Effect of Gender on Clinical Presentation in SLE
Despite the suggestion by many that men with lupus demonstrate a distinct disease profile and a more aggressive disease course, notably of LN, this has not been consistently found in the literature and has not translated into significant differences in objective indices of disease activity, damage or mortality. While some of the more typical mucocutaneous features of SLE appear to affect females preferentially, the frequency of such manifestations varies widely between studies and still remains the most prevalent of lupus manifestations in men. Moreover, certain lupus features, such as thrombocytopenia and neurological involvement, have been shown by some to be more prevalent and others to be reduced in male lupus sufferers. Too few studies have consistently provided evidence for correction of the effect of notable confounders, such as ethnicity, duration of follow-up, age of onset and comorbidites, or indeed for multiple comparisons that would likely alter the significance of studies with weaker results. It is evident that a clear gender effect on SLE phenotype remains elusive.
Conclusion
Despite the suggestion by many that men with lupus demonstrate a distinct disease profile and a more aggressive disease course, notably of LN, this has not been consistently found in the literature and has not translated into significant differences in objective indices of disease activity, damage or mortality. While some of the more typical mucocutaneous features of SLE appear to affect females preferentially, the frequency of such manifestations varies widely between studies and still remains the most prevalent of lupus manifestations in men. Moreover, certain lupus features, such as thrombocytopenia and neurological involvement, have been shown by some to be more prevalent and others to be reduced in male lupus sufferers. Too few studies have consistently provided evidence for correction of the effect of notable confounders, such as ethnicity, duration of follow-up, age of onset and comorbidites, or indeed for multiple comparisons that would likely alter the significance of studies with weaker results. It is evident that a clear gender effect on SLE phenotype remains elusive.