Systemic lupus erythematosus--survival patterns. Experience with 609 patients

Abstract

Patients (609) with systemic lupus erythematosus were followed up for a mean of 10 yr. Some 90 percent were female; 79% were white. Some 369 received diagnosis before 1970, and 234 after. Some 379 did not have nephritis; 230 did. The overall 10-yr survival was 79% (87% without nephritis, 65% with nephritis). Male patients did consistently worse than female patients. No overall white vs. nonwhite difference was noted. Nephrotic syndrome presence at the onset of nephritis was a poor prognostic sign, but its later development was not. Patients younger than 16 yr without nephritis have an excellent prognosis. Some 128 patients died (82 with nephritis, 46 without nephritis). The most common causes of death were renal disease and sepsis. Improved survival of this series may reflect closer follow-up, better nutritional status, and treatment at earlier stages of disease.