Characteristics and treatment of late-onset SLE

Abstract

　SLE commonly affects women of childbearing age, but late-onset SLE is not uncommon. Disease onset after the age of 50 is defined as late-onset SLE and it is reported that 30% of all cases of SLE fall into this category. In late-onset SLE, the ratio between men to women is about 1: 2.5. Clinically, the occurrence of serositis and neuropathy are more frequent and dermatological features, such as malar rash and photosensitivity, are less common in late-onset SLE than younger onset. Because of lack of typical lupus symptoms and myriad differential diagnoses, including drug-induced lupus due to polypharmacy in elderly patients, correct diagnosis of late-onset SLE is often difficult and late. As for the treatment, there are several guidelines for lupus nephritis published abroad that recommend the use of steroid and immunosupppressive drugs in combination. However, because elderly patients have lower renal and immune functions, adjustment of medication is needed in order to avoid the adverse effects.