Neuropsychiatric lupus erythematosus and the elderly

Abstract

Recent research suggests systemic lupus erythematosus (SLE) is more common in the elderly than previously thought. Neuropsychiatric disorder occurs in the majority of patients at some time during the course of the illness. Frequently neuropsychiatric features occur early, and may precede other typical features of multisystem disease by some years. An organic brain syndrome is the most frequently encountered neuropsychiatric manifestation of SLE. It is important that cases presenting to elderly services are recognized, as organic brain disorders resulting from SLE are potentially treatable.

Rare Cause of Seizures, Renal Failure, and Gangrene in an 83-Year-Old Diabetic Male

“…It is generally agreed that SLE in the elderly is a mild disease [ 9 ]. Prevalence of organ involvement in males depends upon the ethnic population being studied, study setting (tertiary versus primary), selection criteria of female controls, and sample size of male subjects [ 10 ].…”

“…Fever, fatigue, and weight loss are common symptoms in elderly SLE patients [ 5 ]. Serositis, muscle pains, and arthritis are more common in this age group as are secondary Sjögren's syndrome but with a lower incidence of cutaneous manifestations and Raynaud's phenomenon [ 9 ]. Males in a Thai study tended to have a shorter duration of symptoms prior to presentation, with alopecia, arthralgia and Raynaud's phenomenon being less common [ 10 ].…”

“…SLE prevalence in India was low at 3.2/100000 population [ 13 ]; contrastingly, renal involvement among Indian SLE patients was the highest in the world [ 13 ]. Neuropsychiatric manifestations are similar in the young and the elderly [ 9 ]. Neuropsychiatric SLE (NSLE) at presentation in the elderly population has been described only as case reports.…”

“…Similar to our case, seizures, coma, and pneumonia have been reported in a 72-year-old lady who had pneumonitis, hypocomplementemia, elevated fibrinogen, and FDP but with normal renal function and negative dsDNA [ 14 ]. Presence of NSLE is generally associated with a poor prognosis [ 9 ]. NSLE can be either focal (stroke, neuropathy, and transient ischemic attack) or diffuse (confusion, dementia, and psychosis) or can present with seizures (partial or generalized) [ 9 ].…”

“…Presence of NSLE is generally associated with a poor prognosis [ 9 ]. NSLE can be either focal (stroke, neuropathy, and transient ischemic attack) or diffuse (confusion, dementia, and psychosis) or can present with seizures (partial or generalized) [ 9 ]. Seizures are reported in 15 to 30% of patients with SLE [ 9 ].…”