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

Department of Internal Medicine, Tao-Yuan, Taiwan

S F Luo

Y J J Wu

Division of Allergy, Immunology and Rheumatology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan

H S Cheng

Department of Internal Medicine, Tao-Yuan, Taiwan

H H Ho

Division of Allergy, Immunology and Rheumatology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan

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.

Key Words: systemic lupus erythematosus • elderly • age at disease onset • late-onset lupus • survival

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