Systemic Lupus Erythematosus in Elderly Populations
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Systemic lupus erythematosus (SLE) is increasingly being recognized among the elderly. The so-called late-onset lupus seems to conform a quite defined patient subgroup with a frequency that ranges from 4–18% in different studies. According to several authors, late-onset lupus patients tend to have less of a female predominance. More insidious and less defined disease manifestations among this patient population may turn the diagnosis into a clinical challenge; therefore, many other diagnoses need to be excluded. It has been suggested that late-onset patients have a more benign disease course as they usually have less major organ system involvement, fewer clinical relapses, and lower degrees of disease activity. Mucocutaneous, renal, and neurological involvement has been reported to be less frequent among these patients. Treatment modalities have not been specifically studied in this patient subgroup; pharmacological interventions need to be tailored not only to the clinical manifestations of the disease, but also to the presence of other comorbidities and the drugs’ safety profiles. Despite this apparent benign course, patients whose disease begins later in life may not have such a good prognosis in terms of survival. It is possible that these patients’ poor long-term outcomes result from the impact SLE, along with other comorbidities, has in this older patient population.
KeywordsSystemic lupus erythematosus Late-onset lupus Elderly Disease activity Damage Mortality
The work of Drs. Guillermo Pons-Estel and Paula Burgos was supported by a Supporting Training Efforts in Lupus for Latin American Rheumatologists (STELLAR) award funded by Rheuminations, Inc.
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