The clinical features and prognosis of lupus with disease onset at age 65 and older

Abstract

Systemic lupus erythematosus (SLE) in the elderly is uncommon and rarely reported with disease onset at age 65 and older. The aim of this study is to retrospectively analyze the influence of age at disease onset on the clinical features and prognosis of SLE. From 1988 to 1998, we encountered 21 lupus patients with disease onset at age 65 and older (all are included in group A). For comparison, 21 lupus patients with disease onset between 50-64 years of age (group B) and 152 lupus patients with disease onset before 50 years of age (group C) were obtained by a simple random sampling method from the hospital registry. Clinical features as included in the 1982 ARA revised criteria for classification of SLE and survival rate were analyzed and compared among these three groups. Group A had a smaller female to male ratio, longer duration from disease onset to diagnosis, less malar rash, more discoid lupus, and shorter survival rate that group C. There was no statistically significant difference in clinical features and survival between groups A and B, as well as between female and male patients of these two groups. The main cause of death in group A was septic shock. In conclusion, the clinical features and prognosis of SLE were influenced by the age at disease onset. However, clinical features and prognosis of SLE were similar in both late-onset lupus groups.

Late-onset systemic lupus erythematosus in the elderly

“…И если у молодых боль-ных СКВ причиной летального исхода наряду с активно-стью заболевания, как правило, является атеросклеротиче-ское поражение сосудов, то у пожилых пациентов -это ин-фекции и перфорация язвы [30,32,33]. Нет убедительных данных об ассоциации «пожилой» СКВ с антифосфолипид-ным синдромом, негативное влияние которого на выживае-мость хорошо известно, особенно при развитии тромбоци-топении и артериальных тромбозов [22,34].…”

“…Данные о причинной связи новообразований с СКВ противоречивы [22,25,34]. Большинство исследователей указывают на незначительное повышение частоты опухоле-вых процессов у больных СКВ.…”

“…По мнению большинства авторов, нефрит и нефроти-ческий синдром встречаются у «возрастных» больных СКВ гораздо реже [10,17,18]. R. Cervera и соавт.…”

A Case of Late-Onset Systemic Lupus Erythematosus with Severe Anemia

“…Age at onset has been recognized as having a modifying effect on the clinical manifestations of SLE, and thus late onset in persons aged 50 years and above may constitute a specific subgroup of SLE [3][4][5]. Patients with late-onset SLE seem to show a more insidious disease onset, and are less likely to have major organ involvement [1].…”

Introduction and Physiology of Lupus

“…They have less organ systems involved, and the disease is mild in them, but the progress and natural course, for some unknown reasons, is bad [100][101][102][103][104][105][106][107][108].…”