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Características clínicas y serológicas de los pacientes con LES de inicio tardío en una población colombiana

Keywords: systemic lupus erythematosus (sle), late onset, colombian population, clinical characteristics, serological characteristics.

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Abstract:

systemic lupus erythematosus (sle) affects all ages and the onset of sle above 50 years of age is uncommon but not rare and up 12% of patients are affect after the 6th decade. it has been reported differences in the form of presentation of late onset sle and variations between young and older patients such as sex predominance, interval between time of onset of symptoms and signs to diagnosis, clinical and immunological features, severity and prognosis. objective: the aim of this study were to describe and compare retrospectively the clinical and serological features between early (> 18 and < 50 years) and late onset (> 50 years) sle in a colombian population. methods: twenty one patients with late onset sle (15 women and 6 men) and 63 patients with early sle (57 women and 6 men) were studied retrospectively. all met four or more acr criteria for the diagnosis of sle. a detailed clinical and laboratory assessment according to a pre-established protocol was made of each patient including age, sex, age at onset and diagnosis, number of acr criteria, clinical manifestations, immunological markers, index of activity illness with sledai and years of follow up. results: late onset sle female/male ratio was much reduced than in the early group (2,5:1 vs. 9.5:1, p= 0.005) and more frequencies of myalgias (47.6 vs. 25.4% p= 0.05), interstitial pneumonitis (19.0% vs. 1.6%, p= 0.003), mood disorders (19 vs. 4.8%, p= 0.04), osteoporosis (23.8% vs. 1,6%, p= 0.0006) instead of early sle who had more malar rash (49.2% vs. 23.85, p= 0.04), oral ulcers (44.4% vs. 0%, p= 0.0001), nephritis (39.7% vs. 14.3% p= 0.032) at the onset of the disease. this features persisted during the follow up. we did not find any differences in activity illness with sledai. conclusion: in this colombian population there are important clinical differences between groups, which can affect the prognosis of sle.

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