Clinical Features of Systemic Lupus Erythematosus in Tunisian Males

Author(s): Sameh Sayhi*, Tayssir B. Achour, Sameh Mezri, Mohamed S. Hamdi, Gueddiche Nour, Arfaoui Bilel, Nadia B. Abdelhafidh, Faida Ajili, Bassem Louzir

Journal Name: Current Rheumatology Reviews

Volume 16 , Issue 2 , 2020

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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 groups.

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.

Keywords: Systemic lupus erythematosus, lupus male, prognosis, tunisian, SLEDAI score, disparity.

Kaufman LD, Gomez-Reino JJ, Heinicke MH, Gorevic PD. Male lupus: retrospective analysis of the clinical and laboratory features of 52 patients, with a review of the literature. Semin Arthritis Rheum 1989; 18(3): 189-97.
[] [PMID: 2648578]
Miller MH, Urowitz MB, Gladman DD, Killinger DW. Systemic lupus erythematosus in males. Medicine (Baltimore) 1983; 62(5): 327-34.
[] [PMID: 6225928]
Kanda N, Tsuchida T, Watanabe T, Tamaki K. Clinical features of systemic lupus erythematosus in men. Characteristics of the cutaneous manifestations. Dermatology (Basel) 1996; 193(1): 6-10.
[] [PMID: 8864610]
Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40(9): 1725.
[] [PMID: 9324032]
Rees F, Doherty M, Grainge M, Davenport G, Lanyon P, Zhang W. The incidence and prevalence of systemic lupus erythematosus in the UK, 1999-2012. Ann Rheum Dis 2016; 75(1): 136-41.
[] [PMID: 25265938]
Tselios K, Gladman DD, Touma Z, Su J, Anderson N, Urowitz MB. Disease course patterns in systemic lupus erythematosus. Lupus 2019; 28(1): 114-22.
[] [PMID: 30526328]
Talal N, Pillarisetty R, Papoian R, Roubinian J. Experimental lupus: a disorder of immunologic regulation. Adv Nephrol Necker Hosp 1976; 6: 37-45.
[PMID: 828451]
Stojan G, Petri M. Epidemiology of systemic lupus erythematosus: an update. Curr Opin Rheumatol 2018; 30(2): 144-50.
[] [PMID: 29251660]
Papoian R, Pillarisetty R, Talal N. Immunological regulation of spontaneous antibodies to DNA and RNA. II. Sequential switch from IgM to IgG in NZB/NZW F1 mice. Immunology 1977; 32(1): 75-9.
[PMID: 300353]
Inman RD, Jovanovic L, Markenson JA, Longcope C, Dawood MY, Lockshin MD. Systemic lupus erythematosus in men. Genetic and endocrine features. Arch Intern Med 1982; 142(10): 1813-5.
[] [PMID: 7125767]
Vilarinho ST, Costallat LT. Evaluation of the hypothalamic-pituitary-gonadal axis in males with systemic lupus erythematosus. J Rheumatol 1998; 25(6): 1097-103.
[PMID: 9632070]
Costallat LTL, Coimbra AMV. Systemic lupus erythematosus in 18 Brazilian males: clinical and laboratory analysis. Clin Rheumatol 1993; 12(4): 522-5.
[] [PMID: 8124916]
Rovenský J. Systemic lupus erythematosus detected in males in the population of slovakia. J Nephrol Urol 2017; 1: 1-6.
Saint Cyr I, Fifi-Math A, Quist D, Arfi S, Jean-Baptiste G. Male systemic lupus Clinical and evolutionary aspects in 28antillais. Rev Rhum 1997; 64: 388.
Font J, Cervera R, Navarro M, et al. Systemic lupus erythematosus in men: clinical and immunological characteristics. Ann Rheum Dis 1992; 51(9): 1050-2.
[] [PMID: 1417135]
Blum A, Rubinow A, Galun E. Predominance of renal involvement in male patients with systemic lupus erythematosus. Clin Exp Rheumatol 1991; 9(2): 206-7.
[PMID: 2060166]
Renau A, Isenberg D. Male versus female lupus: a comparison of ethnicity, clinical features, serology and outcome over a 30 years period. Lupus 2012; 21(10): 1041-8.
Tan TC, Fang H, Magder LS, Petri MA. Differences between male and female systemic lupus erythematosus in a multiethnic population. J Rheumatol 2012; 39(4): 759-69.
[] [PMID: 22382348]
Boodhoo KD, Liu S, Zuo X. Impact of sex disparities on the clinical manifestations in patients with systemic lupus erythematosus: A systematic review and meta-analysis. Medicine (Baltimore) 2016; 95(29)e4272
[] [PMID: 27442661]
Cervera R, Doria A, Amoura Z, et al. Patterns of systemic lupus erythematosus expression in Europe. Autoimmun Rev 2014; 13(6): 621-9.
[] [PMID: 24418306]
Othmani S, Louzir B. Systemic lupus in 24 Tunisian men clinical and biological analysis revmedint 2002; 239830.
Folomeev M, Alekberova Z. Survival pattern of 120 males with systemic lupus erythematosus. J Rheumatol 1990; 17(6): 856-9.
[PMID: 2388214]
Austin HA III, Muenz LR, Joyce KM, et al. Prognostic factors in lupus nephritis. Contribution of renal histologic data. Am J Med 1983; 75(3): 382-91.
[] [PMID: 6351607]

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Year: 2020
Page: [139 - 142]
Pages: 4
DOI: 10.2174/1573397115666190916142945
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