男性全身性エリテマトーデス17例の臨床像の検討

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  • Clinical features of 17 male patients with systemic lupus erythematosus.

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The very low incidence of male patient in systemic lupus erythematosus (SLE) indicates that genetic factors and sex hormones may be importantly associated with the disease. Seventeen male SLE patients were examined to clarify the difference in clinical features, laboratory findings, and endocrinological data from female SLE. Seventeen female SLE patients matched in age of onset and duration of disease were studied as controls. Photosensitivity (p=0.04), lymphadenopathy, and neurological involvement were more frequent in males, with arthritis and skin rash being seen less frequently. The incidence of renal involvement was same in both sexes, however the nephrotic syndrome was noted more often in males. Leukopenia occurred more commonly in the females (p=0.07). Other laboratory findings revealed no significant difference. All patients except one female received corticosteroid. The mean dose of maximum prednisolone was 90.1mg for males and 44.1mg for females.<br>Sex hormones were measured in 10 male patients. No male patient showed increased estrogen levels. Three male patients who received high dose of prednisolone or immunosuppressive drugs showed decreased plasma testosterone. Elevated plasma FSH was found in 4 patients, and 3 of whom received immunosuppressive drugs. Thus, male SLE would appear severer than female SLE and the abnormality of hormonal status in male SLE was possibly due to the therapeutical agents.

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