Systemic lupus erythematosus in the elderly

Abstract

Onset of the disease above the age of 65 years is unusual. This study was undertaken to determine retrospectively the clinical and laboratory features in SLE patients aged over 65 years. It is a retrospective study about 18 elderly patients with SLE out of 342 diagnosed between 1994 and 2009 in the center of Tunisia. All patients had at least 4 of 11 revised ACR criteria of SLE. The frequency of SLE in the elderly was 5.3%. The median age was 70 years (range 66 and 78 years). The sex ratio F/M was 5. The most frequent clinical signs were anemia (83.3%), arthralgia (55.5%), arthritis (38.9%), and malar rash (33.3%). The proteinuria and the neuropsychiatric troubles were present in 27.8% of cases. The pericarditis was present in 16.7% of cases. Antibodies to double stranded DNA (anti-dsDNA) were detected in 66.7%, anti-nucleosome in 50%, anti-SSA and anti-RNP in 27.8%, anti-Sm in 22%, and anti-SSB in 11%. Elderly patients with SLE exhibit distinct clinical and biological manifestations from the classic form. Thus, greater attention should be given for this particular subgroup of SLE patients to avoid delays in diagnosis or misdiagnosis.

Autoantibodies involved in neuropsychiatric manifestations associated with systemic lupus erythematosus: a systematic review

“…Nine studies [44][45][46][47][48][49][50][51][52] studies were excluded because it was not possible to extract the exact numbers of syndromes and/or patients resulting positive for autoantibodies tested or because they were not relevant for the purpose of this review.. Four studies [53][54][55][56] were also excluded as they focused on other biomarkers than autoantibodies.…”

The face of lupus

“…Arthritis and photosensitivity occur less often, female predominance decreases, and renal involvement is found in 42% to 52% of patients. 10 Racial/ethnic background is important to ascertain. The incidence of SLE is two to three times higher in Black women than in non-Hispanic White women.…”

“…Photosensitive dermatitis may also be reported. 10 Subacute cutaneous lupus erythematosus (SCLE) usually presents as annular lesions that are particularly sensitive to UV light but heal without scarring. 13 SCLE also may manifest as thick, scaly lesions most commonly on the knees that are similar in formation and appearance to psoriasis; many patients with SCLE have systemic disease.…”

Update on Biologic Therapies for Systemic Lupus Erythematosus

“…Systemic lupus erythematosus (SLE) is a chronic multisystemic autoimmune disease characterized by a remitting and relapsing course and which predominantly affects women of childbearing age [1,2]. It is ten times more frequent in women than in men and about five times more common in Black than in northern European people [3,4].…”