Comparison of clinicopathological characteristics and outcomes between patients with late and early-onset systemic lupus erythematosus with lupus nephritis: A North African study.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-10-01 Epub Date: 2025-08-26 DOI:10.1177/09612033251374770
Sanda Mrabet, Raja Boukadida, Sidina Emah, Olfa Mahfoudh, Awatef Azzebi, Wissal Sahtout, Nesrine Thabet, Rihem Dahmene, Narjes Ben Aicha, Sonia Dziri, Dorsaf Zellama, Abdellatif Achour
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Abstract

ObjectivesThe aim of this study was to compare the clinicopathological characteristics and outcomes of lupus nephritis (LN) between late-onset and early-onset systemic lupus erythematosus (SLE) patients.MethodsWe reviewed the clinical, serological and histological characteristics of all patients with LN admitted to our nephrology unit between 2007 and 2024. Our patients were divided into two groups according to their age at diagnosis: Early-onset SLE (younger than 50 years) and late-onset SLE (50 years or older).ResultsA total of 231 patients were recruited, of whom 43 had late-onset SLE and 188 had early-onset SLE. The mean age at diagnosis of SLE was 58.36 ± 7.61 years in the late-onset SLE group and 29.23 ± 9.03 years in the early-onset SLE group. There was no difference in the time from SLE diagnosis to LN. Compared with early-onset group, late-onset group had a higher prevalence of discoid rash but a lower frequency of leukopenia. Late-onset patients had higher serum creatinine levels and lower prevalence of anti-SSA and anti-RNP antibodies. The frequency of class VI LN was statistically significantly higher in the late-onset group. The use of oral corticosteroids, hydroxychloroquine and immunosuppressive drugs was significantly lower in late-onset SLE patients than in early-onset SLE patients. The latter were significantly less likely to progress to chronic kidney disease.ConclusionOur results indicate that SLE patients have different clinical, serological and histological manifestations depending on the age at onset of the disease. Late-onset SLE patients are more likely to have rheumatoid arthritis at onset. They have more severe chronic renal lesions and a worse renal outcome.

晚发性和早发性系统性红斑狼疮合并狼疮性肾炎患者的临床病理特征和预后比较:北非研究。
目的比较晚发性和早发性系统性红斑狼疮(SLE)患者狼疮肾炎(LN)的临床病理特征和转归。方法回顾2007年至2024年间我院肾内科收治的所有LN患者的临床、血清学和组织学特征。我们的患者根据诊断年龄分为两组:早发性SLE(年龄小于50岁)和晚发性SLE(年龄大于50岁)。结果共纳入231例患者,其中迟发性SLE 43例,早发性SLE 188例。迟发性SLE组平均诊断年龄为58.36±7.61岁,早发性SLE组平均诊断年龄为29.23±9.03岁。从SLE诊断到LN的时间没有差异。与早发组相比,晚发组盘状皮疹的发生率较高,但白细胞减少的发生率较低。晚发患者血清肌酐水平较高,抗ssa和抗rnp抗体患病率较低。晚发组发生VI级LN的频率有统计学意义。迟发性SLE患者口服皮质类固醇、羟氯喹和免疫抑制药物的使用明显低于早发性SLE患者。后者发展为慢性肾脏疾病的可能性显著降低。结论SLE患者的临床、血清学和组织学表现随发病年龄的不同而不同。迟发性SLE患者在发病时更有可能患有类风湿关节炎。他们有更严重的慢性肾脏病变和更差的肾脏预后。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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