Systemic Lupus Erythematosus in Elderly Algerian Population

Background: Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease, primarily affecting young women of childbearing age. SLE is rare in the elderly and represents clinico-biological characteristics in this age group different from those of young patients. Objectives: To determine the clinical-biological and prognostic specificities of 12 cases of SLE emerged after the age of 50 years and compare them with some cases of early-onset SLE. Methods: On a total of 203 SLE patients, 12 cases aged of 50 years and above were examined. All SLE patients were who had been diagnosed according to the ACR and SLICC criteria and followed up during 2006 - 2019 in two western Algeria hospitals. Results: Twelve patients with late SLE were diagnosed during the research period. The mean age of attack in this age group was 59.17 ± 11.10 years, and the mean age of clinical diagnosis was 67.67 ± 10.95 years. Among the concerned cases, ten patients (83.3%) were postmenopausal women, and two participants were men (16.7%) with an F/M gender ratio of 5 : 1. The mean duration of follow-up was 8.5 ± 4.33 years. The most frequent revealing clinico-serological characteristics were dermatological, articular, hematological, and pulmonary damage (58.3%, 91.7%, 58.3%, and 33.3% respectively), the positivity of anti-dsDNA antibodies (75%), anti-Sm/anti-SSA (41.7%), and hypocomplementemia (25%). Moreover, renal and neuropsychiatric damage was rare after the age of 50 years. The leading cause of death was stroke, with a significantly higher mortality rate in the elderly group (P < 0.001). Conclusions: SLE in the elderly is rare, its diagnosis may be delayed due to the insidious onset, and its low prevalence and similarity and comorbidity with other more common disorders make its diagnosis difficult, especially in this subgroup.