Divergence between initial and cumulative manifestations in systemic lupus erythematosus: effect of age and sex in a prospective lupus cohort from Pakistan

This prospective cohort study of 185 SLE patients in Pakistan, with 138 complete datasets, highlights that arthritis and mucocutaneous features, such as hair loss, are prevalent at disease onset, while sicca, vasculitis, and hematologic manifestations increase over time. The study found significant cumulative increases in mucocutaneous involvement, sicca features, hematologic manifestations, vasculitis, and nephritis. Pediatric patients showed higher rates of mucocutaneous features, and males had higher nephritis rates at onset. These findings emphasize the need for age- and sex-specific monitoring in SLE management.