Systemic Lupus Erythematosus Features in Elderly Patients: Case-Based Review.

Area of Science:

• Rheumatology
• Internal Medicine
• Geriatrics

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune condition typically affecting younger individuals.
• Late-onset SLE (diagnosed in older adults) presents distinct clinical and diagnostic challenges.
• Age-related immune system changes may influence the presentation of SLE in the elderly.

Purpose of the Study:

• To describe a case of late-onset systemic lupus erythematosus in a 93-year-old patient.
• To highlight the diagnostic difficulties and unique manifestations of SLE in the elderly population.
• To emphasize the importance of considering SLE in older patients presenting with atypical symptoms.

Main Methods:

• Case report of a 93-year-old patient presenting with exertional dyspnea, lower limb edema, and abdominal pain.
• Exclusion of common causes of edema, including heart failure, kidney disease, liver cirrhosis, hypothyroidism, and hypoproteinemia.
• Diagnostic workup including immunological tests revealing elevated anti-nuclear antibodies (ANA), anti-dsDNA antibodies, and low complement levels.

Main Results:

• Common etiologies for the patient's edema were successfully excluded.
• Immunological findings confirmed active systemic lupus erythematosus (SLE) as the cause of the patient's symptoms.
• The patient received corticosteroid therapy and was referred for rheumatological follow-up.

Conclusions:

• Late-onset SLE can present with varied and sometimes atypical symptoms in elderly individuals.
• Clinical presentation of SLE may differ significantly between early-onset and late-onset disease.
• Understanding these differences is crucial for accurate diagnosis and management of SLE in geriatric populations.