Clinical expression and morbidity of systemic lupus erythematosus during a post-diagnostic 5-year follow-up: a male:female comparison

Abstract

The aim of this study was to analyse the prevalence of the most relevant clinical features of the diagnosis of systemic lupus erythematosus (SLE) in a sample of male patients with lupus as well as the incidence of the main causes of morbidity in a 5-year period after the diagnosis. A further aim of this study was to investigate the impact of gender on expression and morbidity of SLE. Data were collected from the medical records of 59 male and 535 female patients with SLE who were diagnosed at the hospitals in the region of Thessaloniki. Several differences in the expression and morbidity of the disease were found in relation to the gender of the patient. Male patients had a higher prevalence of thromboses, nephropathy, strokes, gastrointestinal tract symptoms and antiphospholipid syndrome when compared with female patients, but tended to present less often with arthralgia, hair loss, Raynaud's phenomenon and photosensitivity as the initial clinical manifestations. During the 5-year follow-up, positive associations have been found between male gender and the incidence of tendonitis, myositis, nephropathy and infections, particularly of the respiratory tract. In conclusion, this study has provided information regarding the features of clinical expression and morbidity in male patients, and has shown that gender is a possible factor that can influence the clinical expression of SLE.

The Role of Sex in Uveitis and Ocular Inflammation

“…Thus, male gender has been proposed as a predictor for poor systemic outcomes but the exact etiology remains unclear. 5, 28, 29 …”

Impact of sex disparities on the clinical manifestations in patients with systemic lupus erythematosus

“…[1,2] Whereas SLE is more common in women than in men, male patients are thought to have more severe disease than females. [3] Over 5-year follow-up, Stefanidou et al [4] found that male sex might be a poor factor in SLE prognosis.…”

Characteristics of Polish patients with systemic lupus erythematosus obtained from SESAME registry. Activity of the disease, degree of impairment, and availability of social care

“…The previously mentioned Euro-Lupus study revealed that at the diagnosis of SLE men more frequently show serositis, but in the course of fully symptomatic disease they suffer from arthritis less frequently than women [2]. Other studies showed higher prevalence of kidney involvement and failure in men [18,19], as well as higher frequency of thromboembolic episodes [18]. Also the results of studies conducted outside Europe suggest that the manifestation of SLE is more severe in male patients [17].…”