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01.09.2007 | Therapy In Practice

Elderly-Onset Systemic Lupus Erythematosus

Prevalence, Clinical Course and Treatment

verfasst von: Dr Deana Lazaro

Erschienen in: Drugs & Aging | Ausgabe 9/2007

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Abstract

Systemic lupus erythematosus is an autoimmune multi-system disease of uncertain aetiology with highly variable clinical manifestations. Women of child-bearing age are most often affected; however, ≈10–20% of cases occur in older patients. Elderly-onset lupus has been defined in various studies as onset of lupus after age 50–65 years. Menopause and changes in cellular immunity with aging may contribute to development of lupus in older adults.

Many studies suggest that the clinical and serological features of elderly-onset lupus differ from those of lupus in younger patients. Arthritis, fever, serositis, sicca symptoms, Raynaud’s syndrome, lung disease and neuropsychiatric symptoms are more common in patients with elderly-onset lupus, while malar rash, discoid lupus and glomerulonephritis are less common in elderly-onset patients compared with younger lupus patients. Most elderly-onset lupus patients have a positive anti-nuclear antibody test, but the prevalence of anti-double-stranded DNA and hypocomplementaemia is lower in elderly-onset patients than in younger patients. Rheumatoid factor, anti-Ro/Sjögren’s syndrome (SS) A and anti-La/SSB are more often positive in elderly-onset patients. The diagnosis of elderly-onset lupus may be delayed for many months: insidious onset, low prevalence and similarity to other more common disorders make the diagnosis of lupus challenging in this population.

Treatment of lupus in the elderly may be complicated by co-morbidities and increased risk of toxicities from usual treatments. Optimal management of elderly-onset lupus is empiric because of a lack of randomised controlled studies. However, the approach to treatment is similar regardless of the age of the patient.

This article discusses the prevalence, clinical course, serological features, prognosis and treatment of elderly-onset systemic lupus erythematosus.

The use of trade names is for product identification purposes only and does not imply endorsement.

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Titel: Elderly-Onset Systemic Lupus Erythematosus
Prevalence, Clinical Course and Treatment
verfasst von: Dr Deana Lazaro
Publikationsdatum: 01.09.2007
Verlag: Springer International Publishing
Erschienen in: Drugs & Aging / Ausgabe 9/2007
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI: https://doi.org/10.2165/00002512-200724090-00001

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