The clinical features and prognosis of lupus with disease onset at age 65 and older

Systemic lupus erythematosus (SLE) in the elderly is uncommon and rarely re ported with disease onset at age 65 and older. The aim of this study is to retrospectively analyze the influence of age at disease onset on the clinic al features and prognosis of SLE. From 1988 to 1998, we encountered 21 lupu s patients with disease onset at age 65 and older tall are included in grou p A). For comparison, 21 lupus patients with disease onset between 50-64 ye ars of age (group Bland 152 lupus patients with disease onset before 50 yea rs of age (group C) were obtained by a simple random sampling method from t he hospital registry. Clinical features as included in the 1982 ARA revised criteria for classification of SLE and survival rate were analyzed and com pared among these three groups. Group A had a smaller female to male ratio, longer duration from disease onset to diagnosis, less malar rash, more dis coid lupus, and shorter survival rate that group C. There was no statistica lly significant difference in clinical features and survival between groups A and B, as well as between female and male patients of these two groups. The main cause of death in group A was septic shock. In conclusion, the cli nical features and prognosis of SLE were influenced by the age at disease o nset. However, clinical features and prognosis of SLE were similar in both late-onset lupus groups.