Late onset systemic lupus erythematosus: no substantial differences using different cut-off ages.

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with variable clinical presentations.
• Age at disease onset can influence SLE's clinical course and outcomes.
• Understanding these differences is crucial for tailored patient management.

Purpose of the Study:

• To compare clinical, laboratory, and immunological features of Caucasian SLE patients stratified by age at disease onset.
• To identify specific differences in disease manifestations and progression related to age at diagnosis.

Main Methods:

• Retrospective analysis of 255 Caucasian SLE patients.
• Patients categorized into three groups based on age at onset: >or=65 years (Group A), 50-64 years (Group B), and <50 years (Group C).
• Comparison of clinical features, laboratory markers, immunological profiles, disease activity, and organ damage over a mean follow-up of 6.5 years.

Main Results:

• Reduced female predominance in older onset groups (A and B).
• Longer time from onset to diagnosis in older groups (A and B).
• Increased peripheral nervous system (PNS) involvement in Group A. Higher frequency of anti-dsDNA and rheumatoid factor (RF) in Group A. Lower complement levels more frequent in Group C. Higher SLICC/ACR scores in Group A.

Conclusions:

• Age at disease onset in Caucasian SLE patients is not significantly associated with broad clinical feature differences, except for increased PNS involvement in elderly patients.
• Elderly-onset SLE patients may experience more rapid organ damage, potentially due to higher susceptibility to iatrogenic effects.