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PS6:122 Late-onset systemic lupus erythematosus: characteristics and comparison with adult-onset disease
  1. T Ben Salem,
  2. I Naceur,
  3. M Tougorti,
  4. M Lamloum,
  5. I Ben Ghorbel and
  6. MH Houman
  1. Department of internal medicine, La Rabta University Hospital, Tunis, Tunisia


Background Systemic lupus erythematosus (SLE) is uncommon after the age of 50. The aim of this study was to determine clinical, biological and immunological characteristics of late-onset SLE.

Patients and methods We retrospectively analysed 246 files of SLE patients (ACR criteria). Two groups were defined according to age: late-onset SLE (age over 50 years) and adult-onset (between 18 and 50 years). Characteristics of SLE were compared in the two groups. P value was considered significant if <0.05.

Results Thirty four patients with late-onset SLE were studied; 29 women and five men. Adult-onset group included 173 women and 12 men (no difference in sex-ratio between the 2 groups). In late-onset SLE, mean age at disease onset was 56.9±6.4 years) and mean age at SLE diagnosis was 58±6.7 years. Mean delay from SLE onset to diagnosis was 18.64 months in late-onset group (similar to adult-onset SLE).

At time of SLE diagnosis, malar rash (25.8% vs 65.6%; p<0.0001) and Raynaud’s phenomenon (13% vs 35.5%; p=0.033) were significantly less frequent in late-onset group. Renal failure was more frequent in old patients (33.3% vs 10.5%, p=0.005) without difference in lupus nephritis frequencies.

During follow up, cutaneous manifestations (36.4 vs 82%; p<0.0001), lupus nephritis (25% vs 45.6%; p=0.03) were significantly less frequent in late-onset SLE.

Arthralgia was seen in 84.8% of patients (less frequent than adult-onset group without significant difference). Central neurologic involvements (18.2%), pericarditis (48.4%) and pleural effusion (33.3%) were more frequent in late-onset SLE without significant differences.

In late-onset SLE, anaemia was found in 67.5%, leucopenia in 40.6% and thrombocytopenia in 26.5% of patients (no differencies with adult-onset group).

Antinuclear antibodies were positive in all patients with late-onset disease and anti-DNA antibodies were positive in 69% of patients (similar to other group).

Anti-ENA antibodies were significantly less frequent in late-onset SLE (66.7% vs 87.5%, p=0.017).

Mortality rates was higher in older patients without statistical difference (20.9% vs 9%; p=0.14).

Conclusion Late onset SLE patients had less cutaneous manifestations and lupus nephritis but had higher rates of renal insufficiency and mortality; these can be related to co-morbidities.

  • Late-Onset Lupus
  • Adult-Onset Lupus
  • Systemic Manifestations

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