Systemic Lupus in males – clinical-laboratory, immunological and histological characteristics.

Systemic lupus erythematosus is a chronic, systemic, non-organ-specific autoimmune disease that affects all organs and systems of the human body and is characterized by the production of autoantibodies against nuclear antigens. Its prevalence in Europe reaches 1:2500. It affects mostly women (female : male ratio=9 : 1) in fertile age group (15-45 years). The clinical course of lupus in males is characterized by more aggressive clinical course and the development of serious complications, such as vasculitis, central nervous system involvement, antiphospholipid syndrome, etc. For the period of 7 years (2012-2019) we observed overall 18 male patients with systemic lupus, 11 with biopsy-proven renal involvement and 7 without clinically significant renal disease (proteinuria < 0.5 g/24 h., no erythrocyturia/cylindruria, normal renal function), mean age at the diagnosis 39.6 +/- 12.3 years. All patients received pathogenetic treatment (corticosteroids + cytotoxic agents). Three had secondary antiphospholipid syndrome, 1 – inflammatory bowel disease, 1 – seronegative spondyloarthropathy. Three had type 2 diabetes. The authors discuss the clinical, immunological and histological characteristics and the therapeutic approach in males with systemic lupus.