Skip to main content

Advertisement

SpringerLink
Log in

An uncommon cause of fever in the elderly: late-onset systemic lupus erythematosus

  • Case Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Infections, tumors and multisystem disease are common causes of fever of unknown origin (FUO) in the elderly. Late-onset systemic lupus erythematosus (LO-SLE) is a very rare cause of FUO in elderly patients. Serositis and musculoskeletal manifestations are common, but fever as an initial manifestation in LO-SLE is rare. We present two patients with LO-SLE who manifested fever as an initial symptom. Fever was the only symptom for 2 months in the first case and for 3 months in the second. In conclusion, in geriatric patients who have fever, LO-SLE should be considered in the differential diagnosis.

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

Similar content being viewed by others

Abbreviations

ANA:

Antinuclear antibody

ESR:

Erythrocyte sedimentation rate

HBV:

Hepatitis B

HCV:

Hepatitis C

CMV:

Cytomegalovirus

FUO:

Fever of unknown origin

HIV:

Human immunodeficiency virus

LO-SLE:

Late-onset systemic lupus erythematosus

RF:

Rheumatoid factor

References

  1. Knockaert DC, Vanderschueren, Blockmans D (2003) Fever of unknown origin in adults: 40 years on. J Intern Med 253:263–275

    Article  CAS  PubMed  Google Scholar 

  2. Tal S, Guller V, Gurevich A, Levi S (2002) Fever of unknown origin in the elderly. J Intern Med 252:295–304

    Article  CAS  PubMed  Google Scholar 

  3. Knockaert DC, Vanneste LJ, Bobbaers HJ (1993) Fever of unknown origin in elderly patients. J Am Geriatr Soc 41:1187–1192

    CAS  PubMed  Google Scholar 

  4. Esposito AL, Gleckman RA (1978) Fever of unknown origin in the elderley. J Am Geriatr Soc 26:498–505

    CAS  PubMed  Google Scholar 

  5. Kammer GM, Mishra N (2000) Systemic lupus erythematosus in the elderly. Rheum Dis Clin North Am 26: 475–492

    CAS  PubMed  Google Scholar 

  6. Costallat LT, Coimbra AM (1994) Systemic lupus erythematosus: clinical and laboratory aspects related to age at disease onset. Clin Exp Rheumatol 12: 603–607

    CAS  PubMed  Google Scholar 

  7. 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

    CAS  PubMed  Google Scholar 

  8. Maddison P, Farewell V, Isenberg D et al. (2002) The rate and pattern of organ damage in late onset systemic lupus erythematosus. J Rheumatol 29:913–917

    PubMed  Google Scholar 

  9. Mak SK, Lam EK, Wong AK (1998) Clinical profile of patients with late-onset SLE: not a benign subgroup. Lupus 7: 23–28

    CAS  Google Scholar 

  10. Tan EM, Cohen AS, Fries JF et al. (1982) The 1982 revised criteria for the classification of SLE. Arthritis Rheum 25:1271–1277

    PubMed  Google Scholar 

  11. Norman DC (2000) Fever in the elderly. Clin Infect Dis 31:148–151

    Article  CAS  PubMed  Google Scholar 

  12. Lee AG, Brazis PW (1999) Temporal arteritis: A clinical approach. J Am Geriatr Soc 47:1364–1370

    CAS  PubMed  Google Scholar 

  13. Hunder GG, Arend WP, Bloch DA et al. (1990) The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 33:1122–1128

    CAS  PubMed  Google Scholar 

  14. Font J, Pallares L, Cervera R et al. (1991) Systemic lupus erythematosus in the elderly: clinical and immunological characteristics. Ann Rheum Dis 50:702–705

    CAS  Google Scholar 

  15. 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

    CAS  PubMed  Google Scholar 

  16. Jonsson H, Nived O, Sturfelt G (1988) The effect of age on clinical and serological manifestations in unselected patients with systemic lupus erythematosus. J Rheumatol 15:505–509

    CAS  PubMed  Google Scholar 

  17. Maragou M, Siotsiou F, Sfondouris H, Nicolia Z, Vayopoulos G, Dantis P (1989) Late-onset systemic lupus erythematosus presenting as polymyalgia rheumatica. Clin Rheumatol 8:91–97

    CAS  PubMed  Google Scholar 

  18. Ward MM, Studenski S (1990) Age associated clinical manifestations of systemic lupus erythematosus: a multivariate regression analysis. J Rheumatol 17:476–481

    CAS  PubMed  Google Scholar 

  19. Ward MM, Polisson RP (1989) A meta-analysis of the clinical manifestations of older-onset systemic lupus erythematosus. Arthritis Rheum 32:1226–1232

    CAS  PubMed  Google Scholar 

  20. Catoggio LJ, Skinner RP, Smith G, Maddison PJ (1984) Systemic lupus erythematosus in the elderly: clinical and serological characteristics. J Rheumatol 11: 175–181

    CAS  PubMed  Google Scholar 

  21. Hochberg MC, Boyd RE, Ahearn JM et al. (1985) Systemic lupus erythematosus: a review of clinico-laboratory features and immunogenetic markers in 150 patients with emphasis on demographic subsets. Medicine (Baltimore) 64:285–295

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Numune Education and Research Hospital, Ankara, Turkey

    Esin Beyan & Aysel Uzuner

  2. Department of Haematology, Gulhane Military Medical Academy, Ankara, Turkey

    Cengiz Beyan

Authors
  1. Esin Beyan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aysel Uzuner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cengiz Beyan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cengiz Beyan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Beyan, E., Uzuner, A. & Beyan, C. An uncommon cause of fever in the elderly: late-onset systemic lupus erythematosus. Clin Rheumatol 22, 481–483 (2003). https://doi.org/10.1007/s10067-003-0795-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-003-0795-1

Keywords

Search

Navigation