Objectives To describe the demographic, clinical and immunological manifestations in male patients with Systemic Lupus Erythematosus (SLE).
Methods Patients diagnosed of SLE that were in the RELESSER data base (National Registry of Patients with Systemic Lupus Erythematosus of the Spanish Society of Rheumatology) were included. This is a multicenter retrospective cross-sectional study. We analyzed 3658 patients with SLE. All met the ACR criteria. Socio- demographic variables, comorbidities, classification, clinical and immunological manifestations were evaluated. Pearson's chi-square test, t-Student, ANOVA and multivariate logistic regression analysis were performed
Results A total of 3658 patients were included: 353 men (9.7%) and 3298 women (90.2%), with an average onset of symptoms of 37±17 and 32±14 years of age respectively. In 7 (0.1%) the gender was unknown. The male/female ratio was 9/1.The age of onset of symptoms and age at diagnosis was higher in men than in women (P<0.0001). Diagnosis in males was sooner than in females (P=0.04).The most common age range at diagnosis in both genders was 21-49 years (P<0.0001).
Women had a more frequently a history of autoimmune thyroid disease (P<0.001). Males have more cardiovascular comorbidities (P<0.001).Comparing comorbidities in men with SLE by age range, it was found that SLE patients over 50 years of age had more comorbidity with significant differences.A total of 68% (236) of males with SLE required hospitalization in comparison of 53% (1713) of female (P<0.001). During follow-up 208 patients died, 30 (9.3%) were male and 178 (5.9%) women (P=0.02).On multivariate analysis, the only statistically significant variable was age. It was seen that patients over 50 year-old had a higher mortality than those under 50 year-old, regardless of gender, delay in diagnosis, risk factors and clinical features OR: 5.32 (CI: 3.61 to 7.84)P<0.001
Conclusions Patients with SLE older than 50 years old are at increased risk of mortality. In male patients with SLE: the age at diagnosis and the onset of symptoms is higher than in women. The diagnostic delay is lower in men than in women. Men have more cardiovascular comorbidities, especially those over 50 years-old and also more serositis, renal and cardiovascular involvement than women.
Disclosure of Interest None declared