title: Clinical expression and course in patients with late onset systemic lupus erythematosus.
abstract: BACKGROUND
  To analyze the pattern of clinical expression and the 5-year disease course in Caucasian patients with late onset of systemic lupus erythematosus (SLE) and to compare the findings with an early onset SLE group.
  
  
  METHODS
  Medical records of 551 patients who presented with SLE at hospitals of the region of Thessaloniki between 1989 and 2007 were studied. Patients who developed SLE at or after the age of 50 years were classified as the late onset group, while younger patients served as the early onset group. Data on clinical manifestations and damage accrual at disease onset and at 5 years was obtained and compared between the two groups.
  
  
  RESULTS
  In 121 patients, the disease started after the age of 50 years. Elderly patients showed less pronounced female predominance and less often presented with malar rash, nephropathy, fever and lymphadenopathy, while lung involvement, pericarditis and sicca syndrome were more frequent. Damage accrual was similar in both groups. The main causes of damage at 5 years differed, with the elderly exhibiting more cardiovascular damage. They also had a higher incidence of hypertension and osteoporosis at 5 years.
  
  
  CONCLUSIONS
  Caucasian SLE patients with late onset of the disease present with different clinical manifestations, suggesting that age affects the expression of SLE. Damage accrual at 5 years is similar in the elderly and the younger patients. However, the causes of this damage and the occurrence of other comorbidities follow a different pattern, possibly reflecting the disease process and the effects of aging.
authors.affiliation: 4 Department of Internal Medicine, Aristotle University, Hippokration Hospital.
authors.forename: S
authors.initials: S
authors.lastname: Stefanidou
authors.affiliation: 4 Department of Internal Medicine, Aristotle University, Hippokration Hospital.
authors.forename: C
authors.initials: C
authors.lastname: Gerodimos
authors.affiliation: Department of Hygiene, Aristotle University.
authors.forename: A
authors.initials: A
authors.lastname: Benos
authors.affiliation: Department of Rheumatology, Papageorgiou Hospital.
authors.forename: V
authors.initials: V
authors.lastname: Galanopoulou
authors.affiliation: Department of Rheumatology, Agios Pavlos Hospital.
authors.forename: I
authors.initials: I
authors.lastname: Chatziyannis
authors.affiliation: 1 Department of Pediatrics, Aristotle University, Hippokration Hospital.
authors.forename: F
authors.initials: F
authors.lastname: Kanakoudi
authors.affiliation: 2 Propedeutic Department of Internal Medicine, Hippokration Hospital.
authors.forename: S
authors.initials: S
authors.lastname: Aslanidis
authors.affiliation: 2 Department of Internal Medicine, Aristotle University, Hippokration Hospital.
authors.forename: P
authors.initials: P
authors.lastname: Boura
authors.affiliation: Department of Rheumatology, Inter-Balkan Hospital.
authors.forename: T
authors.initials: T
authors.lastname: Sfetsios
authors.affiliation: 1 Department of Internal Medicine, Aristotle University, AHEPA Hospital.
authors.forename: L
authors.initials: L
authors.lastname: Settas
authors.affiliation: 2 Department of Internal Medicine, Papanikolaou Hospital.
authors.forename: M
authors.initials: M
authors.lastname: Katsounaros
authors.affiliation: Department of Nephrology, Papageorgiou Hospital.
authors.forename: D
authors.initials: D
authors.lastname: Papadopoulou
authors.affiliation: Department of Nephrology, Hippokration Hospital.
authors.forename: P
authors.initials: P
authors.lastname: Giamalis
authors.affiliation: Department of Nephrology, AHEPA Hospital.
authors.forename: N
authors.initials: N
authors.lastname: Dombros
authors.affiliation: 2 Department of Pediatrics, Aristotle University, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Chatzistilianou
authors.affiliation: 4 Department of Internal Medicine, Aristotle University, Hippokration Hospital.
authors.forename: A
authors.initials: A
authors.lastname: Garyfallos
keywords: aging; brain; fish oil; omega 3 fatty acids; oxidative stress; rats