Skip to main content
Log in

Systemic lupus erythematosus in the elderly

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

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.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Rovenský J, Tuchynová A (2008) Systemic lupus erythematosus in the elderly. Autoimmun Rev 7:235–239

    Article  PubMed  Google Scholar 

  2. Tsokos GC (2004) Overview of cellular immune function in systemic lupus erythematosus. In: Lahita G (ed) Systemic lupus erythematosus, 4th edn. Elsevier, Amsterdam, pp 29–92

    Chapter  Google Scholar 

  3. Kaslow RA, Masi AT (1978) Age, sex, and race effects on mortality from systemic lupus erythematosus in the United States. Arthritis Rheum 21:473–479

    Article  PubMed  CAS  Google Scholar 

  4. Bertoli AM, Alarcón GS, Calvo-Alén J, Fernández M, Vila LM, Reveille JD LUMINA, LUMINA Study Group (2006) Systemic lupus erythematosus in a multiethnic US cohort. XXXIII. Clinical [corrected] features, course, and outcome in patients with late-onset disease. Arthritis Rheum 54:1580–1587

    Article  PubMed  Google Scholar 

  5. Houman MH, Smiti-Khanfir M, Ben Ghorbell I, Miled M (2004) Systemic lupus erythematosus in Tunisia: demographic and clinical analysis of 100 patients. Lupus 13:204–211

    Article  PubMed  CAS  Google Scholar 

  6. Formiga F, Moga I, Pac M, Mitjavila F, Rivera A, Pujol R (1999) Mild presentation of systemic lupus erythematosus in elderly patients assessed by SLEDAI. SLE Disease Activity Index. Lupus 8:462–465

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  8. Chen TL, Wong CH, Lee CH, Loo JH, Lin M (2009) Systemic lupus erythematosus in the elderly. Int J Geront 3:108–113

    Article  Google Scholar 

  9. Gaujard S, Broussolle C, Cathebras P, Dupond JL, Massot C, Ninet J, Perrot H, Durand DV, Rousset H (2003) Systemic lupus erythematosus with disease onset after age 65. Rev Med Interne 24:288–294

    Article  PubMed  CAS  Google Scholar 

  10. 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 9:96–100

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  12. Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35:630–640

    Article  PubMed  CAS  Google Scholar 

  13. Ghedira I, Sakly W, Jeddi M (2002) Clinical and serological characteristics of systemic lupus erythematosus: 128 cases. Pathol Biol 50:18–24

    Article  PubMed  CAS  Google Scholar 

  14. Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Doménech I, Aydintug AO, Jedryka-Góral A, de Ramón E et al (1993) Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1000 patients. Medicine (Baltimore) 72:113–124

    CAS  Google Scholar 

  15. Dubois EL, Tuffanelli DL (1964) Clinical manifestations of systemic lupus erythematosus. Computer analysis of 520 cases. JAMA 190:112–119

    Article  Google Scholar 

  16. Jallouli M, Frigui M, Hmida MB, Marzouk S, Kaddour N, Bahloul Z (2008) Clinical and immunologic manifestations of systemic lupus erythematosus: a study on 146 south Tunisian patients. Saudi J Kidney Dis Transplant 19:1001–1008

    Google Scholar 

  17. Amoura Z, Piette JC, Bach JF, Koutouzov S (1999) The key role of nucleosomes in lupus. Arthritis Rheum 42:833–843

    Article  PubMed  CAS  Google Scholar 

  18. Amoura Z, Koutouzov S, Piette JC (2000) The role of nucleosomes in lupus. Curr Opin Rheumatol 12:369–373

    Article  PubMed  CAS  Google Scholar 

  19. Simón JA, Cabiedes J, Ortiz E, Alcocer-Varela J, Sánchez-Guerrero J (2004) Anti-nucleosome antibodies in patients with systemic lupus erythematosus of recent onset. Potential utility as a diagnostic tool and disease activity marker. Rheumatology 43:220–224

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study is supported by unité de recherche Auto-Immunité et allergie (03/UR/07-02), Faculté de Pharmacie de Monastir, Tunisie.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amani Mankaï.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Achour, A., Mankaï, A., Thabet, Y. et al. Systemic lupus erythematosus in the elderly. Rheumatol Int 32, 1225–1229 (2012). https://doi.org/10.1007/s00296-010-1744-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-010-1744-3

Keywords

Navigation