Abstract

Introduction: Lupus nephritis (LN) is a renal manifestation of systemic lupus erythematosus (SLE), an autoimmune disease more common in females. Clinicopathological manifestations and outcomes of LN in males are uncertain. Objectives: To assess and compare clinicopathological manifestations and outcomes of males and females with LN. Patients and Methods: Patients with LN were identified from database (male 94, female 344). Clinical manifestations, laboratory data, renal histopathology and outcome were retrieved and compared. Results: Compared to females, males were more likely to present with rapidly progressive glomerulonephritis (RPGN) (21.3% versus 11.6%, P = 0.026) and low-serum complement (76.6% versus 63.7%, P = 0.019). While asymptomatic hematuria and/or proteinuria was the second most common clinical manifestation in females (40%), no males presented with this manifestation. Although LN class IV was most common in both groups, males were more likely to have LN class IV with most severe form of renal manifestation than females (50% versus 38.7%, P = 0.048). Males showed tendency for poorer renal survival, but without statistical significance. Conclusion: Males with LN had more severe clinicopathological manifestations than females. Clinicians should be aware of SLE with LN in males in order to make timely diagnosis and treatment.

Highlights

  • Lupus nephritis (LN) is a renal manifestation of systemic lupus erythematosus (SLE), an autoimmune disease more common in females

  • Our study on 94 males and 344 LN female patients, indicates that LN in males were more severe clinicopathologically than females with males were more likely to present with rapidly progressive glomerulonephritis (RPGN) and LN class IV

  • The patients with diagnosis of SLE according to the Systemic Lupus Collaborating Clinics (SLICC) Criteria for SLE (2012) [8] and biopsy-proven LN were included in the study

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Summary

Introduction

Lupus nephritis (LN) is a renal manifestation of systemic lupus erythematosus (SLE), an autoimmune disease more common in females. Clinicopathological manifestations and outcomes of LN in males are uncertain. Objectives: To assess and compare clinicopathological manifestations and outcomes of males and females with LN. While asymptomatic hematuria and/or proteinuria was the second most common clinical manifestation in females (40%), no males presented with this manifestation. LN class IV was most common in both groups, males were more likely to have LN class IV with most severe form of renal manifestation than females (50% versus 38.7%, P = 0.048). Conclusion: Males with LN had more severe clinicopathological manifestations than females. Lupus nephritis (LN) is a renal manifestation of systemic lupus erythematosus (SLE), a systemic autoimmune disease predominantly occurring in females.

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