Occult systemic lupus erythematosus in elderly men

Systemic lupus erythematosus (SLE) is often not suspected in elderly men with a debilitating illness, particularly when pleuropericarditis is not prominent. Five elderly men with SLE were initially seen with a systemic illness, marked by fever, weight loss, and arthritis. The diagnosis of SLE was established after considerable delay with extensive diagnostic evaluations and was supported by the presence of DNA antibodies in four patients. Treatment with corticosteroids was effective in three patients. Early testing for DNA antibodies may be cost effective in the evaluation of the elderly patient with a debilitating illness.