Systemic lupus erythematosus in the elderly.
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.
Research unit (03/UR/07-02), Faculty of pharmacy, Rue Avicenne, 5000 Monastir, Tunisia.
Achouak
A
Achour
Amani
A
Mankaï
Yosra
Y
Thabet
Wahiba
W
Sakly
Fehmi
F
Braham
Chedia
C
Kechrid
Fethi
F
Bahri
Elyès
E
Bouajina
Sawssen
S
Chouchène
Ons
O
Haddad
Ibtissem
I
Ghedira
D017668:Age of Onset; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014416:Tunisia / Q000453:epidemiology
D000974:Antibodies, Antinuclear; D015415:Biomarkers
Arthritis Rheum. 2006 May;54(5):1580-7
16645994
Medicine (Baltimore). 1993 Mar;72(2):113-24
8479324
Rheumatology (Oxford). 2004 Feb;43(2):220-4
13130152
Curr Opin Rheumatol. 2000 Sep;12(5):369-73
10990171
Arthritis Rheum. 1992 Jun;35(6):630-40
1599520
Lupus. 1999;8(6):462-5
10483015
Rev Med Interne. 2003 May;24(5):288-94
12763174
Arthritis Rheum. 1997 Sep;40(9):1725
9324032
Lupus. 2004;13(3):204-11
15119551
Arthritis Rheum. 1999 May;42(5):833-43
10323438
Pathol Biol (Paris). 2002 Feb;50(1):18-24
11873624
Lupus. 2000;9(2):96-100
10787005
JAMA. 1964 Oct 12;190:104-11
14184513
Saudi J Kidney Dis Transpl. 2008 Nov;19(6):1001-8
18974596
Ann Rheum Dis. 1998 Jul;57(7):437-40
9797573
Arthritis Rheum. 1978 May;21(4):473-9
656162
Autoimmun Rev. 2008 Jan;7(3):235-9
18190884