Einstein (São Paulo) (Mar 2008)
Late onset systemic lupus erythematosus
Abstract
Systemic lupus erythematosus starting beyond the age of 50 yearsis considerate as a late onset disease, and constitutes a subgroupwith some demographic, clinical and laboratory characteristics, inagreement with former studies. We performed a review searching onPubMed using key words present in the title. In this review articlespublished in the last ten years were included besides older ones includedin the rheumatology textbooks. Since the decade of the 1960sthere was the concept that late onset systemic lupus erythematosushad a benign course with less gender difference comparing to theyoung adult onset disease. More recent studies continue confi rmingthe lower predominance in female than male as compared to theyounger onset disease. However, several more recent studies evaluatingethnically different populations showed that the late onset diseasehad worst prognosis than published previously, due to comorbiditiesfrequent in this age group that can infl uence their healthy status. Themost frequent causes of mortality are infection followed by pulmonaryand coronary diseases. The lower frequency of hypocomplementemiain late onset disease continues to be found, however, renal involvementis now considered similar to that found in young adult disease.There is consensus that late onset disease affects less frequently theskin, especially malar rash and photosensitivity, however it seemsthat the course is not as benign as reported in previous studies.
