Sociodemographic, clinical, and laboratory profile of patients with early- versus late-onset systemic lupus erythematosus

A single-center observational study in the Colombian Caribbean.

Abstract

Introduction: Late-onset systemic lupus erythematosus (SLE) is a rare form of the disease, characterized by atypical clinical manifestations and a higher burden of comorbidities, which makes it challenging to diagnose and manage on time.  The objective of this study was to compare the sociodemographic, clinical, and paraclinical characteristics, as well as the therapeutic outcomes, of patients with early- and late-onset SLE in a reference center in the Colombian Caribbean.

Methods: Observational, descriptive, and cross-sectional study, based on the review of medical records from the RENELUP database (2010–2024). Patients aged ≥18 years who met the 2019 EULAR/ACR criteria were included. Chi-square, Fisher's, and Student's T tests were applied.

Results: A total of 282 patients were analyzed: 235 (83%) with early SLE and 47 (17%) with late SLE. Females predominated (89% and 81%, respectively). Late SLE had higher proteinuria (2,900 vs 662 mg/24h; P<0.001) and lower HDL (41 vs 48 mg/dl; P=0.038). There were no significant differences in remission or mortality, although mortality was higher in late SLE (20.7% vs 10.1%).

Conclusion: Patients with late SLE had a lower frequency of typical clinical manifestations, including mucocutaneous, joint, and hematological involvement. In terms of renal involvement, patients with late SLE had a higher burden of proteinuria, with no statistically significant differences in mortality or remission rate.