Clinical characteristics and outcomes of the meningitides in systemic lupus erythematosus

Eur Neurol. 2009;61(3):143-8. doi: 10.1159/000186504. Epub 2008 Dec 18.


Background: The meningitides are rare but well-identified complications in patients with systemic lupus erythematosus (SLE).

Aims: To determine the clinical characteristics, risk factors, prevalence and outcomes of the meningitides (septic and aseptic) in patients with SLE.

Patients and methods: From January 1988 to December 2006, we identified patients with SLE and septic or aseptic meningitis.

Results: We identified 25 episodes of meningitis in 23 patients with SLE, from a total of 1,411 SLE patients (1.63%); in 15 out of 25 episodes, a microorganism was identified. Mycobacterium tuberculosis, Listeria monocytogenes and Criptococcus neoformans represented the main microorganisms. In 10 episodes, aseptic meningitis was diagnosed. Lymphopenia, steroid use, chronic damage and systemic activity of SLE were frequent in both kinds of meningitis. Although the clinical presentation did not differ significantly, patients with septic meningitis had more residual neurological deficits (p = 0.04).

Conclusions: Meningitis was observed in about 1.6% of the patients with SLE; in 40% of the cases, no microorganism could be isolated. A residual neurological deficit was more common in patients with septic meningitis.

MeSH terms

  • Adult
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Male
  • Meningitis / complications*
  • Meningitis / epidemiology
  • Meningitis, Aseptic / complications
  • Meningitis, Aseptic / epidemiology
  • Meningitis, Bacterial / complications
  • Meningitis, Bacterial / epidemiology
  • Meningitis, Cryptococcal / complications
  • Meningitis, Cryptococcal / epidemiology
  • Prevalence
  • Risk Factors
  • Severity of Illness Index