described in the Clinical Problem-Solving article by Haberer et al. (May 2 issue)1 could have been identified as being at high risk for reactivation of tuberculosis before the initiation of immunosuppressive therapy. Isoniazid prophylaxis has been reported to be effective and safe in patients with systemic lupus erythematosus and might have been considered when the immunosuppressive therapy was started.2,3 This case underscores the importance of assessing the risk of infectious complications in immunocompromised patients.

Rainald A. Zeuner, M.D.
University of Kiel, 24116 Kiel, Germany

3 References

1. 1

   Haberer JE, Ix JH, Tierney LM Jr. One foot away. N Engl J Med 2002;346:1394-1397
   Full Text | Web of Science | Medline

2. 2

   Gilliland WR, Tsokos GC. Prophylactic use of antibiotics and immunisations in patients with SLE. Ann Rheum Dis 2002;61:191-192
   CrossRef | Web of Science | Medline

3. 3

   Gaitonde S, Pathan E, Sule A, Mittal G, Joshi VR. Efficacy of isoniazid prophylaxis in patients with systemic lupus erythematosus receiving long term steroid treatment. Ann Rheum Dis 2002;61:251-253
   CrossRef | Web of Science | Medline