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AB0636 Late-onset systemic lupus erythematosus: Clinical features, course and prognosis
  1. A. Tomic Lucic1,
  2. R. Petrovic2,
  3. M. Radak Perovic2,
  4. D. Milovanovic3,
  5. M. Veselinovic1,
  6. S. Zivanovic3,
  7. M. Petrovic3
  1. 1Department of Rheumatology, Clinical Center Kragujevac, Kragujevac
  2. 2Institute of Rheumatology, School of Medicine, University of Belgrade, Belgrade
  3. 3Medical Faculty Kragujevac, Kragujevac, Serbia

Abstract

Background There are contradictory opinions if late-onset systemic lupus erythematosus (SLE) is associated with a different, more benign disease course and better prognosis than early-onset SLE.

Objectives The objective of study was to evaluate the clinical manifestations, course, treatment and prognosis of late-onset SLE.

Methods Patients who developed SLE after/or at the age of 50 years were considered late-onset SLE and compared to a group of randomly selected patients aged younger than 50 years at the diagnosis, matched for disease duration.

Results Lower frequency of cutaneous manifestations (p=0.01) and higher frequency of cytopenia (p=0.02) was registrated at the SLE onset in late-onset group. Atypical clinical presentation of SLE contributed to a longer delay of diagnosis in late-onset patients (p=0.005), who fullfiled less American College of Rheumatology crteria at the diagnosis (p=0.022). Cumulative incidence of clinical manifestations showed lower frequency of cutaneous (p=0.017), neuropsychiatric manifestations(p=0.021), lupus nephritis (p=0.006) and higher frequency of Sjogren$′ $s syndrome (p=0.025) in late-onset group. Late-onset patients received lower corticosteroid (p=0.006) and cyclophosphamide doses (p=0.001), and had more cyclophosphamide induced complications (p=0.005). Higher prevalence of comorbid conditions was noticed in late-onset group. (p<0.0005).

Conclusions Despite the less maior organ involvement, and more benign course of disease, late-onset SLE has worse prognosis, because of the higher frequency of comorbid conditions, due to the aging and longer exposition to a classical vascular risk factors.

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Disclosure of Interest None Declared

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