Long term complications in systemic lupus erythematosus.

O the past few decades survival in patients with SLE has gradually improved in the Western world. Under optimal conditions of diagnosis and supervised treatment, with good social support, life-expectancy can be as high as 0% at 10 years.1 Although there have been a dramatic improvement in the short term prognosis with proper immunosuppression and care of infection, the mortality rates in patients surviving for more than 5 years and specially for more than 10 years have not shown such gratifying improvement particularly in the developing countries. In the late 0’s the bimodal mortality in lupus erythematosus has been attributed to active disease or infections in first 5 years of onset and second peak of mortality due to consequences of therapy or atherosclerotic vascular disease. In 1 5 this was further strengthened; patients of SLE in their late years die of causes other than the disease itself.3 The long-term consequences of drug treatment of SLE contribute to its late morbidity and mortality to a great way. Most of the long-term complications are the effects of aging, disease related life-style changes, atherothrombotic end-organ damage and quite often include drug-related complications and consequences of associated immune disorders. Early recognition and intervention may be needed to prevent such complications. The late complications of SLE are enumerated in Table 1.4