Duration and Death in Systemic Lupus Erythematosus

Of 491 patients with systemic lupus erythematosus (SLE), 249 (51%) are known dead. From 1950 to 1955, 15 of 57 patients (26%) died of central nervous system (CNS) damage and an equal number died of uremia. High-dosage corticosteroid therapy for CNS involvement was introduced in 1956. From 1956 to 1962, only 11 of 100 patients died of CNS involvement and 36% of the patients died of uremia. During the past ten years, with high-dose corticosteroid therapy, dialysis, and renal transplantation, only 7 of 92 patients (8%) died of CNS damage and 14% of the patients died of uremia. Death from infections, vascular complications, and malignant neoplasms occurred more frequently. The changes were significant (P<.0001). Black patients did not have a more malignant course than others. The median time from diagnosis to death in 79 blacks was 3.5 years; this was identical in 170 other patients.