Clinical and immunological pattern of systemic lupus erythematosus in men in a cohort of 2355 patients

Abstract

Aim: To investigate the impact of gender on expression of systemic lupus erythematosus (SLE) in a cohort of 2355 SLE patients as one of the largest series of cases among the present reports.Method: In this retrospective study we used medical records of all patients (239 male and 2116 female) of the SLE registry of Rheumatology Research Center (RRC), Tehran University of Medical science (TUMS), Iran. Both clinical and paraclinical manifestations of SLE patients have been registered in this database since 1976 and updated during their follow-up. Chi-square test was used to compare the clinical and paraclinical manifestations in men and women at disease onset and during the disease course. We used logistic regression to compute odds ratios with 95% confidence intervals. A P-value < 0.05 was considered as statistically significant.Results: Mean age at disease onset was 25 AE 11.8 and 24.5 AE 10.3 years in men and women, respectively (P = 0.48). Comparison of clinical and immunological manifestations showed that male patients had a higher prevalence of mucocutaneous (43.5% vs. 33.7%, P = 0.005) and a lower prevalence of musculoskeletal symptoms (44% vs. 54.7%, P = 0.003) as the initial manifestation. During the disease course, discoid rash (25.9% vs. 13%, P = 0.000) and type IV lupus nephritis (23.4% vs. 18.1%, P = 0.03) were significantly more common, whereas arthritis (61.1% vs. 71.7%, P = 0.01) and leukopenia (28.5% vs. 35.8%, P = 0.024) were significantly less common in men.Conclusion: This study reveals gender influence on some manifestations of SLE. Considering sex differences is recommended in diagnostic and therapeutic features of the disease.

Chinese SLE Treatment and Research group (CSTAR) registry: V. gender impact on Chinese patients with systemic lupus erythematosus

“…10 Arthritis was found to be significantly less common in male SLE patients in our study, which concurred with previous studies. 10,15,[17][18][19][20][21] Moreover, reduced arthralgia/arthritis rates have been reported in Chinese (p ¼ 0.02), 4 Greek (p ¼ 0.004) 22 and Caucasian (p < 0.03) 12,15 populations.…”

Depression, Anxiety and Disease-Related Variables and Quality of Life Among Individuals With Systemic Lupus Erythematosus Living in Kermanshah Province, Iran

“…To understand the reasons behind this difference, the role of disease clinical characteristics in determining QoL should be considered. The existence of different clinical manifestations of SLE between men and women has been previously shown ( 37 ). Men are known to be more likely to develop discoid rash and type IV lupus nephritis whereas arthritis and leukopenia occur more frequently among women ( 37 ).…”

“…The existence of different clinical manifestations of SLE between men and women has been previously shown ( 37 ). Men are known to be more likely to develop discoid rash and type IV lupus nephritis whereas arthritis and leukopenia occur more frequently among women ( 37 ). These differences may contribute to the diverse patterns of HRQoL among men and women with SLE.…”

Clinical and biochemical manifestations of systemic lupus erythematosus at first diagnosis within Chinese patients

“…The most frequent manifestations at onset of SLE are typically of musculoskeletal or mucocutaneous involvements 1 . In juvenile SLE, pallor and fever tend to present first 21 .…”