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Published on: November 1, 2015
Differences between male and female systemic lupus erythematosus in a multiethnic population
Tze Chin Tan1, Hong Fang, Laurence S Magder
1Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 7500, Baltimore, MD 21205, USA.
Insights
Systemic lupus erythematosus (SLE) presents differently in men and women, with distinct clinical features and outcomes. These differences are also influenced by ethnicity, requiring consideration in future research and patient care.
Area of Science:
- Rheumatology
- Immunology
- Clinical Medicine
Background:
- Systemic lupus erythematosus (SLE) is a complex autoimmune disease.
- While often considered similar, male and female SLE patients may exhibit distinct clinical profiles.
- Understanding these differences is crucial for tailored patient management.
Purpose of the Study:
- To compare the clinical characteristics and outcomes of male and female patients with SLE.
- To identify gender-specific patterns in SLE presentation and disease progression.
- To explore the influence of ethnicity on these gender-based differences.
Main Methods:
- Analysis of 1979 patients from the Hopkins Lupus Cohort.
- Retrospective review of demographic, clinical, and outcome data.
- Statistical comparison of male and female patient cohorts.
Main Results:
- Men with SLE were more prone to disability, hypertension, thrombosis, renal, hematological, and serological issues.
- Men experienced more end-organ damage (neuropsychiatric, cardiovascular) and higher mortality rates.
- Significant ethnic variations in gender differences were observed, particularly in white patients regarding lupus nephritis and thrombosis.
Conclusions:
- Major clinical disparities exist between male and female SLE patients.
- Ethnicity significantly modulates these gender-based differences in SLE.
- Future SLE research must incorporate both gender and ethnicity for comprehensive understanding.
Objective:
Male patients with systemic lupus erythematosus (SLE) are thought to be similar to female patients with SLE, but key clinical characteristics may differ. Comparisons were made between male and female patients with SLE in the Hopkins Lupus Cohort.
Methods:
A total of 1979 patients in the Hopkins Lupus Cohort were included in the analysis.
Results:
The cohort consisted of 157 men (66.2% white, 33.8% African American) and 1822 women (59.8% white, 40.2% African American). The mean followup was 6.02 years (range 0-23.73). Men were more likely than women to have disability, hypertension, thrombosis, and renal, hematological, and serological manifestations. Men were more likely to be diagnosed at an older age and to have a lower education level. Women were more likely to have malar rash, photosensitivity, oral ulcers, alopecia, Raynaud's phenomenon, or arthralgia. Men were more likely than women to have experienced end organ damage including neuropsychiatric, renal, cardiovascular, peripheral vascular disease, and myocardial infarction, and to have died. In general, differences between males and females were more numerous and striking in whites, especially with respect to lupus nephritis, abnormal serologies, and thrombosis.
Conclusion:
Our study suggests that there are major clinical differences between male and female patients with SLE. Differences between male and female patients also depend on ethnicity. Future SLE studies will need to consider both ethnicity and gender to understand these differences.
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