Peñaranda-Parada E, Quintana G, Yunis J J, Mantilla R, Rojas W, Panqueva U, Caminos J E, Garces M F, Sanchez E, Rondón-Herrera F, de Jesús Iglesias-Gamarra A
Rheumatology Unit, National University of Colombia, Bogotá, Colombia.
Unit of Genetics, National University of Colombia, Bogotá, Colombia.
Lupus. 2015 Oct;24(12):1293-9. doi: 10.1177/0961203315588576. Epub 2015 May 28.
Late-onset systemic lupus erythematosus (SLE) represents a specific subgroup that is defined as onset after 50 years of age. Late-onset lupus may have a different clinical course and serological findings, which may delay diagnosis and timely treatment.
The objective of this paper is to determine the clinical, serologic, and immunogenetic differences among Colombian patients with late-onset SLE versus conventional SLE patients.
This was a cross-sectional study in a Colombian population. Patients and their medical records were analyzed from the services of Rheumatology in Bogotá and met the criteria for SLE, according to the American College of Rheumatology (ACR) revised criteria for the classification of SLE.In a reference group of late-onset SLE patients (98 participants, with an onset after 50 years of age) and a group of conventional SLE patients (72 participants, with an onset of age of 49 years or less), multiple clinical variables (age, clinical criteria for lupus, alopecia, weight loss, fever, Raynaud's phenomenon) and multiple serological variables (blood count, blood chemistry profile, autoantibodies) were analyzed. Additionally, the HLA class II (DRB1) of all the patients was genotyped, including an additional group of patients without the autoimmune disease. Statistical analysis was performed using the STATA 10.0 package.
In the group of late-onset lupus, there was a higher frequency of pleurisy (p = 0.002), pericarditis (p = 0.026), dry symptoms (p = 0.029), lymphopenia (p = 0.007), and higher titers of rheumatoid factor (p = 0.001) compared with the group of conventional SLE. Late-onset SLE patients had a lower seizure frequency (p = 0.019), weight loss (p = 0.009), alopecia (p < 0.001), and Raynaud's phenomenon (p = 0.013) compared to the conventional SLE group. In late-onset SLE, HLA DR17 (DR3) was found more frequently compared with individuals without autoimmune disease (OR 3.81, 95% CI 1.47 to 10.59) (p = 0.0016).
In the Colombian SLE population analyzed, there may be a probable association of several clinical and serologic variants, which would allow the differentiation of variables in the presentation of the disease among patients with late-onset SLE vs. conventional SLE.
迟发性系统性红斑狼疮（SLE）是一个特定的亚组，定义为发病年龄在50岁之后。迟发性狼疮可能具有不同的临床病程和血清学表现，这可能会延迟诊断和及时治疗。
本文的目的是确定哥伦比亚迟发性SLE患者与传统SLE患者在临床、血清学和免疫遗传学方面的差异。
这是一项针对哥伦比亚人群的横断面研究。根据美国风湿病学会（ACR）修订的SLE分类标准，对波哥大风湿病科服务的患者及其病历进行分析，纳入符合SLE标准的患者。在一个迟发性SLE患者参考组（98名参与者，发病年龄在50岁之后）和一组传统SLE患者（72名参与者，发病年龄在49岁或以下）中，分析了多个临床变量（年龄、狼疮临床标准、脱发、体重减轻、发热、雷诺现象）和多个血清学变量（血细胞计数、血液化学指标、自身抗体）。此外，对所有患者进行了HLA II类（DRB1）基因分型，包括另一组无自身免疫性疾病的患者。使用STATA 10.0软件包进行统计分析。
与传统SLE组相比，迟发性狼疮组胸膜炎（p = 0.002）、心包炎（p = 0.026）、干燥症状（p = 0.029）、淋巴细胞减少（p = 0.007）的发生率更高，类风湿因子滴度更高（p = 0.001）。与传统SLE组相比，迟发性SLE患者癫痫发作频率更低（p = 0.019）、体重减轻更少（p = 0.009）、脱发更少（p < 0.001）、雷诺现象更少（p = 0.013）。在迟发性SLE中，与无自身免疫性疾病的个体相比，HLA DR17（DR3）的发现频率更高（OR 3.81，95%CI 1.47至10.59）（p = 0.0016）。
在所分析的哥伦比亚SLE人群中，可能存在几种临床和血清学变异的关联，这有助于区分迟发性SLE患者与传统SLE患者在疾病表现方面的变量。
