SPECTRUM OF CLINICAL MANIFESTATIONS, AUTOANTIBODIES AND LEVELS OF INFLAMMATORY MARKERS IN MEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

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.