Systemic lupus erythematosus in males: a retrospective study with a review of the literature.

OBJECTIVE: To delineate the clinical pattern of a cohort of male patients with systemic lupus erythematosus (SLE) and compare it with previously reported data. DESIGN: Retrospective review of hospital records. SUBJECTS: Male patients (n = 11) who were diagnosed with SLE and admitted to a 500-bed university hospital between 1990 and 1998. Eight of the men were African-American and three were Latino. The mean age was 36 years (range, 29-46). METHODS: Clinical and laboratory data were collected according to a well-established protocol. Imaging and invasive studies (including aspirations and biopsies) were also recorded. RESULTS: Nine of the patients (82%) had renal involvement, with five needing dialysis within a year of presentation. Five patients had neurologic involvement: two presented with psychosis and three with seizures. Eight patients had hematologic involvement, and seven had serosal and articular involvement. Cutaneous lesions (discoid lupus) were noted in only one patient. A majority of the patients were noncompliant and were lost to follow-up; therefore, ultimate outcome could not be clearly delineated. CONCLUSION: Renal, serosal, neurologic, articular, and hematologic involvement occurred frequently in our sample of male patients with SLE. The most striking finding was the high frequency of renal involvement with poor prognosis. A high index of suspicion for SLE in males may permit earlier diagnosis and may dictate the need for more aggressive therapy.