Purpose: Systemic Lupus Erythematosus (SLE) in males is rare. Clinical and biological
features, as well as, the outcome may differ comparatively to female patients. The purpose of our
study is to define these clinical and biological features in Tunisian male patients presenting SLE.
Methods: A mono-centric, retrospective and descriptive study of 96 patients followed for SLE out
of which 21 are males. A comparative study was then performed between male and female patients
Results: Sex-ratio female/male was 3.6/1, the average age at diagnosis of SLE was 37.8±14 years.
The most frequently noted clinical manifestations were: skin involvement (81%), renal involvement
(71.4%) and joint damage (66.7). We observed a significant difference in clinical features between
male and female patients (21 males and 76 females): renal failure (52% vs. 71.4%), serositis
(23.8% vs. 2.7%), peripheral neuropathy (19% vs. 4%) and lung interstitial disease (14.3% vs.
1.3%). No significant difference was found in the positivity of serum antibodies between the two
groups. Fifteen male patients (71.4%) had a SLEDAI score greater than or equal to 11, referring to
high/very high disease activity. Out of the 32 patients who developed infectious complications during
the course of the disease, 11 were male (52.4% of males). Concerning the male group, complete
remission was observed in 10 patients (47.6%), while 10 others presented persistent sequella. We
observed one death in the male group secondary to infective acute respiratory failure.
Conclusion: SLE in male patients is rare and associated with poor prognosis. Disparity was observed
in clinical and biological features as well as outcome in the different studies. In our study,
we concluded that male lupus is more severe.