Abstract
There have been numerous studies on elder-onset systemic lupus erythematosus, but few on elderonset lupus nephritis. Many studies have shown that the severity of systemic lupus erythematosus declines with the advance of age. We retrospectively studied the clinical characteristics and prognosis of a Japanese lupus nephritis population to review the behavior of 12 elder-onset patients whose onset of disease, defined as the initial manifestation of systemic lupus erythematosus, occurred after the age of 50 years. Data on the clinical features and laboratory findings of 37 patients with lupus nephritis were collected. Elder-onset patients tended to have a decreased incidence of class V histology and an increased incidence of class II histology compared with younger-onset patients. The incidences of nephrotic syndrome, renal failure and class IV histology as well as the requirements of immunosuppressive therapies were similar in the two groups. In the intensive therapy (IV methylprednisolone, plasmapheresis and their combination) group, elder-onset patients had a higher mortality rate. In this study, elder-onset lupus nephritis patients did not belong to a benign subgroup of the lupus nephritis population, and it was found that intensive therapy of elder-onset patients potentially increased the risk of death.
