A Case of Late-Onset Systemic Lupus Erythematosus With Systemic Symptoms Leading to Multiple Organ Failure

This case report discusses the diagnosis and management of late-onset systemic lupus erythematosus (SLE) in an elderly patient. Systemic lupus erythematosus is an autoimmune disease that affects several organs. Sex differences in incidence, especially among women in their childbearing years, have been linked to estrogen fluctuations. This study focuses on an 87-year-old male who initially presented with anorexia, a history of heart failure, pancytopenia, and elevated antinuclear antibodies. His symptoms were initially attributed to heart failure and pneumonia. However, further evaluation led to the suspicion of immune-mediated vasculitis. Treatment with prednisolone improved his condition; however, a recurrent decrease in food intake and increased inflammation prompted the consideration of late-onset SLE. The diagnosis was supported by laboratory results, including antinuclear antibodies and complement levels, in accordance with the diagnostic criteria. This case highlights the challenges in diagnosing late-onset SLE owing to its overlap with other conditions and emphasizes the importance of a multidisciplinary approach for accurate diagnosis and treatment. Early recognition and intervention are crucial for managing late-onset SLE, even in elderly patients, to prevent multiple organ failure and improve outcomes.