Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Classically, late onset Systemic Lupus Erythematosus (SLE) has been described as a milder variant of the disease. The objective of this study is to describe the clinical and immunological features, the damage accrual and mortality of late onset compared with adult onset SLE.
Methods: The data was obtained from a long term prospective cohort of 353 patients diagnosed with SLE in the Rheumatology Department of Gregorio Marañon Hospital in Madrid, Spain. Demographic, clinical, and laboratory data were collected at disease onset and during it´s course from 1986 to 2006. Patients were divided into 2 groups: adult onset 19-49 years (n=276) and late onset ≥50 years (n=77). Organ damage was scored using the Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index. Damage accrual was defined as an SLICC/ACR score ≥1. The groups were compared using the chi-square, Fisher-Holton and t-student tests.
Results: A total of 353 patients were recruited, with a following mean time of 11 years. The female to male ratio differed significantly (p=0.005) between groups. At diagnosis, the late-onset group presented cutaneous manifestations less frequently (p<0.001). During follow-up, the late-onset group presented a lower incidence of arthritis (p=0.02), malar rash (p=0.001), photosensitivity (p=0.04), fever (p=0.03), low serum complement (p=0.001), hematologic (p=0.03) and renal (p=0.01) manifestations. The late-onset group had significantly more hypertension (p=0.03), neoplasms (p=0.02), damage accrual (p=0.007) and mortality (p=0.006). As for autoantibody profile, no statistically significant differences were found.
Conclusion: Late onset SLE is clinically different with less arthritis, fever, low serum complement, cutaneous, hematologic and renal manifestations, but with higher mortality and organ damage rates, compared with the adult onset group. The higher frequency of damage accrual, mortality and hypertension observed in the late-onset group can be affected by aging-related factors other than disease activity or duration.
|
CHARACTERISTICS |
Adult Onset 19-49 Years (n=276) |
Late Onset ≥50 Years (n=77) |
p |
|
At Disease Onset |
|||
|
DEMOGRAPHIC |
|
|
|
|
Female/Male Ratio |
8.9 (248/28) |
3.5 (60/13) |
0.005 |
|
Age at diagnosis, (range) |
31.9 (19-50) |
61.2 (51-86) |
<0.001 |
|
CLINICAL MANIFESTATIONS (%) |
|
|
|
|
Cutaneous |
93 (33.7) |
8 (10.4) |
<0.001 |
|
During Follow-up |
|||
|
CLINICAL MANIFESTATIONS (%) |
|
|
|
|
Arthritis |
254 (92) |
64 (83.1) |
0.02 |
|
Malar Rash |
130 (47.1) |
17 (22.1) |
<0.001 |
|
Photosensitivity |
147 (53.3) |
31 (40.3) |
0.04 |
|
Fever |
103 (37.3) |
19 (24.7) |
0.03 |
|
Hematologic Manifestations |
228 (82.6) |
55 (71.4) |
0.03 |
|
Renal Manifestations |
124 (44.9) |
22 (28.6) |
0.01 |
|
Hypertension |
77 (27.9) |
31 (40.3) |
0.03 |
|
Neoplasms |
13 (4.7) |
9 (11.7) |
0.02 |
|
SLICC/ACR (mean ± SD) |
1.7 ± 2.1 |
2.5 ± 2.5 |
0.007 |
|
Mortality |
17 (6.2) |
13 (16.9) |
0.006 |
|
Disease duration time (mean ± SD) |
12.6 ± 8.6 |
9.9 ± 7.5 |
0.01 |
|
Low serum complement |
220 (81.2) |
40 (58) |
<0.001 |
Disclosure:
J. G. Ovalles-Bonilla,
None;
J. Martínez-Barrio,
None;
J. Lopez-Longo,
None;
I. de la Torre,
None;
C. Gonzalez Fernandez,
None;
M. Montoro Álvarez,
None;
F. Aramburu,
None;
C. Marin,
None;
L. Martinez-Estupiñan,
None;
J. C. Nieto,
None;
M. Hinojosa,
None;
N. Bello,
None;
I. Monteagudo,
None;
L. Carreño,
None.
« Back to 2012 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/late-onset-systemic-lupus-erythematosus-is-it-actually-a-milder-variant/