The mortality of patients with systemic lupus erythematosus (SLE) decreased between 1954 and 1974 from 50% survival over 4 years to more than 90% survival over 10 years.1 However, these rates have since remained unchanged.
We performed a retrospective study of inpatients with the diagnosis of SLE who died at a 2000-bed teaching hospital in São Paulo, Brazil, from January 1981 to December 1994: 1427 inpatients with SLE were registered in the hospital; 13.9% died, and 113 autopsies were performed (100 women and 13 men; mean ± SD age, 31.3 ± 11.7 years). Of these, 58% had infection as the major cause of death. Fungus and tuberculosis were together responsible for 13% of all deaths.