Men with Lupus

(1/2) > >>


Men with Lupus

     It is a mistake to think of SLE as exclusively a womens health concern.

(The following are excerpts taken from the complete article entitled Lupus in Men by Elizabeth A. Mewshaw, RN, MSN, and William R. Gilliland, M.D.)

--"Most people think of SLE as a disease of women of childbearing age and with good reason: 90 percent of lupus patients between the ages of 15 and 45 are women. However, after the age of 50 (approximately the age of the onset of menopause) the percentage of women with lupus falls to 75 percent and the percentage of men with the disease rises to 25 percent. Therefore it is a mistake to think of SLE as exclusively a womens health concern.

Role of Sex Hormones:

      The role of sex hormones in the development and clinical _expression of SLE is complex. For instance, flares in women may be influenced by their hormonal status; one example is that pregnancy can trigger a flare.

      Simply put, two broad types of sex hormones exist. Estrogens are typically considered the "female hormones," and androgens are considered to be the "male hormones." Both types are produced in both sexes. However, estrogen in addition to their role in the development of the secondary sex characteristics (i.e., facial hair in males or breast development in females) may encourage autoimmune disorders, while androgens may be protective instead.

      Some studies have noted lower levels of a specific androgen, testosterone, in some men with SLE. Men with lupus, however, are in no way less masculine than men without lupus, and sexual activity, potency, and fertility in men with SLE does not differ from men without lupus."

--"A recent study by Dr. Michelle Petri from Johns Hopkins University tried to address the differences I men and women lupus patients by comparing the clinical and laboratory features of a group of 41 males and 545 females. She found that men had an increased frequency of seizures, immune-mediated anemia, and lupus anticoagulant (which may lead to clotting problems), but a lower frequency of Sjogrens disease. Her conclusion, suggesting that men may have more severe disease than women, was presented at the recent national meeting of the American College of Rheumatology."

The above excerpts were from the complete medical article entitled "Lupus In Men" by Elizabeth A. Mewshaw, RN, MSN, and William R. Gilliland, MD. This originally appeared in Lupus News, a publication of the Lupus Foundation of America. The complete medical article may be ordered through the BALF medical article library, article #42

[/size] [/color]


LUPUS and Men
Although systemic lupus erythematosus (SLE orlupus for short) is about ten times more common in women than it is in men, it is important not to forget the men with lupus and the effects of the disease ontheir health and life.
In particular, the development of a chronic disease may necessitate life style changes which can alter their traditional role within the family.

Hormonal influences on lupus
The role of sex hormones in lupus is suggested byobservations showing that about ten times as many women as men have lupus. The evidence suggeststhat hormones can exert an important influence onthe immune system and, in particular, that the femalehormone oestrogen can affect the development of lupus.

Some studies have suggested that there aredifferences in the way that sex hormones arechemically changed in lupus patients. Males andfemales with lupus have increased amounts of 16-hydroxylated oestrogens, and female, but not male,lupus patients have increased oestriol.

The 16-hydroxylated compounds are the ones which caninteract with cells of the immune system and whichmay be important in lupus. Levels of these compounds can be increased by talking the oralcontraceptive pills containing oestrogen.
These contraceptive pills have been reported to trigger thestart of lupus or to cause it to have greater impact onsome female patients.

Some studies have suggested that levels oftestosterone, one of the male hormones orandrogens, are reduced in males with lupus but theseobservations have not been supported in the majority of studies.

However, there is a difference in the way that the male hormone androgen is metabolised (processed) between the sexes.
 There is a suggestion that women with lupus metaboliseandrogens at a faster rate than those without lupus and, consequently, have lower levels of certainandrogens. Androgens have been shown to have some immunosuppressive properties.

Recently,studies have been started in which androgens are being tested as a treatment for lupus in women, butthe potential value of such treatment for males withnormal androgen levels is unclear. For the few menwith low androgen levels they may be of benefit, and would reduce the risks of osteoporosis, even if they are not effective at suppressing lupus disease.

Clinical disease in men
Although lupus is uncommon in males, it does notdiffer clinically in major ways from the presentation oflupus in females. Some have suggested that lupus ismore severe in males but most studies have notfound this to be so. The difference may be explained by a delay in diagnosing or treating lupus in males, as the disease is less often thought of in men, being more common in females, and because men may be more reluctant to seek medical advice than women.

The aspects of lupus which have been reported to be increased in males in some studies include skin rashes, pleurisy,neurological disease affecting the nerves in the arms and legs(peripheral neuropathy), kidney disease, vasculitis and Raynaud’s phenomenon.
Impotence has been reported in some patients with abnormal hormones,particularly low androgen levels.
More men develop drug-induced lupus than women mainly becausemedications that produce drug induced lupus aremore frequently used in men. These drugs includehydralazine and procainaimide, and may reflect more heart disease in men than women.

However, in recent studies it has been shown that it is women with lupus, particularly those in their forties, who are at increased risk of heart attack and stroke compared with women without lupus of the same age andwhether men with lupus are at greater risk of these conditions than men without lupus of the same age is not yet clear.

Lifestyle considerations
Men may react differently from women when the diagnosis of lupus is given. This may be because ofthe misconception that lupus is a woman’s disease giving rise to the idea that a man with lupus Is lessmasculine than his colleagues without lupus. This isnot true. As discussed above, most men with lupus,as far as sex hormones and sexual function areconcerned, are no different from males without lupus.

Men with lupus are usually sexually active, potent and have normal reproductive histories. There may besome interruption in this when the disease is veryactive or with the use of certain drugs, especially cyclophosphamide which can affect fertility

Many of the day to day stresses in life are equalemotionally for men and women with lupus. However,in some ways it may be more difficult for men to cope with having lupus because of the pressures createdby what they think their family, friends and society expect of them. They may not be able to work or follow hobbies in the environment previously expected of them (eg in the cold due to Raynaud’sphenomenon).

There may be difficulties in performing activities that require physical strength or prolonged periods of physical labor and a change of role in the work place may be necessary but not available.
Historically it has been the male who is the provider for the family. If a man with lupus has to stop workingor change job this may result in significant financialand emotional stress. However, this is by no means necessary in most men (or women) with lupus.
With earlier diagnosis and better treatment, many patientscan remain in work, although some will have to change job, modify duties, or reduce the hours

Lupus in Men

Lupus erythematosus is an autoimmune disease that can affect many areas of the body. It occurs when, for unknown reasons, the body attacks its own tissues. The condition can affect the skin, joints, kidneys, lungs, heart, blood vessels and brain. Symptoms vary IN severity and may include swollen joints/joint pain, fever, fatigue, muscle pain, hair loss, sensitivity to light, red butterfly-shaped facial rash, chest pain, problems with blood clotting, anemia, seizures, mouth ulcers and swollen glands.

There are three main types of lupus. IN discoid LUPUS erythematosus (DLE), symptoms are limited to the skin. A rash appears on the face, neck and scalp. Patients may develop crusty skin plaques that develop into scars. Some people also experience patches of hair loss on the scalp.

About 10 percent of patients with DLE develop the second form of lupus, called systemic LUPUS erythematosus (SLE). SLE is a more severe, chronic form of the disease and can affect one or more organs of the body. It accounts for about 70 percent of all cases of lupus. No two patients develop the same symptoms or follow the same course. Patients can experience periods of improvement and sudden, increased disease activity (called flares). IN most cases, people who use the term “lupus” are referring to SLE.

Drug-induced lupus occurs after taking certain medications. Researchers have found a definite link between onset of LUPUS and use of chloropromazine, hydralazine, isoniazid, methyldopa and procainamide. Patients develop many of the same symptoms seen with SLE. The condition occurs IN fewer than four percent of those taking these drugs and symptoms usually fade when the medicine is discontinued.

According to the LUPUS Foundation of America, up to 1.5 million Americans have lupus. Another 16,000 are diagnosed each year. The condition is ten times more common IN women than IN men. Women are also five times more likely to die of LUPUS than men. Most patients are between 15 and 44 at the time of diagnosis. There may be some genetic component to the disease. About five percent of children of women with LUPUS will also develop the disease.

Lupus IN Men
Lupus is largely considered a disease of women – 90 percent of cases are diagnosed IN females. However, males of all ages can be affected. Before puberty, the LUPUS Foundation estimates the male to female ratio for LUPUS diagnosis is one to three. During adulthood, the ratio jumps to one male for every ten females. After 50, the ratio increases slightly – with one man affected for every 8 women.

Men with LUPUS usually have the same symptoms as women with the disease. However, since LUPUS is mainly considered a disease of women, it may be more difficult for a man to get a proper diagnosis. Susan Manzi, M.D., M.P.H., a Rheumatologist with the University of Pittsburgh Medical Center, says LUPUS symptoms also mimic other conditions. So it may take years for a man to be correctly diagnosed.

Treatment for LUPUS is similar for MEN and women. Non-steroidal anti-inflammatory medications may help reduce muscle and joint pain. Arthritis and skin problems may respond to antimalarial drugs, like hydroxycholorquine. Patients with major organ problems may need corticosteroids or immune suppressing drugs (like those used for some transplant patients).

Manzi says there are several new medications being tested for lupus. A new blood test has also been developed that may help IN faster, accurate diagnosis. IN the future, researchers would like to see a cure for LUPUS or a vaccine to prevent the disease.

Men With Systemic Lupus Erythematosus Fare Worse Than Women, Study Confirms

WASHINGTON, DC -- November 16, 2006 -- Male gender is a strong predictor of target organ damage in systemic lupus erythematosus (SLE) early in the course of disease, according to a study reported here at the American College of Rheumatology - Association of Rheumatology Health Professionals Annual Scientific Meeting (ACR-ARHP).

"Men with SLE should be treated more aggressively, earlier in their disease," asserted Rosa M. Andrade, MD, research post-doctoral fellow, University of Alabama, Birmingham, Alabama, in a presentation on November 12th.

Men are believed to suffer more renal, neurological, and cardiovascular involvement than do women but no clinical studies have confirmed or denied this belief. Dr. Andrade and colleagues therefore set out to determine the whether gender plays any role in severity of SLE. The investigators believed their institution was an excellent site to study SLE longitudinally because it has a multiethnic patient population. They studied the cohort for 10 years.

The study enrolled patients with SLE 16 years and older and had disease duration no greater than 5 years at enrollment. The cohort consisted of Hispanics, African Americans and Caucasians. Socioeconomic-demographic, clinical and serological manifestations as well as disease activity (SLAM-R) and damage accrual (SLICC damage index or SDI) were compared between male and female patient groups.

Sixty-three male SLE patients (10.2%) from all ethnic groups were included. Mean ages for male and female patients were comparable.

Caucasians, smokers, alcohol drinkers, presence of positive lupus anticoagulant (LAC) and renal involvement were more frequent among male patients, whereas musculoskeletal involvement was less common. Time to accrual of ACR criteria and disease duration were shorter in male patients; damage was more common and of higher magnitude in men.

Positive LAC, shorter disease duration and higher early damage were independently associated with male SLE. Male gender was a strong predictor of damage, early in the course of disease.
Dr. Andrade concluded that, though men and women with SLE appeared similar in their clinical profiles, men accrued ACR criteria for SLE 17 months earlier than women and entered the cohort with greater baseline organ damage.

"Men require higher doses of prednisone and generally do worse than women, not specifically in any particular organ system but overall," Dr. Andrade stated.


LANGDON Green's office is set under his family's Indooroopilly home in a charmingly scruffy garden surrounded by trees and trailing plants.

At the age of 25, Langdon is a bit of a medical anomaly.
When he was 11 he was diagnosed with lupus, a chronic, inflammatory, auto immune disease.

Lupus has been dubbed the "women's disease" and it's relatively rare for it to manifest itself in a male.

The incidence in Queensland is put at one in 2000, which means about 2000 people in Queensland could have it – and the gender ratio is one male for every six females.

Langdon's mum Barbara first became concerned when her son started getting heavy nosebleeds, overwhelming fatigue and a rash on his cheeks.

Lupus – systemic lupus erythematosus – is a difficult disease to diagnose and symptoms include a butterfly rash across the cheeks, a skin reaction to sunlight and kidney problems caused by excess protein or cells in the urine.

Lupus is Latin for wolf and the red butterfly rash, that has become synonymous with the illness but only occurs in 40 per cent of cases, gives the patient a wolf-like appearance.

As a sporty pre-teen, Langdon's diagnosis in his final year of primary school meant a three-month stint in hospital, innumerable tests and an opportunity to hone his then budding computer skills – skills he now puts to use running his company Ideal Computer Solutions and playing complicated computer games with his friends.

It's the sport side of things he misses the most.

"I probably would be sportier than I am now," he said with a grin.

"Although I'm not sure if it's because I can't do it or if I just got out of the habit of it."

Langdon's lupus affects his kidneys, which makes it a more severe branch of the illness, and it is controlled using a finely honed drug regime.

He has also had several other symptoms, including sun sensitivity, which causes blistering of the skin after even mild exposure.

A genetically-based autoimmune disease, a lupus attack is triggered by an external factor, often by drugs used to treat other problems such as hypertension.

The defining factor for a lupus diagnosis is the presence in the body of a specific auto-antibody – antibodies against the DNA in the cell's nucleus that don't appear in any other disease except lupus.

Rheumatologist John Webb, who specialises in lupus, said the right genetic background coupled with an appropriate trigger could aid the onset of the disease.

"The simplest way of looking at that is that the patient is genetically set up – and you don't know if they are – to develop an abnormal immune response to some event," Dr Webb said.

There is no cure for lupus but it can be effectively treated, depending on its severity, with a variety of drug regimes including corticosteroids and antimalarial drugs.

Dr Webb said that while readily managed, lupus could go on to cause pleurisy, several types of pneumonia, inflammation of the lining of the heart and lungs and kidney problems.

It can also affect the brain, cause meningitis, stroke and nerve palsies.

For Langdon, the disease has steered him towards a quieter, more contemplative life than he would otherwise have had but when it comes to beating his friends on the computer he's certainly ferocious and hungry – like a wolf.

Maler rash: rash over the cheeks
Discoid rash: scaly red or raised rash
Photosensitivity: reaction to sunlight – skin rashes that develop or become worse on exposure to sunlight
Ulcers: nose or mouth ulcers
Arthritis: inflammation of two or more joints but the inflammation does not damage the joint
Serositis: inflammation of the lining of the heart or lungs
Renal disorder: excess protein or cells in the urine
Neurological disorder: seizures and/or abnormal behaviour when there are no other likely causes
Haematological disorder: lower numbers of red or white blood cells or blood platelets (these disorders are known as anaemia, leukopenia and thrombocytopenia, respectively)
Immunological disorder: testing positive in laboratory tests for one or more antibodies that are distinctive of lupus
Anti-nuclear antibody: testing positive for a protein known as the anti-nuclear antibody, a protein indicative of lupus


[0] Message Index

[#] Next page

© Page Contents, Layout, Graphics and Design All Copyrighted by Credited Artists and are Not Public Domain.

LupusMCTD Founder & Patient
Former Domestic Violence SURVIVOR
Kathy A. Patterson

Author of the Upcoming Memoir Book:
"Fighting From The Inside Out"..
A lupus patient fights the beast within her immune system and the beast at home....

e-Booklet filled with photos and videos of what abuse was, signs to look for,
where to turn to for help, and much more to help others like me...

For more information
Call the National Domestic Violence Hotline at 1−800−799−SAFE(7233)

"The Meaning of the Words in the Second Amendment .... "That the people have a right to freedom of speech, and of writing, and publishing their sentiments;"

PRIVACY NOTICE: Warning--any person and/or institution and/or Agent and/or Agency of any governmental structure including but not limited to the United States Federal Government also using or monitoring/using this website or any of its associated websites, you do NOT have my permission to utilize any of my profile information nor any of the content contained herein including, but not limited to my photos, and/ or the comments made about my photo's or any other "picture" art posted on my profile. You are hereby notified that you are strictly prohibited from disclosing, copying, distributing, disseminating, or taking any other action against me with regard to this profile and the contents herein. The foregoing prohibitions also apply to your employee(s), agent(s), student(s) or any personnel under your direction or control. The contents of this profile are private and legally privileged and confidential information, and the violation of my personal privacy is punishable by law
© 2008 LupusMCTD Foundation of America - All Rights Reserved
Est.November 11, 2005
"We Understand What You Are Going Through"™