Abstract

       Six hundred nine private patients with systemic lupus erythematosus were followed up for a mean of ten years.  Ninety percent were female; 79% were white.  Three hundred sixty-nine received diagnosis before 1970, and 234 after.  Three hundred seventy-nine did not have nephritis; 230 did. The overall ten-year 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.  The presence of nephrotic syndrome at the onset of nephritis was a poor prognostic sign, but its development later was not.  Patients younger than 16 years without nephritis have an excellent prognosis.  One hundred twenty-eight 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 nutrional status, and treatment at earlier stages of disease.

(JAMA 1981;245;934-938)