Skip to main content

Advertisement

SpringerLink
Log in

The differential panorama of clinical features of lupus erythematosus patients with different onset ages: a cross-sectional multicenter study from China

  • ORIGINAL ARTICLE
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Objectives

This study aims to compare the differences among patients of different onset ages in various subtypes of lupus erythematosus (LE) and to draw a panorama of the clinical characteristics of patients with different onset ages.

Method

Subjects were recruited from the Lupus Erythematosus Multicenter Case–control Study in Chinese populations (LEMCSC), grouped by the age of onset (childhood-onset: onset < 18 years, adult-onset: onset 18–50 years, late-onset: onset > 50 years). The data collected included demographic characteristics, LE-related systemic involvement, LE-related mucocutaneous manifestations, and laboratory results. All included patients were assigned into three groups: systemic LE (SLE) group (with systemic involvement, with or without mucocutaneous lesions), cutaneous LE (CLE) group (patients who were accompanied by any type of LE-specific cutaneous manifestations), and isolated cutaneous LE (iCLE) group (patients who were in CLE group without systemic involvements). Data were analyzed using R version 4.0.3.

Results

A total of 2097 patients were involved, including 1865 with SLE and 232 with iCLE. We also identified 1648 patients with CLE among them, as there was some overlap between the SLE population and CLE population (patients with SLE and LE-specific cutaneous manifestations). Later-onset lupus patients seemed to be less female predominance (p < 0.001) and have less systemic involvement (except arthritis), lower positive rates of autoimmune antibodies, less ACLE, and more DLE. Moreover, childhood-onset SLE patients presented a higher risk of LE family history (p = 0.002, vs adult-onset SLE). In contrast to other LE-nonspecific manifestations, the self-reported photosensitivity history decreased with the age of onset in SLE patients (51.8%, 43.4%, and 39.1%, respectively) but increased in iCLE patients (42.4%, 64.9%, and 89.2%, respectively). There was also a gradual increase in self-reported photosensitivity from SLE, CLE, to iCLE in both adult-onset and late-onset lupus patients.

Conclusions

A negative correlation was suggested between the age of onset and the likelihood of systemic involvement, except for arthritis. As the age of onset increases, patients have a greater propensity to exhibit DLE compared to ACLE. Moreover, the presence of rapid response photodermatitis (i.e., self-reported photosensitivity) was associated with a lower rate of systemic involvement.

Trial registration

This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2100048939) on July 19, 2021, retrospectively registered.

Key Points

• We confirmed some phenomena that have been found in patients with SLE, such as the highest proportion of females of reproductive age, the higher risk of LE family history in childhood-onset SLE patients, and the less self-reported photosensitivity in the late-onset SLE group. We also compared the similarities and differences of these phenomena in patients with CLE or iCLE for the first time.

• In patients with SLE, the proportion of females peaked in adult-onset patients, but this phenomenon disappeared in iCLE patients: the female-male ratio tends to decrease from childhood-onset iCLE, adult-onset iCLE, to late-onset iCLE.

• Patients with early-onset lupus are more likely to have acute cutaneous lupus erythematosus (ACLE), and patients with late-onset lupus are more likely to have discoid lupus erythematosus (DLE).

• In contrast to other LE-nonspecific manifestations, the incidence of rapid response photodermatitis (i.e., self-reported photosensitivity) decreased with the age of onset in SLE patients but increased with the age of onset in iCLE patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig.4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Justiz Vaillant AA, Goyal A, Varacallo M (2023) Systemic lupus erythematosus. In: StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL)

  2. Wenzel J (2019) Cutaneous lupus erythematosus: new insights into pathogenesis and therapeutic strategies. Nat Rev Rheumatol 15(9):519–532

    Article  PubMed  Google Scholar 

  3. Pineles D, Valente A, Warren B, Peterson MG, Lehman TJ, Moorthy LN (2011) Worldwide incidence and prevalence of pediatric onset systemic lupus erythematosus. Lupus 20(11):1187–1192

    Article  CAS  PubMed  Google Scholar 

  4. Hiraki LT, Feldman CH, Liu J, Alarcon GS, Fischer MA, Winkelmayer WC et al (2012) Prevalence, incidence, and demographics of systemic lupus erythematosus and lupus nephritis from 2000 to 2004 among children in the US Medicaid beneficiary population. Arthritis Rheum 64(8):2669–2676

    Article  PubMed  PubMed Central  Google Scholar 

  5. Rees F, Doherty M, Grainge M, Davenport G, Lanyon P, Zhang W (2016) The incidence and prevalence of systemic lupus erythematosus in the UK, 1999–2012. Ann Rheum Dis 75(1):136–141

    Article  PubMed  Google Scholar 

  6. Font J, Pallares L, Cervera R, Lopez-Soto A, Navarro M, Bosch X et al (1991) Systemic lupus erythematosus in the elderly: clinical and immunological characteristics. Ann Rheum Dis 50(10):702–705

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Hashimoto H, Tsuda H, Hirano T, Takasaki Y, Matsumoto T, Hirose S (1987) Differences in clinical and immunological findings of systemic lupus erythematosus related to age. J Rheumatol 14(3):497–501

    CAS  PubMed  Google Scholar 

  8. Antolin J, Amerigo MJ, Cantabrana A, Roces A, Jimenez P (1995) Systemic lupus erythematosus: clinical manifestations and immunological parameters in 194 patients. Subgroup classification of SLE. Clin Rheumatol 14(6):678–685

    Article  CAS  PubMed  Google Scholar 

  9. Domenech I, Aydintug O, Cervera R, Khamashta M, Jedryka-Goral A, Vianna JL et al (1992) Systemic lupus erythematosus in 50 year olds. Postgrad Med J 68(800):440–444

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Jacobsen S, Petersen J, Ullman S, Junker P, Voss A, Rasmussen JM et al (1998) A multicentre study of 513 Danish patients with systemic lupus erythematosus. I. Disease manifestations and analyses of clinical subsets. Clin Rheumatol 17(6):468–77

    Article  CAS  PubMed  Google Scholar 

  11. Massias JS, Smith EMD, Al-Abadi E, Armon K, Bailey K, Ciurtin C et al (2020) Clinical and laboratory characteristics in juvenile-onset systemic lupus erythematosus across age groups. Lupus 29(5):474–481

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Cann MP, Sage AM, McKinnon E, Lee SJ, Tunbridge D, Larkins NG et al (2022) Childhood systemic lupus erythematosus: presentation, management and long-term outcomes in an Australian cohort. Lupus 31(2):246–255

    Article  PubMed  Google Scholar 

  13. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40(9):1725

    Article  CAS  PubMed  Google Scholar 

  14. Ghosh AP, Nag F, Biswas S, Rao R, De A (2020) Clinicopathological and immunological profile of patients with cutaneous manifestations and their relationship with organ involvement in systemic lupus erythematosus attending a tertiary care center of Eastern India. Indian J Dermatol 65(1):22–28

    Article  PubMed  PubMed Central  Google Scholar 

  15. De Oliveira NT, Gomes Silva N, Dos Santos TAFG, Nisihara R, Skare TL (2020) Clinical and autoantibody profile in male and female patients with systemic lupus erythematosus: a retrospective study in 603 Brazilian patients. Eur J Rheumatol 7(4):164–168. https://doi.org/10.5152/eurjrheum.2020.20023

  16. Ribero S, Sciascia S, Borradori L, Lipsker D (2017) The cutaneous spectrum of lupus erythematosus. Clin Rev Allergy Immunol 53(3):291–305

    Article  PubMed  Google Scholar 

  17. Fetter T, Braegelmann C, de Vos L, Wenzel J (2022) Current concepts on pathogenic mechanisms and histopathology in cutaneous lupus erythematosus. Front Med (Lausanne) 9:915828

    Article  PubMed  Google Scholar 

  18. Petri M, Orbai AM, Alarcon GS, Gordon C, Merrill JT, Fortin PR et al (2012) Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 64(8):2677–2686

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kuhn A, Kuehn E, Meuth AM, Haust M, Nyberg F, Werth V et al (2009) Development of a core set questionnaire by the European Society of Cutaneous Lupus Erythematosus (EUSCLE). Autoimmun Rev 8(8):702–712

    Article  CAS  PubMed  Google Scholar 

  20. Jin H, Huang T, Wu R, Zhao M, Wu H, Long H et al (2020) A comparison and review of three sets of classification criteria for systemic lupus erythematosus for distinguishing systemic lupus erythematosus from pure mucocutaneous manifestations in the lupus disease spectrum. Lupus 29(14):1854–1865

    Article  PubMed  Google Scholar 

  21. Jin H, Zhou S, Yu Y, Zhao M, Wu H, Long H, Fu S, Wu R, Yin H, Liao J, Luo S, Liu Y, Zhang Q, Zhang P, Tan Y, Luo S, Huang X, Li F, Ling G, Lu Q (2023) Panoramic view of clinical features of lupus erythematosus: a cross-sectional multicentre study from China. Lupus Sci Med 10(1):e000819. https://doi.org/10.1136/lupus-2022-000819

  22. Hedrich CM, Smith EMD, Beresford MW (2017) Juvenile-onset systemic lupus erythematosus (jSLE) - Pathophysiological concepts and treatment options. Best Pract Res Clin Rheumatol 31(4):488–504

    Article  PubMed  Google Scholar 

  23. Smith EMD, Lythgoe H, Hedrich CM (2019) Vasculitis in juvenile-onset systemic lupus erythematosus. Front Pediatr 7:149

    Article  PubMed  PubMed Central  Google Scholar 

  24. Smith EMD, Lythgoe H, Midgley A, Beresford MW, Hedrich CM (2019) Juvenile-onset systemic lupus erythematosus: Update on clinical presentation, pathophysiology and treatment options. Clin Immunol 209:108274

    Article  CAS  PubMed  Google Scholar 

  25. Arnaud L, Mathian A, Boddaert J, Amoura Z (2012) Late-onset systemic lupus erythematosus: epidemiology, diagnosis and treatment. Drugs Aging 29(3):181–189

    Article  CAS  PubMed  Google Scholar 

  26. Riveros Frutos A, Holgado S, Sanvisens Berge A, Casas I, Olive A, Lopez-Longo FJ et al (2021) Late-onset versus early-onset systemic lupus: characteristics and outcome in a national multicentre register (RELESSER). Rheumatology (Oxford) 60(4):1793–1803

    Article  PubMed  Google Scholar 

  27. Catoggio LJ, Soriano ER, Imamura PM, Wojdyla D, Jacobelli S, Massardo L et al (2015) Late-onset systemic lupus erythematosus in Latin Americans: a distinct subgroup? Lupus 24(8):788–795

    Article  CAS  PubMed  Google Scholar 

  28. Feng JB, Ni JD, Yao X, Pan HF, Li XP, Xu JH et al (2010) Gender and age influence on clinical and laboratory features in Chinese patients with systemic lupus erythematosus: 1,790 cases. Rheumatol Int 30(8):1017–1023

    Article  PubMed  Google Scholar 

  29. Alonso MD, Martinez-Vazquez F, de Teran TD, Miranda-Filloy JA, Dierssen T, Blanco R et al (2012) Late-onset systemic lupus erythematosus in Northwestern Spain: differences with early-onset systemic lupus erythematosus and literature review. Lupus 21(10):1135–1148

    Article  CAS  PubMed  Google Scholar 

  30. Aljohani R, Gladman DD, Su J, Urowitz MB (2017) Disease evolution in late-onset and early-onset systemic lupus erythematosus. Lupus 26(11):1190–1196

    Article  CAS  PubMed  Google Scholar 

  31. Kalim H, Pratama MZ, Mahardini E, Winoto ES, Krisna PA, Handono K (2020) Accelerated immune aging was correlated with lupus-associated brain fog in reproductive-age systemic lupus erythematosus patients. Int J Rheum Dis 23(5):620–626

    Article  CAS  PubMed  Google Scholar 

  32. Franceschi C, Garagnani P, Parini P, Giuliani C, Santoro A (2018) Inflammaging: a new immune-metabolic viewpoint for age-related diseases. Nat Rev Endocrinol 14(10):576–590

    Article  CAS  PubMed  Google Scholar 

  33. Cevenini E, Monti D, Franceschi C (2013) Inflamm-ageing. Curr Opin Clin Nutr Metab Care 16(1):14–20

    Article  CAS  PubMed  Google Scholar 

  34. Fulop T, Larbi A, Dupuis G, Le Page A, Frost EH, Cohen AA et al (2017) Immunosenescence and inflammaging as two sides of the same coin: friends or foes? Front Immunol 8:1960

    Article  PubMed  Google Scholar 

  35. Yaar M, Eller MS, Gilchrest BA (2002) Fifty years of skin aging. J Investig Dermatol Symp Proc 7(1):51–58

    Article  PubMed  Google Scholar 

  36. Murphy G, Isenberg D (2013) Effect of gender on clinical presentation in systemic lupus erythematosus. Rheumatology (Oxford) 52(12):2108–2115

    Article  PubMed  Google Scholar 

  37. Moulton VR (2018) Sex hormones in acquired immunity and autoimmune disease. Front Immunol 9:2279

    Article  PubMed  PubMed Central  Google Scholar 

  38. Li WG, Ye ZZ, Yin ZH, Zhang K (2017) Clinical and immunological characteristics in 552 systemic lupus erythematosus patients in a southern province of China. Int J Rheum Dis 20(1):68–75

    Article  CAS  PubMed  Google Scholar 

  39. Borba EF, Araujo DB, Bonfa E, Shinjo SK (2013) Clinical and immunological features of 888 Brazilian systemic lupus patients from a monocentric cohort: comparison with other populations. Lupus 22(7):744–749

    Article  CAS  PubMed  Google Scholar 

  40. Baek YS, Park SH, Baek J, Roh JY, Kim HJ (2020) Cutaneous lupus erythematosus and its association with systemic lupus erythematosus: a nationwide population-based cohort study in Korea. J Dermatol 47(2):163–165

    Article  PubMed  Google Scholar 

  41. Jarrett P, Thornley S, Scragg R (2016) Ethnic differences in the epidemiology of cutaneous lupus erythematosus in New Zealand. Lupus 25(13):1497–1502

    Article  CAS  PubMed  Google Scholar 

  42. Durosaro O, Davis MD, Reed KB, Rohlinger AL (2009) Incidence of cutaneous lupus erythematosus, 1965–2005: a population-based study. Arch Dermatol 145(3):249–253

    Article  PubMed  PubMed Central  Google Scholar 

  43. Jarukitsopa S, Hoganson DD, Crowson CS, Sokumbi O, Davis MD, Michet CJ Jr et al (2015) Epidemiology of systemic lupus erythematosus and cutaneous lupus erythematosus in a predominantly white population in the United States. Arthritis Care Res (Hoboken) 67(6):817–828

    Article  PubMed  Google Scholar 

  44. Lim SC, Chan EWL, Tang SP (2020) Clinical features, disease activity and outcomes of Malaysian children with paediatric systemic lupus erythematosus: a cohort from a tertiary centre. Lupus 29(9):1106–1114

    Article  CAS  PubMed  Google Scholar 

  45. Tucker LB, Uribe AG, Fernandez M, Vila LM, McGwin G, Apte M et al (2008) Adolescent onset of lupus results in more aggressive disease and worse outcomes: results of a nested matched case-control study within LUMINA, a multiethnic US cohort (LUMINA LVII). Lupus 17(4):314–322

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Maloney KC, Ferguson TS, Stewart HD, Myers AA, De Ceulaer K (2017) Clinical and immunological characteristics of 150 systemic lupus erythematosus patients in Jamaica: a comparative analysis. Lupus 26(13):1448–1456

    Article  CAS  PubMed  Google Scholar 

  47. Hersh AO, von Scheven E, Yazdany J, Panopalis P, Trupin L, Julian L et al (2009) Differences in long-term disease activity and treatment of adult patients with childhood- and adult-onset systemic lupus erythematosus. Arthritis Rheum 61(1):13–20

    Article  PubMed  PubMed Central  Google Scholar 

  48. Mina R, Brunner HI (2010) Pediatric lupus–are there differences in presentation, genetics, response to therapy, and damage accrual compared with adult lupus? Rheum Dis Clin N Am 36(1):53–80, vii−viii

    Article  Google Scholar 

  49. Torrente-Segarra V, Salman Monte TC, Rua-Figueroa I, Sanchez-Alonso F, Lopez-Longo FJ, Galindo-Izquierdo M et al (2017) Juvenile- and adult-onset systemic lupus erythematosus: a comparative study in a large cohort from the Spanish Society of Rheumatology Lupus Registry (RELESSER). Clin Exp Rheumatol 35(6):1047–1055

    PubMed  Google Scholar 

  50. Ho CT, Mok CC, Lau CS, Wong RW (1998) Late onset systemic lupus erythematosus in southern Chinese. Ann Rheum Dis 57(7):437–440

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Pu SJ, Luo SF, Wu YJ, Cheng HS, Ho HH (2000) The clinical features and prognosis of lupus with disease onset at age 65 and older. Lupus 9(2):96–100

    Article  CAS  PubMed  Google Scholar 

  52. Medlin JL, Hansen KE, Fitz SR, Bartels CM (2016) A systematic review and meta-analysis of cutaneous manifestations in late- versus early-onset systemic lupus erythematosus. Semin Arthritis Rheum 45(6):691–697

    Article  PubMed  PubMed Central  Google Scholar 

  53. Janwityanujit S, Totemchokchyakarn K, Verasertniyom O, Vanichapuntu M, Vatanasuk M (1995) Age-related differences on clinical and immunological manifestations of SLE. Asian Pac J Allergy Immunol 13(2):145–149

    CAS  PubMed  Google Scholar 

  54. Biazar C, Sigges J, Patsinakidis N, Ruland V, Amler S, Bonsmann G et al (2013) Cutaneous lupus erythematosus: first multicenter database analysis of 1002 patients from the European Society of Cutaneous Lupus Erythematosus (EUSCLE). Autoimmun Rev 12(3):444–454

    Article  PubMed  Google Scholar 

  55. Patel P, Werth V (2002) Cutaneous lupus erythematosus: a review. Dermatol Clin 20(3):373–85, v

    Article  PubMed  Google Scholar 

  56. Tebbe B, Orfanos CE (1997) Epidemiology and socioeconomic impact of skin disease in lupus erythematosus. Lupus 6(2):96–104

    Article  CAS  PubMed  Google Scholar 

  57. Chanprapaph K, Tankunakorn J, Suchonwanit P, Rutnin S (2021) Dermatologic manifestations, histologic features and disease progression among cutaneous lupus erythematosus subtypes: a prospective observational study in Asians. Dermatol Ther (Heidelb) 11(1):131–147

    Article  PubMed  Google Scholar 

  58. Chiewchengchol D, Murphy R, Edwards SW, Beresford MW (2015) Mucocutaneous manifestations in juvenile-onset systemic lupus erythematosus: a review of literature. Pediatr Rheumatol Online J 13:1

    Article  PubMed  PubMed Central  Google Scholar 

  59. Tomic-Lucic A, Petrovic R, Radak-Perovic M, Milovanovic D, Milovanovic J, Zivanovic S et al (2013) Late-onset systemic lupus erythematosus: clinical features, course, and prognosis. Clin Rheumatol 32(7):1053–1058

    Article  PubMed  Google Scholar 

  60. Sanders CJ, Van Weelden H, Kazzaz GA, Sigurdsson V, Toonstra J, Bruijnzeel-Koomen CA (2003) Photosensitivity in patients with lupus erythematosus: a clinical and photobiological study of 100 patients using a prolonged phototest protocol. Br J Dermatol 149(1):131–137

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful to the 32 volunteers from Xiangya Medical College of Central South University for their contributions to the data entry.

Funding

This work was funded by CAMS Innovation Fund for Medical Sciences (CIFMS) No.2021-I2M-1–059, the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2020-RC320-003) to QL, the National Natural Science Foundation of China (No.81830097) (https://www.nsfc.gov.cn/) to QL, and the Special Program of National Natural Science Foundation of China (No. 32141004) to QL. The National Natural Science Foundation of China (No. 81874253) (https://www.nsfc.gov.cn/), the 15th medium-term special grant of postdoctoral Science Foundation of China (2022T150742) (https://jj.chinapostdoctor.org.cn/website/index.html), Excellent postdoctoral innovative talents of Hunan province in 2020 (No. 2020RC2014) (http://kjt.hunan.gov.cn/), and Natural Science Foundation of Hunan Province China (No. 2021JJ40837) (http://kjt.hunan.gov.cn/) granted funding to HJ.

Author information

Author notes

  1. Yangyiyi Yu, Hui Jin, and Shihang Zhou contributed equally to this work.

Authors and Affiliations

  1. Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China

    Yangyiyi Yu, Hui Jin, Shihang Zhou, Ming Zhao, Haijing Wu, Hai Long, Siqi Fu, Ruifang Wu, Heng Yin, Jieyue Liao, Shuangyan Luo, Yu Liu, Qing Zhang, Peng Zhang, Yixin Tan, Xin Huang & Qianjin Lu

  2. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China

    Hui Jin, Ming Zhao & Qianjin Lu

  3. Key Laboratory of Basic and Translational Research On Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China

    Hui Jin, Ming Zhao & Qianjin Lu

  4. Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China

    Hui Jin, Ming Zhao & Qianjin Lu

  5. Department of Dermatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Shihang Zhou

  6. Department of Rheumatology and Immunology, The Second Xiangya Hospital, Central South University, Changsha, China

    Fen Li & Guanghui Lin

Authors
  1. Yangyiyi Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hui Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shihang Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ming Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haijing Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hai Long
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Siqi Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ruifang Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Heng Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jieyue Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shuangyan Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yu Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Qing Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Peng Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Yixin Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Xin Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Fen Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Guanghui Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Qianjin Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qianjin Lu.

Ethics declarations

Ethics approval

This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2100048939) and was approved by the Ethics Committee of The Second Xiangya Hospital of Central South University (LEMCSC_2013.11.05) and the ethics committees of participating institutions. This study has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.

Disclosures

None.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yu, Y., Jin, H., Zhou, S. et al. The differential panorama of clinical features of lupus erythematosus patients with different onset ages: a cross-sectional multicenter study from China. Clin Rheumatol 42, 2353–2367 (2023). https://doi.org/10.1007/s10067-023-06661-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-023-06661-1

Keywords

Search

Navigation