Lupus in Men

November 5, 2006 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. AUDIENCE INQUIRY For information on lupus: American College of Rheumatology, http://www.rheumatology.org Lupus Foundation of America, http://www.lupus.org Lupus Research Institute, http://www.lupusresearchinstitute.org National Institute of Arthritis and Musculoskeletal and Skin Diseases, http://www.niams.nih.gov BIBLIOGRAPHY "About Lupus," New York: Lupus Research Institute, downloaded from website (http://www.lupusresearchinstitute.org), October 5, 2006. Boeckler, P., et al., "The Combination of Complementary Deficiency and Cigarette Smoking as Risk Factor for Cutaneous Lupus Erythematosus," British Journal of Dermatology, February 2005, Vol. 152, No. 2, pp. 265-270. "Frequently Asked Questions About Lupus," Washington, DC: Lupus Foundation of America, downloaded from website (http://www.lupus.org), October 5, 2006. 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