scholarly journals Systemic lupus erythematosus among male patients in Malaysia: how are we different from other geographical regions?

Lupus ◽  
2018 ◽  
Vol 28 (1) ◽  
pp. 137-144
Author(s):  
S.S. Shaharir ◽  
W.D.Abdul Kadir ◽  
F. Nordin ◽  
F Abu Bakar ◽  
M W H Ting ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Renal Damage ◽  
Organ Damage ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
Disease Characteristics ◽  
Geographical Regions ◽  
Disease Damage ◽  
Male Patients

Background Systemic lupus erythematosus (SLE) is an autoimmune disease which predominantly affects females. The disease characteristics in male SLE patients are reported to be distinct and may vary across ethnicities and geographical regions. Objective To determine and compare the clinical phenotype and organ damage between male and female patients with SLE in Malaysia. Methodology This was a cross-sectional study involving SLE patients from Universiti Kebangsaan Malaysia Medical Centre from June 2016 until June 2017. Information on their socio-demographics and disease characteristics were obtained from the clinical records. Disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) scores. The disease characteristics, autoantibody profiles and organ damage were compared between male and female patients, and multivariable analysis using male sex as dependent variable was then performed. Results A total of 418 patients were recruited and a total of 59 (14.1%) patients were male. Male patients presented with lower SLE ACR criteria at initial presentation but a significantly higher number of them had renal involvement (lupus nephritis) (78.0% versus 63.8%, p = 0.04). Male patients had less musculoskeletal involvement (45.8% versus 63.0%, p = 0.02) and tended to have lesser mucocutaneous involvement. Immunologic profile revealed that a lower number of male patients had positive anti-Ro antibody (22.7% versus 44.7%, p = 0.04) and they tended to have positive lupus anticoagulant antibody (27.6% versus 14.3%, p = 0.06). Presence of organ damage (SDI score ≥ 1) was significantly higher among males (55.9% versus 39.6%, p = 0.02) with higher renal damage (25.4% versus 9.2%, p = 0.004) and cardiovascular event of ischaemic heart disease or stroke (20.3% versus 7.0%, p = 0.004). They were also inclined to develop damage much earlier as compared to female patients, 3 (interquartile range (IQR) 7.5) versus 5 (IQR 7) years, p = 0.08. The occurrence of disease damage was independently associated with male gender with odds ratio of 1.9 (95% confidence interval 1.1–3.5), p = 0.02. Conclusion Male patients with SLE have more severe disease with renal damage and cardiovascular event.

Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) Registry XI: gender impact on long-term outcomes

Lupus ◽  
2019 ◽  
Vol 28 (5) ◽  
pp. 635-641
Author(s):  
S Zhang ◽  
Z Ye ◽  
C Li ◽  
Z Li ◽  
X Li ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Causes Of Death ◽  
Survival Rates ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
American College Of Rheumatology ◽  
Male Patients

Objective The objective of this paper is to assess the role of gender on survival rate and causes of death and organ damage in systemic lupus erythematosus (SLE) patients in China from 2009 to 2015. Methods We conducted a multicenter cohort study to analyze the differences in outcome data between male and female SLE patients. A group of 1494 SLE patients who fulfilled the 1997 American College of Rheumatology SLE classification criteria were enrolled in the Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) registry from April 2009 to February 2010. All enrolled patients were followed up at least once per year from 2009 to 2015. For patients who could not attend the outpatient clinic, follow-up was conducted by telephone interview. We collected demographic data, clinical manifestations and damage scores (System Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)). Survival rates were evaluated using the Kaplan-Meier method. Results This study included 1352 women and 142 men. The five-year survival rates were 92.0% for men and 97.6% for women. The survival rates of males were significant lower than for females ( p = 0.019). Male patients received methylprednisolone pulse therapy and cyclophosphamide significantly more than female patients ( p = 0.010). During follow-up, 12 male patients and 66 female patients died. The most common cause of death was infection (41.7%) for men and active SLE disease (27.3%) for women. At the end of the study, the major accumulated organ damages included renal (8.5%) and musculoskeletal (7.7%), and nervous system (5.6%) for men and renal (8.8%) and musculoskeletal (6.7%) for women. There were no significant differences in SDI scores between the two groups at baseline and at the end of the study. Conclusions Male SLE patients had lower survival rates than female patients. Male patients received more methylprednisolone pulse and cyclophosphamide therapy. The most common causes of death were infection for male patients and active SLE disease for female patients. The major accumulated organ damages were renal, musculoskeletal, and nervous system both for male and female SLE patients in China.

scholarly journals Differences between Male and Female Systemic Lupus Erythematosus in a Multiethnic Population

2012 ◽  
Vol 39 (4) ◽  
pp. 759-769 ◽  
Author(s):  
TZE CHIN TAN ◽  
HONG FANG ◽  
LAURENCE S. MAGDER ◽  
MICHELLE A. PETRI
Keyword(s):  
Systemic Lupus Erythematosus ◽  
African American ◽  
Lupus Erythematosus ◽  
Organ Damage ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
Oral Ulcers ◽  
Lower Education Level ◽  
And Gender

Objective.Male patients with systemic lupus erythematosus (SLE) are thought to be similar to female patients with SLE, but key clinical characteristics may differ. Comparisons were made between male and female patients with SLE in the Hopkins Lupus Cohort.Methods.A total of 1979 patients in the Hopkins Lupus Cohort were included in the analysis.Results.The cohort consisted of 157 men (66.2% white, 33.8% African American) and 1822 women (59.8% white, 40.2% African American). The mean followup was 6.02 years (range 0–23.73). Men were more likely than women to have disability, hypertension, thrombosis, and renal, hematological, and serological manifestations. Men were more likely to be diagnosed at an older age and to have a lower education level. Women were more likely to have malar rash, photosensitivity, oral ulcers, alopecia, Raynaud’s phenomenon, or arthralgia. Men were more likely than women to have experienced end organ damage including neuropsychiatric, renal, cardiovascular, peripheral vascular disease, and myocardial infarction, and to have died. In general, differences between males and females were more numerous and striking in whites, especially with respect to lupus nephritis, abnormal serologies, and thrombosis.Conclusion.Our study suggests that there are major clinical differences between male and female patients with SLE. Differences between male and female patients also depend on ethnicity. Future SLE studies will need to consider both ethnicity and gender to understand these differences.

Clinical Features of Systemic Lupus Erythematosus in Tunisian Males

2020 ◽  
Vol 16 (2) ◽  
pp. 139-142
Author(s):  
Sameh Sayhi ◽  
Tayssir B. Achour ◽  
Sameh Mezri ◽  
Mohamed S. Hamdi ◽  
Gueddiche Nour ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Clinical Features ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
Biological Features ◽  
Male Group ◽  
Significant Difference ◽  
Male Patients

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.

scholarly journals Correlations of Expression Levels of a Panel of Genes (IRF5, STAT4, TNFSF4, MECP2, and TLR7) and Cytokine Levels (IL-2, IL-6, IL-10, IL-12, IFN-γ, and TNF-α) with Systemic Lupus Erythematosus Outcomes in Jordanian Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Amal H. Uzrail ◽  
Areej M. Assaf ◽  
Shtaywy S. Abdalla
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Renal Damage ◽  
Organ Damage ◽  
Systemic Lupus ◽  
Expression Levels ◽  
Cardiovascular Damage ◽  
Tnf Α ◽  
Cytokine Levels ◽  
Ifn Γ

Systemic lupus erythematosus (SLE) is characterized by systemic end-organ damage. We investigated the involvement of IRF5, TLR-7, MECP2, STAT4, and TNFSF4 genes and TNF-α, IFN-γ, IL-2, IL-12, IL-6, and IL-10 cytokines in SLE pathogenesis and in organ damage in Jordanian patients. Blood was collected from 51 patients and 50 controls. Expression levels of SLE genes in PBMCs and cytokine levels were determined using RT-PCR and ELISA, respectively. Expression levels of all genes and levels of TNF-α, IL-12, IL-6, and IL-10 were higher in SLE patients than those in controls (p<0.05), whereas IL-2 level was lower. High STAT4 (α), TNFSF4, and IL-10 levels correlated with cardiovascular damage, and high MECP2 (α) and TNF-α correlated with renal damage. Pulmonary and musculoskeletal damages correlated with high levels of TNFSF4. We concluded that STAT4 and TNFSF4 genes with TNF-α and IL-10 cytokines could be used as biomarkers to assess SLE activity and manage treatment.

scholarly journals Clinical and autoantibody profile in male and female patients with systemic lupus erythematosus: A retrospective study in 603 Brazilian patients

2020 ◽  
Vol 7 (4) ◽  
pp. 164-168
Author(s):  
Natália Teixeira De Oliveira ◽  
◽  
Nícolas Gomes Silva ◽  
Thiago A.F. Gomes Dos Santos ◽  
Renato Nisihara ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Retrospective Study ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
Autoantibody Profile

Soluble E-cadherin in Systemic Lupus Erythematosus

2013 ◽  
Vol 40 (10) ◽  
pp. 1677-1682 ◽  
Author(s):  
Tao Jin ◽  
Katarina Almehed ◽  
Yihong Zhu ◽  
Hans Carlsten ◽  
Helena Forsblad-d’Elia
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Multiple Regression ◽  
Lupus Erythematosus ◽  
Renal Damage ◽  
Serum Levels ◽  
Systemic Lupus ◽  
Female Patients ◽  
Healthy Women ◽  
Markers Of Inflammation ◽  
E Cadherin

Objective.E-cadherin is a potent adherens junction molecule implicated in tissue morphogenesis, epithelial functioning, and immune regulation. Serum levels of soluble E-cadherin (sE-cadherin), an end product of proteolytic cleavage of E-cadherin, is increased in patients with cancer, infections, and inflammation-related diseases. The aim of our study was to measure serum levels of sE-cadherin in systemic lupus erythematosus (SLE) and to determine associations between serum levels of sE-cadherin and markers of inflammation and organ damage in female patients with SLE.Methods.Serum levels of sE-cadherin were analyzed by ELISA in 150 female patients with SLE and 31 healthy women. Simple and multiple regression analyses between sE-cadherin levels and disease-related variables were performed in patients with SLE.Results.Serum levels of sE-cadherin were elevated in patients with SLE compared with levels in healthy controls. sE-cadherin levels correlated positively with age, disease duration, SLE Collaborating Clinics Damage Index, erythrocyte sedimentation rate (ESR), s-creatinine, cholesterol, triglycerides, interleukin 6, and matrix metalloproteinase-3. In multiple regression analysis, s-creatinine, age, ESR, and triglycerides remained determinants of sE-cadherin. Within the patients with SLE, higher sE-cadherin levels were found only in patients with renal damage, i.e., s-creatinine > 90 μmol/l, glomerular filtration rate < 50 ml/min, or renal involvement ever by SLE.Conclusion.Our study demonstrates significantly elevated serum levels of sE-cadherin in women with SLE compared with healthy women. The levels of sE-cadherin were positively correlated to s-creatinine, age, ESR, and triglycerides. Significantly elevated sE-cadherin levels were observed only in patients with renal damage.

Longitudinal associations of active renal disease with irreversible organ damage accrual in systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (14) ◽  
pp. 1669-1677 ◽  
Author(s):  
R Kandane-Rathnayake ◽  
J R Kent ◽  
W Louthrenoo ◽  
S -F Luo ◽  
Y -JJ Wu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Renal Damage ◽  
Organ Damage ◽  
Systemic Lupus ◽  
Damage Accrual ◽  
Active Lupus Nephritis ◽  
Longitudinal Associations ◽  
Active Lupus

Objective To examine longitudinal associations of active lupus nephritis with organ damage accrual in patients with systemic lupus erythematosus (SLE). Methods This study was performed using data from a large multinational prospective cohort. Active lupus nephritis at any visit was defined by the presence of urinary casts, proteinuria, haematuria or pyuria, as indicated by the cut-offs in the SLE Disease Activity Index (SLEDAI)-2K, collected at each visit. Organ damage accrual was defined as a change of SLICC-ACR Damage Index (SDI) score >0 units between baseline and final annual visits. Renal damage accrual was defined if there was new damage recorded in renal SDI domains (estimated glomerular filtration rate <50%/proteinuria >3.5 g per 24 h/end-stage kidney disease). Time-dependent hazard regression analyses were used to examine the associations between active lupus nephritis and damage accrual. Results Patients ( N = 1735) were studied during 12,717 visits for a median (inter-quartile range) follow-up period of 795 (532, 1087) days. Forty per cent of patients had evidence of active lupus nephritis at least once during the study period, and active lupus nephritis was observed in 3030 (24%) visits. Forty-eight per cent of patients had organ damage at baseline and 14% accrued organ damage. Patients with active lupus nephritis were 52% more likely to accrue any organ damage compared with those without active lupus nephritis (adjusted hazard ratio = 1.52 (95% confidence interval (CI): 1.16, 1.97), p < 0.02). Active lupus nephritis was strongly associated with damage accrual in renal but not in non-renal organ domains (hazard ratios = 13.0 (95% CI: 6.58, 25.5) p < 0.001 and 0.96 (95% CI: 0.69, 1.32) p = 0.8, respectively). There was no effect of ethnicity on renal damage accrual, but Asian ethnicity was significantly associated with reduced non-renal damage accrual. Conclusion Active lupus nephritis measured using the SLEDAI-2K domain cut-offs is associated with renal, but not non-renal, damage accrual in SLE.

Sign in / Sign up

Export Citation Format

Share Document