Systemic lupus erythematosus in 24 tunisian males: clinico-biological analysis and clinical course

PURPOSE: The systemic lupus erythematosus (SLE) is rare at the male. The clinic and biological characteristics and the evolution are variable between different studies. From 24 Tunisian observations we try to contribute to the precision of these characteristics on this ground. METHOD: It's a tunisian, multicentric, retrospective study of 24 males lupus, follow-up from 1990 to 1999 within a total lupus cohort of 295 patients. RESULTS: The sex-ratio female/male is 11/29, mean age at diagnosis is 31.75 years (range 10 to 63). The most frequent clinical manifestations are: arthritis (95%), malar rash (71%), photosensitivity (41%), glomerular nephropathy (66%) (classes III and IV = 7 cases/9), the serositis (37.5%) and Raynaud phenomenon (25%). Comparing these characteristics of two patient groups (24 males and 271 females), significant difference was observed : vascular thrombosis in male (16% vs 4% p : 0,027) and alopecia in female (12.5% vs 4% p : 0.03). For the other manifestations as nephropathy and serositis which are frequent in male the difference was not significant. The overall survival rate at 5 years 93% is and it was nearly the same in woman SLE patients. CONCLUSION: SLE in male is rare. In SLE male patients vascular thrombosis and nephropathy are more frequent without survival's influence.