Cause of death may be related to active disease, toxicity of medications, or other causes. Death early in the course of disease is usually related to the disease itself. Nephritis and CNS disease are the most ominous prognostic factors. Of the causes of death not directly related to active disease, infection is singly most common followed by myocardial infarction, stroke, and other atherosclerotic complications. Two recent studies have shown the presence of accelerated atherosclerosis in SLE.
Reference: Gladman DD, Urowitz MB: Prognostic subsets and mortality in systemic lupus erythematosus. In Wallace DJ, Hahn BH (eds): Dubois’ Lupus Erythematosus, 5th ed. Baltimore, Williams & Wilkins, 1997.
Roman MJ, Shanker BA, et al: Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med 349:2399-2340, 2003.
Asanuma Y, Oeser A, et al: Premature coronary-artery atherosclerosis in systemic lupus erythematosus. N Engl J Med 349:2407, 2003.