Cardiac manifestations develop in the majority of patients with systemic lupus erythematosus (SLE) at some time during the course of their disease. This study was designed to assess cardiac abnormalities in patients with SLE by echocardiography and to compare the 2 groups of patients with and without cardiac manifestations. It was a transversal, descriptive study, conducted in the Internal Medicine Department at the Military Hospital of Tunis from January 2016 to June 2018. Eighty lupus patients, diagnosed on the basis of ACR (American college of rheumatology) criteria, were enrolled in the study and were evaluated by standard echocardiography with color Doppler. Out of 80 patients 42 (52%) had abnormal echocardiographic findings. Pericardial effusion was found in 55%, valvular abnormalities in 52% and 38% had pulmonary hypertension. Patients with pleural effusion (45 vs 15%) were more vulnerable to cardiac involvement as well as renal impairment (57 vs 44%). The difference, however, were not statistically significant (p>0.05) in the renal involvement. Active disease with low complement (80%) was associated with higher frequency of cardiac involvement than disease in remission (64%) but the result was not statistically significant (p=0.11). Cardiac abnormalities are very common in lupus patients even when clinically asymptomatic form. Echocardiography is an excellent non-invasive tool for cardiac evaluation. Their research must be systematic with echocardiography in order to reduce subsequent cardiac morbidity and mortality among the lupus patients.

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BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects the adult woman. Male involvement is rare.We report a series of men with systemic lupus in order to specify the particularities of the different manifestations of SLE in men.Objectiveswe aim to describe the clinical feature of male tunisien patients presenting SLEMethodsThis is a retrospective study of male lupus patients hospitalised in internal medicine for a period of 9 years. All patients are Tunisian and meet the lupus criteria established by the ACR.ResultsTwenty-one patients with male lupus were enrolled in a total of 97 systemic lupus (gender-to-sex ratio 3.6). The mean age at diagnosis was 34 years (range: 14 to 84 years). A family l upus in one case. The clinical manifestations are dominated by joint damage (95%) with non-erosive arthritis in 9 cases and arthralgia in 12 cases, followed by cutaneous manifestations (erythema vespertilio=71%, photosensitivity=41%), Raynaud (25%). Pericarditis was found in 37.5% and pleurisy in 23%. Venous thrombosis was only observed in 4 cases associated with anti-cardiolipin antibodies in one case, and complicated by pulmonary embolism in one case. Sixteen patients had progressive nephropathy (permanent proteinuria >0.5 g/24 hours with mean proteinuria of 3.2 g/24 hours and extremes of 0.7 and 8 g/24 hours) of which 9 underwent kidney biopsy puncture. Membranoproliferative glomerulonephritis was observed in 4 cases, segmental and focal in 3 cases, mesangial and extramembranous, each in one case. Two patients had progressed to end-stage renal disease requiring hemodialysis. Concerning haematological involvement, anaemia, observed in 50% of cases, was haemolytic in 12.5% of cases. Leukopenia and lymphopenia were each scored in 46% of cases. Sixteen patients 16 were put on chloroquine, all patients were placed on high dose corticosteroids for an average of 25 months with boli in 7 cases, combined with cyclophosphamide (700 mg/month IV) in 4 patients cases in patients with proliferative glomerulonephritis. The evolution was enamelled with flares in 11 cases, 2 of which had progressed to end-stage renal failure. Aseptic osteonecrosis of the femoral head was observed in one patient after 1 year of corticosteroid therapy. Complete remission was observed in 3 patients with a follow-up of 14, 24, and 144 months and one patient died as a result of peritonitis.ConclusionsSystemic lupus is a disease essentially of adult women and rarely affects humans. The prevalence of the disease in the female gender suggests the intervention of a hormonal factor. In favour of the deleterious role of estrogens, lupus relapses are triggered by pregnancy, the peri and postpartum, as well as the eostroprogestative pill. The most common manifestations in humans in our study were renal impairment including membranoproliferative glomerulonephritis and segmental and focal glomerulonephritis complicated by renal failure in two patients. These data join those of the literature. The same is true for hemolytic anaemi...

Background:Systemic lupus erythematosus (SLE) is a common chronic multi-system autoimmune disorder of unknown etiology causing injury to many organ Systems. It predominantly affects young women. Cardiac manifestations develop in the majority of patients with SLE at some time during the course of their disease.Objectives:The aim of our study is to assess cardiac abnormalities in patients with systemic lupus erythematosus (SLE) by echocardiography and to compare the 2 groups of patients with and without cardiac manifestations.Methods:We have performed a transversal, descriptive study of SLE patients hospitalized in the Internal Medicine department at the Military Hospital of Tunis between January 2016 and June 2018. Diagnosis of SLE was made according to the criteria of ACR. All patients underwent a cardiac ultrasound externally or during their stay in our department.Results:The patients were 61 females and 19 males (sex-ratio=3) with a mean age of 38 years.Fourty two patients had cardiac involvement. They were 33 female and 9 male with a mean age of the disease of 31,8 years (16-80 years) at the beginning of the disease and 41 years at the time of the study.83% of patients were symptomatic. The symptoms were dominated by objectified chest pain (43%). In Doppler echocardiography, pericarditis was found in 23 patients (55%) with a single case of cardiac tamponade. Libman Saks endocarditis and lupus myocarditis were found in one case each. Pulmonory hypertension (HTP) was observed in 16 patients (38%) and valvular disease in 22 patients (52%). Cardiomegaly was observed in 9 patients (21%). Electrical abnormalities were dominated by microvoltage found in 8 patients. The general symptoms (83%), skin lesions (76%) and musculoskeletal involvement (64%) were the most frequent events associated with the cardiac manifestations in group 1. ANA were positive in 97% of cases and antiphospholipid antibodies in 24%. Prednisone: 1mg/kg/day and immunosuppressive therapy were indicated respectively in 71% and 38% of patients.Conclusion:Cardiac abnormalities are very common in lupus patients even when clinically asymptomatic. SLE is among systemic diseases most providers of heart disease. Echocardiography is an excellent non-invasive tool for cardiac evaluation. Their research must be systematic with echocardiography in order to reduce subsequent cardiac morbidity and mortality among the lupus patients.Disclosure of Interests:None declared

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