A Retrospective Study of Clinical Characteristics and Serological Profile of Male Systemic Lupus Erythematosus Patients in India.

Abstract

Objective: Systemic lupus erythematosus (SLE) is a female-preponderant disease, and a few studies from outside India have observed that the clinical characteristics of SLE in male patients vary from those of females. There is a lack of data about SLE in male patients in the Indian subcontinent. Hence, we have reported our observations on the various clinical characteristics of SLE in male patients in this retrospective 5-year cohort study.

Methods: This was a retrospective case record-based study at a tertiary care rheumatology center in North India. Records of all the SLE patients of all age-groups maintained with the department over 5 years were perused. All the patients fulfilling either of the classification criteria, viz., American College of Rheumatology (ACR) 1997 criteria and Systemic Lupus International Collaborating Clinics (SLICC) 2012, were included in the study. Data on clinical features were retrieved at the presentation and during the follow-up, immunological profile, treatment received, and long-term complications.

Results: Records of 45 patients were included in the study, of which two were juvenile lupus. Mucocutaneous manifestations were the most common clinical presentation and minor organ involvement. Among the major organs, renal involvement was the most common, followed by hematological manifestations. Two patients had thrombotic manifestations. Four patients had overlap with other connective tissue disorders. Hypertension was the most common complication developed during follow-up, followed by avascular necrosis (AVN) of the femoral head. Two patients died during follow-up. Eleven patients were tested for antiphospholipid syndrome (APS) antibodies, of which one lupus anticoagulant (LAC)-positive patient had thrombotic complications. All patients were antinuclear antibodies (ANA) positive, with a speckled pattern being common, and anti-double-stranded deoxyribonucleic acid (anti-dsDNA) was the common antibody. All patients received hydroxychloroquine and low-dose steroids, and up to 35% received steroid-sparing agents. Most patients with lupus nephritis (LN) took >1 year to achieve clinical remission.

Conclusion: Our study showed that male SLE patients are at high risk of severe organ damage at an early age and are susceptible to various other complications during follow-up. This may differ from female SLE patients, and larger studies in the future can further enlighten tailored treatment approaches in male patients. Ethical consent was taken wide letter no. IEC Reg. no. 54/2024 AH RR.