El Bakry, S., Abd-Elrahman, M., Elsayed, M., Badr, F. (2023). Late Onset Systemic Lupus Erythematosus: Different Clinical, Serological Presentations and Damage Compared to Adult Lupus in Egypt. The Egyptian Journal of Hospital Medicine, 90(1), 71-78. doi: 10.21608/ejhm.2023.279198
Samah A. El Bakry; Mariem Abd-Elrahman; Marwa Elsayed; Fatma Badr. "Late Onset Systemic Lupus Erythematosus: Different Clinical, Serological Presentations and Damage Compared to Adult Lupus in Egypt". The Egyptian Journal of Hospital Medicine, 90, 1, 2023, 71-78. doi: 10.21608/ejhm.2023.279198
El Bakry, S., Abd-Elrahman, M., Elsayed, M., Badr, F. (2023). 'Late Onset Systemic Lupus Erythematosus: Different Clinical, Serological Presentations and Damage Compared to Adult Lupus in Egypt', The Egyptian Journal of Hospital Medicine, 90(1), pp. 71-78. doi: 10.21608/ejhm.2023.279198
El Bakry, S., Abd-Elrahman, M., Elsayed, M., Badr, F. Late Onset Systemic Lupus Erythematosus: Different Clinical, Serological Presentations and Damage Compared to Adult Lupus in Egypt. The Egyptian Journal of Hospital Medicine, 2023; 90(1): 71-78. doi: 10.21608/ejhm.2023.279198
Late Onset Systemic Lupus Erythematosus: Different Clinical, Serological Presentations and Damage Compared to Adult Lupus in Egypt
Internal Medicine, Rheumatology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abstract
Background: Comparing cases of adult onset and late onset systemic lupus erythematous (SLE) reveals significant differences in clinical, serological, disease activity, and damage score. Objective: This study aimed to analyze clinical manifestations, laboratory data, serological markers, and prognosis of late-onset SLE (L-SLE) and for comparing with adult- onset SLE. Patients and Methods: One hundred fifty individuals with SLE were included in a cross-sectional study conducted at Ain Shams University Hospital. They were divide into: Group 1 included 100 cases with adult-onset (age of onset ≥ 19 years and below 50 years). Group 2 included 50 Patients with L-SLE (age of onset ≥ 50 years). All patients were subjected to medical history, physical examination, disease activity measured by the SLE disease activity index (SLEDAI-2K) and a damage score. Laboratory investigations as complete blood count (CBC), blood urea nitrogen (BUN), serum creatinine, anticardiolipin antibodies, lupus anticoagulant, protein creatinine ratio, serum complement (C3, C4), anti-dsDNA antibody, and antinuclear antibodies (ANA). Results: Mucocutaneous manifestations, frequency of hematuria, proteinuria, urinary cast, consumed C3, positive anti-dsDNA antibodies, anti-cardiolipin antibody and lupus anticoagulant titers had considerably greater rates in-group 1 compared to group 2 (P-value <0.05) while group 2 had significantly more musculoskeletal symptoms (P-value <0.05). The SLEDAI scores of the two groups were equivalent, however the damage index was greater in group 2 (P-value 0.00). Neuropsychiatric, cutaneous, renal, and skin damage were more frequent in group 1, while musculoskeletal, endocrinal, pulmonary, cardiovascular and ocular damage were more frequent in- group 2. Conclusion: late-onset SLE is different from adult onset SLE with more frequent damage.
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