Lupus erythematosus systemic late-onset type

The clinical picture of late-onset SLE is different from the classic clinical picture of the "adult onset type". The course of the disease also appears to be milder in comparison to younger patients.

Late-onset SLE is often misdiagnosed. The most common clinical symptoms are arthritis (50%), skin changes (extensive erythema, which after a longer period of existence transform into bizarrely configured, poikilodermatic plaques). Skin changes are detectable in 40% of cases. Photosensitivity exists in 30% of cases. Further clinical signs are nephropathies (40%), ulcerations of the oral mucosa (30%), interstitial diseases of the lung (30%), recurrent fever (25%), leukopenia (65%), thrombocytopenia (35%). Thrombotic complications were experienced by about 40% of patients.

Comparing the patients of the late-onset group (≥50 years old) with the adult onset group (≥18 and <50 years old), it is shown in larger collectives (Sohn IW et al. 2018; n=917 patients) that the number of clinical ACR criteria is lower in the late-onset group. The clinical course is often atypical. This is also reflected in the observation that in the late-onset patients the diagnosis is made only after a considerable time delay (Jeleniewicz R et al. 2015). The clinical prognosis of these patients is more favourable and the course of the disease is rather mild.

1. Jeleniewicz R et al (2015) Clinical picture of late-onset systemic lupus erythematosus in a group of Polish patients. Pol Arch Med Wewn 125:538-544.
2. Kang JH et al (2017) Comparison of clinical, serological, and prognostic differences among juvenile, adult, and late-onset lupus nephritis in Korean patients. Clin Rheumatol. 2017 Jun;36(6):1289-1295.
3. Son IW et al (2018)Late-onset systemic lupus erythematosus: Is it "mild lupus"? Lupus 27:235-242.