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Hippokratia. 2013 Apr;17(2):153-6.

Clinical expression and course in patients with late onset systemic lupus erythematosus.

Author information

  • 14 Department of Internal Medicine, Aristotle University, Hippokration Hospital.
  • 2Department of Hygiene, Aristotle University.
  • 3Department of Rheumatology, Papageorgiou Hospital.
  • 4Department of Rheumatology, Agios Pavlos Hospital.
  • 51 Department of Pediatrics, Aristotle University, Hippokration Hospital.
  • 62 Propedeutic Department of Internal Medicine, Hippokration Hospital.
  • 72 Department of Internal Medicine, Aristotle University, Hippokration Hospital.
  • 8Department of Rheumatology, Inter-Balkan Hospital.
  • 91 Department of Internal Medicine, Aristotle University, AHEPA Hospital.
  • 102 Department of Internal Medicine, Papanikolaou Hospital.
  • 11Department of Nephrology, Papageorgiou Hospital.
  • 12Department of Nephrology, Hippokration Hospital.
  • 13Department of Nephrology, AHEPA Hospital.
  • 142 Department of Pediatrics, Aristotle University, AHEPA Hospital, Thessaloniki, Greece.



To analyze the pattern of clinical expression and the 5-year disease course in Caucasian patients with late onset of systemic lupus erythematosus (SLE) and to compare the findings with an early onset SLE group.


Medical records of 551 patients who presented with SLE at hospitals of the region of Thessaloniki between 1989 and 2007 were studied. Patients who developed SLE at or after the age of 50 years were classified as the late onset group, while younger patients served as the early onset group. Data on clinical manifestations and damage accrual at disease onset and at 5 years was obtained and compared between the two groups.


In 121 patients, the disease started after the age of 50 years. Elderly patients showed less pronounced female predominance and less often presented with malar rash, nephropathy, fever and lymphadenopathy, while lung involvement, pericarditis and sicca syndrome were more frequent. Damage accrual was similar in both groups. The main causes of damage at 5 years differed, with the elderly exhibiting more cardiovascular damage. They also had a higher incidence of hypertension and osteoporosis at 5 years.


Caucasian SLE patients with late onset of the disease present with different clinical manifestations, suggesting that age affects the expression of SLE. Damage accrual at 5 years is similar in the elderly and the younger patients. However, the causes of this damage and the occurrence of other comorbidities follow a different pattern, possibly reflecting the disease process and the effects of aging.


aging; brain; fish oil; omega 3 fatty acids; oxidative stress; rats

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