Male versus female lupus: a comparison of ethnicity, clinical features, serology and outcome over a 30 year period

Abstract

Objective: To review the differences between male and female lupus patients with respect to clinical features, serology and outcome over a thirty year period. Material and methods: An observational study of all SLE patients seen at University College of London Hospital between 1976 and 2005 was performed. Demographic, clinical and serological data and outcome were retrospectively collected from hospital records or questionnaires and reviewed. Comparisons between continuous variables were made using the Kruskal–Wallis test and Student’s t-test. Chi-square test or Fisher´s exact test were used for categorical variables when it was appropriate. Results: A total of 484 patients (439 females and 45 males) were identified between 1976 and 2005. Their mean age at diagnosis was 29.3 years (SD 12.6) with no significant differences between men and women. There were no significant differences between the number of men and women diagnosed over the different decades or in the mean age at diagnosis. Female gender was significantly associated with the presence of oral ulcers (29.2% vs. 13.3%, p < 0.05) and Ig M ACA (9.9% vs. 0%, p < 0.05). There were no significant differences in the comparison of other variables. With respect to outcome, although renal failure and death were higher in females (6.8% vs. 4.4% and 13.2% vs. 6.6% respectively), no statistically significant differences were found. Cardiovascular disease was the commonest cause of death in men. Conclusion: Over this thirty year follow-up period, relatively few differences have emerged comparing the frequencies of clinical and serological features or outcome in male and female lupus patients.