Very Late-Onset Systemic Lupus Erythematosus as Unusual Cause of Reversible Functional and Cognitive Impairments in an Octogenarian Patient

Stéphanie de Montjoye; Benoit Boland; Jacqueline Van Raemdonck; Frédéric A Houssiau

doi:10.12890/2020_001570

Very Late-Onset Systemic Lupus Erythematosus as Unusual Cause of Reversible Functional and Cognitive Impairments in an Octogenarian Patient

Eur J Case Rep Intern Med. 2020 May 7;7(8):001570. doi: 10.12890/2020_001570. eCollection 2020.

Authors

Stéphanie de Montjoye¹, Benoit Boland², Jacqueline Van Raemdonck², Frédéric A Houssiau¹

Affiliations

¹ Rheumatology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
² Geriatric Medicine Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.

Abstract

While functional decline is a common syndrome in geriatric medicine, the diagnosis of the underlying disease can be complex. We present a case of very late-onset systemic lupus erythematosus with fever, arthritis, lymphadenopathy, sicca syndrome, pleurisy, renal impairment and reversible functional and cognitive impairments. Prompt improvement was observed on prednisolone and hydroxychloroquine.

Learning points: Systemic lupus erythematosus (SLE) rarely occurs in octogenarian patients.In such oldest old patients, SLE may predominantly present with subacute cognitive and functional impairments.Low-dose treatment (prednisolone 7.5 mg/day and hydroxychloroquine 5 mg/kg/day) can reverse all SLE manifestations within 1 month.

Keywords: Late-onset systemic lupus erythematosus; cognitive impairment; functional decline.