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Systemic lupus erythematosus in males.

M H Miller, M B Urowitz, D D Gladman

    Medicine
    |September 1, 1983
    PubMed
    Summary

    Systemic lupus erythematosus (SLE) in males shows similar disease spectrum and severity compared to females. Age of onset in males is more varied, with some diagnosed after age 50.

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    Area of Science:

    • Rheumatology
    • Immunology
    • Genetics

    Background:

    • Systemic lupus erythematosus (SLE) predominantly affects females, but male SLE is increasingly recognized.
    • Understanding differences and similarities in SLE presentation between sexes is crucial for diagnosis and management.

    Purpose of the Study:

    • To compare the clinical spectrum and severity of SLE in males versus females.
    • To investigate potential differences in maleness and sex hormone profiles between affected males and unaffected males.
    • To analyze age of onset and genetic factors (HLA antigens) in male SLE patients.

    Main Methods:

    • A cohort of 51 males with SLE (including one with Klinefelter syndrome) was studied.
    • Phenotypic males were compared to 50 age- and disease-duration-matched female SLE patients.
    • Twenty-one clinical and laboratory manifestations were assessed, alongside disease severity indicators like corticosteroid and cytotoxic agent usage.
    • Family history, age of onset, and Human Leukocyte Antigen (HLA) typing were analyzed.

    Main Results:

    • No statistically significant differences in the spectrum of 21 assessed SLE manifestations were found between males and females, though some trends were observed (e.g., less neurologic involvement, alopecia, thrombocytopenia in males; more pleuritis).
    • Disease severity was similar, with females showing a longer mean duration of corticosteroid use.
    • Age of onset was more evenly distributed in males, with 25% diagnosed after age 50.
    • Increased frequencies of HLA-B8 and HLA-DR3 antigens were noted in SLE males, similar to female SLE populations.

    Conclusions:

    • The clinical spectrum and severity of SLE are largely similar between males and females.
    • Male SLE patients exhibit a broader age distribution at diagnosis and share similar genetic predispositions (HLA antigens) with female SLE patients.
    • Further research into sex-specific factors influencing SLE pathogenesis and presentation is warranted.

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