Late onset systemic lupus erythematosus

198

We compared the frequency of clinical features of systemic lupus erythematosus (SLE) and determined survival in 113 patients with younger-onset lupus (age <55 at clinical diagnosis) and 25 patients with olderonset disease (age 155 at diagnosis). The most striking difference was in the racial distribution; 59% of the younger patients were black, compared with only 20% of the oldeponset patients (I' < 0.001). Major manifestations of lupus (including clinically evident renal disease, central nervous system involvement, cutaneous involvement, and hemocytopenia) occurred with similar frequency in both age groups. Antibodies to DNA were detectable equally often in both groups, but hypocomplementemia was more common in the younger patients. Five-year survival in the younger-onset group (79%) was similar to that of the older-onset group (72%); there was a tendency toward relatively improved survival in patients in the latter group when compared with the expected survival of appropriately matched control populations. Major significant differences in racial distribution included 1) a higher incidence of serositis in older whites and in blacks regardless of age, and 2 ) more frequent hypocomplementemia in younger patients ' within both racial groups.

Section: Discussionmentioning

confidence: 99%

Clinical features of systemic lupus erythematosus

Ballou

Khan

Kushner

1982

198

“…Patients with SLE are a heterogeneous group with respect to clinical course, therapeutic requirements, and prognosis. The identification of more homogeneous subsets, such as the late onset, ANA negative, serologically active clinically quiescent, and subacute cutaneous subsets has led to a more rational approach to management (15)(16)(17)(18)(19)(20)(21). …”

Section: Discussionmentioning

confidence: 99%

The significance of thrombocytopenia in systemic lupus erythematosus

Miller

Urowitz

Gladman

1983

The significance of thrombocytopenia in systemic lupus erythematosus (SLE) is unclear. Some researchers have found it associated with severe disease, others with mild disease. Thrombocytopenia (platelets < 100,000) occurred in 21 patients seen at an SLE clinic over 18 months. Prospective assessment of 19 (non‐SLE causes excluded) revealed 2 distinct subgroups. Seven were thrombocytopenic only during severe multisystem flares. Twelve had chronic thrombocytopenia with intermittent mild flares in other systems. Serious bleeding was rare in both subgroups. It was concluded that thrombocytopenia clearly is not a prognostic indicator.

“…Aside from the negative impact of renal and neuropsychiatric manifestations on outcome in SLE (10,l l), few studies have identified a role for other clinical features of the disease in the prognosis. Demographic characteristics, particularly race (5,9,15-18), sex (19), and young age at disease onset (17,18,(20)(21)(22)(23)(24)(25)(26), have also been shown to affect the clinical presentation of SLE. Moreover, this disease has been shown to be more common among the American black population (9,27), and some studies have found a worse prognosis for American black patients with SLE than for Caucasian SLE patients (5,15,16).…”

Section: Prognosis In Systemic Lupus Erythematosusmentioning

confidence: 99%

Prognosis in systemic lupus erythematosus

Reveille¹,

Bartolucci²,

Alarcón³

1990

300

To assess the impact of demographic and clinical factors on prognosis in patients with systemic lupus erythematosus (SLE), we examined survivorship by Life-table analysis in 389 patients. There were approximately equal numbers of Caucasian patients and American black patients in this study group. On both univariate and multivariate analyses, we found that both American black race and increasing age at SLE onset independently worsened the probability of survival. Of all the clinical factors we analyzed, thrombocytopenia emerged as the only independent risk factor for a worse prognosis in SLE. In all clinical and demographic groups considered, the leading cause of death was infection.Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease that predominantly affects women of childbearing age. The extensive cutaneous, musculoskeletal, and visceral manifestations of this disease, especially in younger patients, are often associated with considerable limi-