Men Get Lupus Too
There is a misconception that men don’t get system lupus erythematosus, a so-called “Women’s Disease” because lupus occurs 10-12 times more frequently in adult females than adult males. However, lupus can occur in any sex at any age. Some related forms of lupus such as discoid lupus, lupus confined to the skin and drug induced lupus are more frequent in males. Men develop drug induced lupus more often than women, because many of the heart medications produce drug-induced lupus. These drugs are used more frequently in men since more males than females suffer heart attacks.
When men do get lupus, their treatment may be affected by a physician’s relatively limited experience in treating men with lupus. Little is known about the disease when it attacks men. In fact, to date, the majority of the studies published about lupus have contained relatively few men, as little as 4% males, thus meaningful conclusions about the disease in men have not been made.
At present, most physicians believe that the disease is similar in males and females. At least all the manifestations of systemic lupus erythematosus that can be seen in women are also seen in men. However, some more recent studies have published the disturbing news that the disease may be even more serious when it affects males. Several investigators show that the mortality for males with lupus may even be higher. Whether or not this is related to the growing evidence that lupus seems to occur at an older age in males than females remains to be definitively evaluated. There are many questions as yet to be answered about the lupus disease progression in males.
As Chief of Rheumatology, at Long Beach Veterans Administration Medical Center, I have been researching the gender differences in autoimmune disease expression for over 20 years, since first publishing the difference in immune response between males and females in an experimental animal model of lupus. Clinical observations and anecdotal reports of the features of male systemic lupus erythematosus in the predominantly male Veterans Administration population over the years have suggested that this is an ideal population to study. The high male to female ratio would favor a preponderance of male patients in any lupus study. In the collaboration with Azadeh Mohyi, M.D., staff physician in Adolescent Rheumatology at Children’s Hospital of Orange County and Stuart Gilman, M.D., at the Long Beach Veterans Administration Medical Center and with access to the information contained in the National Veterans Administration Data Registry, I hope that a study can finally be done with a sufficient number of male systemic lupus erythematosus patients as well as female patients to make important deduction about the disease.