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Systemic lupus erythematosus in later life
The Medical Journal of Australia
|April 3, 1982
Summary
Late-onset systemic lupus erythematosus (SLE) presents insidiously with non-specific symptoms, often delaying diagnosis by years. Older adults with SLE show more neuropsychiatric issues and fewer typical signs like serositis.
Area of Science:
- Rheumatology
- Internal Medicine
- Clinical Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
- Diagnosis in older adults (>45 years) is often challenging due to atypical presentations.
Purpose of the Study:
- To describe the clinical features of late-onset SLE.
- To highlight diagnostic challenges in elderly patients with SLE.
Main Methods:
- Retrospective analysis of 14 patients diagnosed with SLE after age 45.
- Review of clinical presentations, diagnostic delays, and laboratory findings.
Main Results:
- Mean diagnostic delay was five years.
- Predominant symptoms included non-specific complaints (fever, weight loss, malaise), and neuropsychiatric disturbances.
- Low incidence of serositis and less frequent occurrence of elevated ESR, neutropenia, and thrombocytopenia compared to younger patients.
- Immunoglobulins and complement detected in skin basement membranes in 7/12 patients.
Conclusions:
- Late-onset SLE presents differently from classic SLE, with a higher prevalence of neuropsychiatric symptoms and non-specific complaints.
- Diagnosis is often delayed, suggesting SLE may be underdiagnosed in older populations.
- Awareness of these atypical features is crucial for timely diagnosis and management of SLE in the elderly.