AB0626 Clinical features of systemic lupus erythematosus in males
Authors: S. Sayhi, T. Ben Achour, N. Boussetta, B. Arfaoui, N.E.H. Gueddich, F. Ajili, B. Louzir
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects the adult woman. Male involvement is rare. We report a series of men with systemic lupus in order to specify the particularities of the different manifestations of SLE in men. <h3>Objectives</h3> we aim to describe the clinical feature of male tunisien patients presenting SLE <h3>Methods</h3> This is a retrospective study of male lupus patients hospitalised in internal medicine for a period of 9 years. All patients are Tunisian and meet the lupus criteria established by the ACR. <h3>Results</h3> Twenty-one patients with male lupus were enrolled in a total of 97 systemic lupus (gender-to-sex ratio 3.6). The mean age at diagnosis was 34 years (range: 14 to 84 years). A family l upus in one case. The clinical manifestations are dominated by joint damage (95%) with non-erosive arthritis in 9 cases and arthralgia in 12 cases, followed by cutaneous manifestations (erythema vespertilio=71%, photosensitivity=41%), Raynaud (25%). Pericarditis was found in 37.5% and pleurisy in 23%. Venous thrombosis was only observed in 4 cases associated with anti-cardiolipin antibodies in one case, and complicated by pulmonary embolism in one case. Sixteen patients had progressive nephropathy (permanent proteinuria &gt;0.5 g/24 hours with mean proteinuria of 3.2 g/24 hours and extremes of 0.7 and 8 g/24 hours) of which 9 underwent kidney biopsy puncture. Membranoproliferative glomerulonephritis was observed in 4 cases, segmental and focal in 3 cases, mesangial and extramembranous, each in one case. Two patients had progressed to end-stage renal disease requiring hemodialysis. Concerning haematological involvement, anaemia, observed in 50% of cases, was haemolytic in 12.5% of cases. Leukopenia and lymphopenia were each scored in 46% of cases. Sixteen patients 16 were put on chloroquine, all patients were placed on high dose corticosteroids for an average of 25 months with boli in 7 cases, combined with cyclophosphamide (700 mg/month IV) in 4 patients cases in patients with proliferative glomerulonephritis. The evolution was enamelled with flares in 11 cases, 2 of which had progressed to end-stage renal failure. Aseptic osteonecrosis of the femoral head was observed in one patient after 1 year of corticosteroid therapy. Complete remission was observed in 3 patients with a follow-up of 14, 24, and 144 months and one patient died as a result of peritonitis. <h3>Conclusions</h3> Systemic lupus is a disease essentially of adult women and rarely affects humans. The prevalence of the disease in the female gender suggests the intervention of a hormonal factor. In favour of the deleterious role of estrogens, lupus relapses are triggered by pregnancy, the peri and postpartum, as well as the eostroprogestative pill. The most common manifestations in humans in our study were renal impairment including membranoproliferative glomerulonephritis and segmental and focal glomerulonephritis complicated by renal failure in two patients. These data join those of the literature. The same is true for hemolytic anaemia. LES is rare in men, nevertheless it correlates with a higher mortality in front of the association most frequent with the renal involvement which imposes a better knowledge of these clinical and laboratory particularities. <h3>Disclosure of Interest</h3> None declared