Abstract
Studies have demonstrated that male systemic lupus erythematosus (SLE) patients present with atypical manifestations, serious kidney involvement and worse prognosis. This article summarizes the findings obtained from the literature review of 16 studies to obtain an understanding of the gender correlation with SLE and lupus nephritis. We compared the influence of gender on various factors of SLE like incidence of lupus nephritis, age at manifestation of SLE, time between SLE manifestation and lupus nephritis diagnosis, frequency of dialysis, mortality risk and biopsy findings. Studies included in our review composed of remote published work, case-control studies, case reports and cross-sectional studies. Of 16 studies, 14 were conducted exclusively on lupus nephritis in SLE with comparison of gender correlation and remaining 2 studied SLE generally without any gender comparison. Six studies pointed to an increase in incidence of lupus nephritis in males, 9 studies demonstrated no disparity in gender, and one study showed contradicting results. In addition, 4 studies pointed that males had a more severe renal outcome as revealed by laboratory tests. Interestingly the age at which SLE manifests was the same in both genders according to 2 studies. Moreover, the frequency of dialysis and remission were similar between both genders. There is no consensus if these atypical manifestations are more common in males. Although some studies do show a significant increase in lupus nephritis among male SLE patients, others showed no difference or contradicting results. Hence, we suggest further studies comparing the disease manifestations.
Highlights
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder with a circulation of autoantibodies and deposition of immune complexes in various organs and systems
Shaukat et al progression and long-term prognosis in males is disputed in the literature
The main gain of this literature review is to distinguish a difference in respect to clinical presentation, morphological class with activity index, and renal outcome prognosis in male patients with lupus nephritis
Summary
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder with a circulation of autoantibodies and deposition of immune complexes in various organs and systems. The disease etiology remains unknown, numerous risk factors are associated with the onset and progression of SLE, such as ethnicity, age and gender (1). One of the most important poor prognostic factor associated with an increased rate of mortality is the development of lupus nephritis. Time from the disease onset and establishing a clinical diagnosis of lupus nephritis was described to be more prolonged in males due to overlooking of SLE symptoms (3). Morphological presentation and its progression to the end stage of renal disease among male patients was described as more severe rather than female counterparts (2-5). Opinions of the male gender as a risk factor for lupus nephritis varies. The onset of lupus nephritis, and Shaukat et al progression and long-term prognosis in males is disputed in the literature
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