Article PDF (Українська)


systemic lupus erythematosus, male, clinical and laboratoty date

Abstract views: 37
PDF Downloads: 15

How to Cite

Iaremenko , O., & Koliadenko , D. (2022). SPECTRUM OF CLINICAL MANIFESTATIONS, AUTOANTIBODIES AND LEVELS OF INFLAMMATORY MARKERS IN MEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Medical Science of Ukraine (MSU), 18(4), 21-30. https://doi.org/10.32345/2664-4738.4.2022.04


Relevance. The proportion of men among patients with systemic lupus erythematosus (SLE) is only 4-22%, but possible differences in the context of the clinical course and prognosis of the disease in this group of patients require more detailed study.

Objective: to assess the spectrum of clinical manifestations, autoantibodies and the level of inflammatory markers in men with SLE.

Materials and methods. 371 patients with SLE were examined, including 321 women (86.5%) and 50 men (13.5%). Clinical data, SLEDAI index and SLICC/DI damage, levels of inflammatory markers (erythrocyte sedimentation rate, C-reactive protein) and spectrum of specific autoantibodies (antibodies to dsDNA, Sm, Ro/SSA, La/SSB, RNP, antiphospholipid antibodies) were evaluated.

Results. Alopecia (18.0% vs 33.0%; p=0.036) and arthralgia (22.0% vs 40.0%; p=0.016) were significantly less common in men with SLE. In contrast, nephritis with nephrotic syndrome was more than three times more common in male SLE patients (14.3%) than in women (4.1%; p=0.032). There was also a difference in the frequency of serositis: men were significantly more likely to have pleurisy (36.7%) than women (21.6%; p=0.044). Nervous system involvement was less common in men (12.0% vs 29.6%; p=0.007), as well as Raynaud's syndrome (16.0% vs 29.8%; p=0.05) and Sjogren's syndrome (0% vs 8.0%, p=0.023) compared with women. However, trophic ulcers were three times more common in men with SLE (14.3% vs 3.5%; p=0.019). Involvement of the mononuclear phagocyte system, heart, lungs, constitutional symptoms, antiphospholipid syndrome, hematological manifestations did not differ significantly between the representatives of both sexes. There were also no gender differences in SLEDAI indices and SLICC damage, erythrocyte sedimentation rate, C-reactive protein, C3, C4 complement levels. Antibodies to Ro/SSA were significantly less common in male SLE patients than in women (23.1% and 58.5%, respectively, p=0.033).

Conclusions. Men with SLE are less likely to have alopecia, arthralgia, Raynaud's syndrome, nervous system involvement and Sjogren's syndrome than women. However, males with SLE are more likely to have kidney disease with nephrotic syndrome, pleuritis and trophic ulcers. Presence of anti-Ro/SSA antibodies in men with SLE is less common than in women.

Article PDF (Українська)


Urowitz M.B., Gladman D.D. Contributions of observational cohort studies in systemic lupus erythematosus: the University of Toronto lupus clinic experience. Rheum Dis Clin North Am. 2005;31(2):211-21. DOI: 10.1016/j.rdc.2005.01.008.

View at:

Publisher Site: https://rheumatic.theclinics.com//retrieve/pii/S0889857X05000104

PubMed: https://pubmed.ncbi.nlm.nih.gov/15922142/

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. DOI: 10.1136/annrheumdis-2014-206334.

View at:

Publisher Site: https://ard.bmj.com/content/75/1/136

PubMed: https://pubmed.ncbi.nlm.nih.gov/25265938/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717400/

Muñoz-Grajales C., González L.A., Alarcón G.S., Acosta-Reyes J. Gender differences in disease activity and clinical features in newly diagnosed systemic lupus erythematosus patients. Lupus. 2016;25(11):1217-1223. DOI: 10.1177/0961203316635286.

View at:

Publisher Site: https://journals.sagepub.com/doi/10.1177/0961203316635286

PubMed: https://pubmed.ncbi.nlm.nih.gov/26921269/

Santamaría-Alza Y., Motta J.Z.N., Fajardo-Rivero J.E., Pineda C.L. Systemic lupus erythematosus, gender differences in Colombian patients. Clin Rheumatol. 2018;37(9): 2423-2428. DOI: 10.1007/s10067-018-4161-8.

View at:

Publisher Site: https://link.springer.com/article/10.1007/s10067-018-4161-8

PubMed: https://pubmed.ncbi.nlm.nih.gov/29860566/

Feng J.B., Ni J.D., Yao X., Pan H.F., Li X.P., Xu J.H., Pan F.M., Xu S.Q., Ye D.Q. Gender and age influence on clinical and laboratory features in Chinese patients with systemic lupus erythematosus: 1,790 cases. Rheumatol Int. 2010;30(8):1017-23. DOI: 10.1007/s00296-009-1087-0.

View at:

Publisher Site: https://link.springer.com/article/10.1007/s00296-009-1087-0

PubMed: https://pubmed.ncbi.nlm.nih.gov/19701756/

Schwartzman-Morris J., Putterman C. Gender differences in the pathogenesis and outcome of lupus and of lupus nephritis. Clin Dev Immunol. 2012;2012:604892. DOI: 10.1155/2012/604892.

View at:

Publisher Site: https://www.hindawi.com/journals/jir/2012/604892/

PubMed: https://pubmed.ncbi.nlm.nih.gov/22690240/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368358/

Boodhoo K.D., 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. DOI: 10.1097/MD.0000000000004272.

View at:

Publisher Site: https://journals.lww.com/md-journal/Fulltext/2016/07190/Impact_of_sex_disparities_on_the_clinical.31.aspx

PubMed: https://pubmed.ncbi.nlm.nih.gov/27442661/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265778/

Nusbaum J.S., Mirza I., Shum J., Freilich R.W., Cohen R.E., Pillinger M.H., Izmirly P.M., Buyon J.P. Sex Differences in Systemic Lupus Erythematosus: Epidemiology, Clinical Considerations, and Disease Pathogenesis. Mayo Clin Proc. 2020;95(2):384-394. DOI: 10.1016/j.mayocp.2019.09.012.

View at:

Publisher Site: https://www.mayoclinicproceedings.org/article/S0025-6196(19)30822-5/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/32029091/

Sawalha A.H., Wang L., Nadig A., Somers E.C., McCune W.J.; Michigan Lupus Cohort, Hughes T., Merrill J.T., Scofield R.H., Strickland F.M., Richardson B. Sex-specific differences in the relationship between genetic susceptibility, T cell DNA demethylation and lupus flare severity. J Autoimmun. 2012;38(2-3):J216-22. DOI: 10.1016/j.jaut.2011.11.008.

View at:

Publisher Site: https://www.sciencedirect.com/science/article/abs/pii/S0896841111001211?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/22305513/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313010/

Alarcón G.S., Calvo-Alén J., McGwin G. Jr, Uribe A.G., Toloza S.M., Roseman J.M., Fernández M., Fessler B.J., Vilá L.M., Ahn C., Tan F.K., Reveille J.D.; LUMINA Study Group. Systemic lupus erythematosus in a multiethnic cohort: LUMINA XXXV. Predictive factors of high disease activity over time. Ann Rheum Dis. 2006;65(9):1168-74. DOI: 10.1136/ard.200X.046896.

View at:

Publisher Site: https://ard.bmj.com/lookup/doi/10.1136/ard.200X.046896

PubMed: https://pubmed.ncbi.nlm.nih.gov/16905579/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1798273/

Stojan G., Petri M. Epidemiology of systemic lupus erythematosus: an update. Curr Opin Rheumatol. 2018;30(2):144-150. DOI: 10.1097/BOR.0000000000000480.

View at:

Publisher Site: https://journals.lww.com/co-rheumatology/Abstract/2018/03000/Epidemiology_of_systemic_lupus_erythematosus__an.3.aspx

PubMed: https://pubmed.ncbi.nlm.nih.gov/29251660/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026543/

Tan T.C., Fang H., Magder L.S., Petri M.A. Differences between male and female systemic lupus erythematosus in a multiethnic population. J Rheumatol. 2012;39(4):759-69. DOI: 10.3899/jrheum.111061.

View at:

Publisher Site: https://www.jrheum.org/content/39/4/759

PubMed: https://pubmed.ncbi.nlm.nih.gov/22382348/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3605704/

Moroni G., Quaglini S., Gallelli B., Banfi G., Messa P., Ponticelli C. Progressive improvement of patient and renal survival and reduction of morbidity over time in patients with lupus nephritis (LN) followed for 20 years. Lupus. 2013;22(8):810-8. DOI: 10.1177/0961203313492576.

View at:

Publisher Site: https://journals.sagepub.com/doi/10.1177/0961203313492576

PubMed: https://pubmed.ncbi.nlm.nih.gov/23764764/

Wenderfer S.E., Orjuela A., Bekheirnia M.R., Pereira M., Muscal E., Braun M.C., De Guzman M. Lupus Nephritis, Autoantibody Production and Kidney Outcomes in Males with Childhood-Onset Systemic Lupus Erythematosus. Pediatr Rep. 2022;14(2):220-232. DOI: 10.3390/pediatric14020030.

View at:

Publisher Site: https://www.mdpi.com/2036-7503/14/2/30

PubMed: https://pubmed.ncbi.nlm.nih.gov/35645367/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9149811/

Aringer M. EULAR/ACR classification criteria for SLE. Semin Arthritis Rheum. 2019;49(3S):S14-S17. DOI: 10.1016/j.semarthrit.2019.09.009.

View at:

Publisher Site: https://www.sciencedirect.com/science/article/abs/pii/S0049017219306444?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/31779843/

Gladman D.D., Ibañez D., Urowitz M.B. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29(2):288-91.

View at:

PubMed: https://pubmed.ncbi.nlm.nih.gov/11838846/

Gladman D., Ginzler E., Goldsmith C., Fortin P, Liang M, Urowitz M, Bacon P, Bombardieri S, Hanly J, Hay E, Isenberg D, Jones J, Kalunian K, Maddison P, Nived O, Petri M, Richter M, Sanchez-Guerrero J, Snaith M, Sturfelt G, Symmons D, Zoma A. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum. 1996;39(3):363-9. DOI: 10.1002/art.1780390303.

View at:

Publisher Site: https://onlinelibrary.wiley.com/doi/10.1002/art.1780390303

PubMed: https://pubmed.ncbi.nlm.nih.gov/8607884/

Alonso M.D., Martínez-Vázquez F., Riancho-Zarrabeitia L., Díaz de Terán T., Miranda-Filloy J.A., Blanco R., González-Juanatey C., Llorca J., González-Gay M.A. Sex differences in patients with systemic lupus erythematosus from Northwest Spain. Rheumatol Int. 2014;34(1):11-24. DOI: 10.1007/s00296-013-2798-9.

View at:

Publisher Site: https://link.springer.com/article/10.1007/s00296-013-2798-9

PubMed: https://pubmed.ncbi.nlm.nih.gov/23812032/

Yacoub Wasef S.Z. Gender differences in systemic lupus erythematosus. Gend Med. 2004;1(1):12-7. DOI: 10.1016/s1550-8579(04)80006-8.

View at:

Publisher Site: https://www.sciencedirect.com/science/article/abs/pii/S1550857904800068?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/16115579/

Rastin M., Mahmoudi M., Sahebari M., Tabasi N. Clinical & immunological characteristics in systemic lupus erythematosus patients. Indian J Med Res. 2017;146(2):224-229. DOI: 10.4103/ijmr.IJMR_1356_15.

View at:

Publisher Site: https://journals.lww.com/ijmr/pages/default.aspx

PubMed: https://pubmed.ncbi.nlm.nih.gov/29265023/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761032/

Riveros Frutos A., Casas I., Rúa-Figueroa I., López-Longo F.J., Calvo-Alén J., Galindo M., Fernández-Nebro A., Pego-Reigosa J.M., Olivé Marqués A.; RELESSER Group, part of the Spanish Society of Rheumatology Systemic Autoimmune Diseases Study Group (EASSER). Systemic lupus erythematosus in Spanish males: a study of the Spanish Rheumatology Society Lupus Registry (RELESSER) cohort. Lupus 2017;26(7):698-706. DOI: 10.1177/0961203316673728

View at:

Publisher Site: https://journals.sagepub.com/doi/10.1177/0961203316673728

PubMed: https://pubmed.ncbi.nlm.nih.gov/27799439/

Ramírez Sepúlveda J.I., Bolin K., Mofors J., Leonard D., Svenungsson E., Jönsen A., Bengtsson C.; DISSECT consortium, Nordmark G., Rantapää Dahlqvist S., Bengtsson A.A., Rönnblom L., Sjöwall C., Gunnarsson I., Wahren-Herlenius M. Sex differences in clinical presentation of systemic lupus erythematosus. Biol Sex Differ. 2019;10(1):60. DOI: 10.1186/s13293-019-0274-2.

View at:

Publisher Site: https://bsd.biomedcentral.com/articles/10.1186/s13293-019-0274-2

PubMed: https://pubmed.ncbi.nlm.nih.gov/31843005/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915972/

Garcia M.A., Marcos J.C., Marcos A.I., Pons-Estel B.A., Wojdyla D., Arturi A., Babini J.C., Catoggio L.J., Alarcon-Segovia D. Male systemic lupus erythematosus in a Latin-American inception cohort of 1214 patients. Lupus 2005;14(12):938-46. DOI: 10.1191/0961203305lu2245oa.

View at:

Publisher Site: https://journals.sagepub.com/doi/10.1191/0961203305lu2245oa

PubMed: https://pubmed.ncbi.nlm.nih.gov/16425573/

Faezi S.T., Hosseini Almodarresi M., Akbarian M., Gharibdoost F., Akhlaghi M., Jamshidi A., Shahram F., Nadji A., Shafaie N., Akhlaghkhah M., Paragomi P., Davatchi F. Clinical and immunological pattern of systemic lupus erythematosus in men in a cohort of 2355 patients. Int J Rheum Dis. 2014;17(4):394-9. DOI: 10.1111/1756-185X.12268.

View at:

Publisher Site: https://onlinelibrary.wiley.com/doi/10.1111/1756-185X.12268

PubMed: https://pubmed.ncbi.nlm.nih.gov/24618453/

Mok C.C., Lau C.S., Chan T.M., Wong R.W. Clinical characteristics and outcome of southern Chinese males with systemic lupus erythematosus. Lupus 1999;8(3):188-96. DOI: 10.1191/096120399678847605.

View at:

Publisher Site: https://journals.sagepub.com/doi/10.1191/096120399678847605

PubMed: https://pubmed.ncbi.nlm.nih.gov/10342711/

Molina J.F., Drenkard C., Molina J., Cardiel M.H., Uribe O., Anaya J.M., Gomez L.J., Felipe O., Ramirez L.A., Alarcon-Segovia D. Systemic lupus erythematosus in males. A study of 107 Latin American patients. Medicine (Baltimore). 1996;75(3):124-30. DOI: 10.1097/00005792-199605000-00002

View at:

Publisher Site: https://journals.lww.com/md-journal/Citation/1996/05000/Systemic_Lupus_Erythematosus_in_Males_A_Study_of.2.aspx

PubMed: https://pubmed.ncbi.nlm.nih.gov/8965681/

PubMed Central:

Stefanidou S., Benos A., Galanopoulou V., Chatziyannis I., Kanakoudi F., Aslanidis S., Boura P., Sfetsios T., Settas L., Katsounaros M., Papadopoulou D., Giamalis P., Dombros N., Chatzistilianou M., Garyfallos A. Clinical expression and morbidity of systemic lupus erythematosus during a post-diagnostic 5-year follow-up: a male:female comparison. Lupus 2011;20(10):1090-4. DOI: 10.1177/0961203311403640.

View at:

Publisher Site: https://journals.sagepub.com/doi/10.1177/0961203311403640

PubMed: https://pubmed.ncbi.nlm.nih.gov/21700658/

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.