Clinical profile of patients with late-onset SLE: not a benign subgroup

The onset of systemic lupus erythematosus (SLE) in later life has been associated with a benign clinical course and better prognosis compared with those with earlier onset. However, different reported studies have failed to agree on a distinct pattern of presentation. We retrospectively studied the clinical profile of a predominantly Chinese lupus population to review the behaviour of late-onset patients. Cumulative clinical features and laboratory findings in 102 patients with SLE were collected. Late-onset patients tended to have a less marked female predominance, a more insidious onset at presentation (P < 0.001), a decreased incidence of cutaneous lesions (P < 0.05), an increased occurrence of serositis (P = 0.004) and a lower cumulative number of SLE manifestations (P = 0.022) compared with the early-onset group. The incidences of all major organ involvement as well as the requirement of immunosuppressive therapies were similar in the two groups. Thus, in this study, late-onset SLE patients had a different clinical profile from the early-onset group, but did not constitute a benign subgroup of the lupus population.