SISTEMSKI ERITEMSKI LUPUS SA KASNIM POČETKOM BOLESTI

Aleksandra Tomić Lučić

doi:10.5937/mckg48-6173

Aleksandra Tomić Lučić Klinički centar Kragujevac, Klinika za internu medicinu, Centar za reumatologiju, alergologiju i kliničku imunologiju Univerzitet u Kragujevcu, Fakultet medicinskih nauka

DOI: https://doi.org/10.5937/mckg48-6173

Sažetak

Smatra se da sistemski eritemski lupus (SLE) sa početkom u starijim godinama života, posle 50-te godine starosti, ima drugačiji klinički tok, sa neprimetnim početkom bolesti i veoma nespecifičnim prvim manifestacijama oboljenja. Incidenca lupusa sa početkom u starijim godinama života je 2-20% od svih bolesnika sa SLE. Atipična klinička slika, nespecifične inicialne kliničke manifestacije i mala incidenca SLE u starijoj populaciji utiče na otežano postavljenje dijagnoze kod ovih bolesnika. Može se reći da uprkos manjem broju ozbiljnih klničkih manifestacija SLE (nefritis, lupus CNS), kao i manjem stepenu aktivnosti bolesti bolesnici sa kasnim početkom SLE imaju lošiju prognozu zahvaljujući većem broju udruženih oboljenja koja nastaju kao posledica starenja orgnizma, kao i duže ekspozicije kardiovaskularnim faktorima rizika. Bolesnici sa kasnim početkom SLE moraju biti pažljivo tretirani i praćeni u skladu sa njihovim visokim rizikom za smrtni ishod, zbog veće podložnosti oštećenjima vitalnih organa i drugim udruženim oboljenjima. Njihova prognoza ne zavisi samo od same osnovne bolesti, već i od kliničkog konteksta u kojem se ona pojavljuje. Kod bolesnika sa kasnim početkom SLE naročito je neophodno primenjivanje strategija koje dovode do smanjivanja učestalosti kardiovaskularnih bolesti, osteoporoze, patoloških fraktura, infekcija, kao i drugih oblika oštećenja.

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