Background The late-onset Systemic Lupus Erithematosus (SLE) has been defined as that one beginning after 50 years old, and supposes around 6–18% of the SLE patients. According to the literature, the most common clinical manifestations are interstitial lung disease, serositis, Sjögren's syndrome and cytopenias. Though the illness activity is lower in these patients, this population usually stands with more accumulative damage and has a higher mortality than the early-onset SLE patients.
Objectives To study the differences between the late-onset SLE patients and the conventional-onset ones, regarding to the debut and actual manifestations, biomarkers of autoimmunity, accumulative damage and disease activity.
Methods Cross-sectional prospective study of SLE patients according to the SLICC-2012 criteria, coming from the Rheumatology Service of Arnau de Vilanova Hospital and La Fe Hospital in Valencia, Spain. All patients had a complete blood-test with autoimmunity markers, and clinical and activity data were collected using the SLICC-ACR and SELENA-SLEDAI questionnaires.
Results A total of 140 patients were evaluated; (95% were women) with 33,39±13,63 year-old average at the diagnosis time with a 10,05±11,42 year-evolution of SLE. Of them, 12% had a late-onset of the disease (diagnosis at >50 years old). In this group of patients we found a higher incidence of SS and Raynaud's phenomenon as the initial symptom (5,9% and 11,8% respectively), compared to the early-onset patients (2,4% and 4,1%). However, regarding to the actual manifestations, this group has a lower incidence of Raynaud's, as well as renal damage or cytopenias. We observe a higher proportion of SS between the late-onset group, although the ENAs levels are lower than in the early-onset group. In addition, the late-onset group has an incidence of cardiovascular events 4 times higher than the early-onset one.
Conclusions We observe a concordance between the debut symptoms in our late-onset series and other series described previously in the literature, where SS presents with a higher proportion in these patients. On the other hand, we cannot distinguish if the higher proportion of cardiovascular events in this groups is due to the late-onset SLE characteristics itself, or to other factors regarding to the older age.
Disclosure of Interest None declared