Pancytopenia as a first presentation of late-onset systemic lupus erythematosus: a case report.
| Autor: | Haidar G; Departments of Rheumatology., Khalayli N; Psychiatry, Faculty of Medicine, Damascus University, Damascus., Drie T; Departments of Rheumatology., Safiah MH; Syrian Private University, Daraa, Syria., Kudsi M; Departments of Rheumatology. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2024 Mar 06; Vol. 86 (5), pp. 3025-3028. Date of Electronic Publication: 2024 Mar 06 (Print Publication: 2024). |
| DOI: | 10.1097/MS9.0000000000001891 |
| Abstrakt: | Introduction: Systemic lupus erythematosus (SLE) is a systemic immune disease that classically occurs in young to middle-aged women and may present with cutaneous, renal, haematologic, neurological, and/or other symptoms at the time of diagnosis. Late-onset SLE or SLE in the elderly is a subtype that differs from classic SLE in terms of age group, clinical symptoms, organ involvement and severity. Case Presentation: A 63-year-old female noted to have pancytopenia. The patient was diagnosed with lupus upon obtaining clinical presentations and serological marker, along with high titres of the antinuclear antibody and/or anti-double-stranded DNA antibody. The patient was managed with glucocorticoids and mycophenolate mofetil therapy, which led to a rapid response. Discussion: Late-onset SLE accounts for 2-12% of SLE patients with a minimum age of onset of 50 years and older, leading to significant delays in diagnosis. Late-onset SLE differs from early-onset SLE in terms of sex and ethnicity prevalence, clinical symptoms and signs, development of organ damage, disease activity and severity, and prognosis. Some studies have also shown that late-stage SLE patients have higher rates of RF and anti-Ro/anti-La antibody positivity, lower complement titre, and higher incidence of elevated creatinine and decreased creatinine clearance. First-line treatment of pancytopenia is glucocorticoid. In refractory cases, rituximab and immunosuppressants can be used. Conclusion: It is important to assess any unusual presentation of SLEs when clinical suspicion remains high and conducting further laboratory and imaging investigation. Competing Interests: The author declares no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.) |
| Databáze: | MEDLINE |
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