Characteristics Of Clinical And Immunological Manifestations In Male Patients With Systemic Lupus Erythematosus

Objective:To explore the clinical characteristics and immunological manifestations in male patients with systemic lupus erythematosus(SLE).Methods:Male SLE patients admitted to the Affiliated Hospital of Qingdao University from January 2001 to July 2016 were collected in our study.A total of 182 patients were included in the standard.The general history of the patients,the name,hospital number,age,the first age of onset,the number of days of hospitalization,the history of smoking and drinking,family history(whether there is connective tissue disease in the family);the first and the clinical manifestations: Fever,mouth ulcers,joint pain,skin damage,hair loss,kidney damage,mental system damage,digestive system symptoms,blood system damage,serositis,myositis,vasculitis,Renault phenomenon.To improve the detection of clinical indicators,including blood routine,urine routine,24-hour urine protein quantitative determination,liver function,renal function,electrolytes,blood lipids,C-reactive protein(CRP),erythrocyte sedimentation rate,thyroid function,coagulation function,immunological indicators(Ig A,Ig G,Ig M,complement C3,complement C4,anti-double-stranded DNA antibody(anti-ds-DNA),antinuclear antibody(ANA),immunofluorescence assay(immuno-turbidimetric method)Anti-SSA antibody(SSA),anti-Sm antibody(SSB),anti-ribosomal P protein antibody(ARPA / Rib-P),anti-mitochondrial antibody(AMA M2),anti-U1 Rnp antibody(U1Rnp)Anti-neutrophil antibody(ANCA),anti-Scl-70 antibody(Scl-70),anti-proliferating cell nuclear antigen antibody(PCNA),anti-PM-Scl antibody(PM-Scl),anti-nucleosome antibody(Anu A),Anti-histone antibody(AHA),anti-JO-1 antibody(JO-1),anticardiolipin antibody(ACL),etc.} Auxiliary examination: electrocardiogram,abdominal abdomen ultrasound,chest radiograph,chest CT or MRI,The subjects were divided into youth group(14 ~ 35 years old),middle age group(36 years old to 59 years old),elderly group(? 60 years old);according to the age of the study group(LN group)and non-lupus nephritis lupus group(non-LN group).Statistical analysis was performed on the age,onset symptoms,clinical manifestations,immunological characteristics,misdiagnosis and so on.Quantitative data were expressed as x ±s,and qualitative data were expressed as frequency(percentage).Comparison between groups using t test or chi-square test.P<0.05 as the difference was statistically significant.Results: A totle of 182 male SLE patients were collected,and the average age was(38.3±17.5)years old.They were divided into three groups: 93 cases of young group(?35years old),64 cases of middle-aged group(36 ~ 59 years old),25 cases of elderly group(?60 years old).The onset age of SLE was(35.8 ± 17.0)years old,and the age at diagnosis was(37.9 ± 17.5)years old.The rate of misdiagnosis is as high as 57.7% at preliminary diagnosis.The most common clinical symptoms of male SLE patients were blood system damage(86.8%),kidney damage(63.2%),serositis(50.0%).Skin lesions(29.1%),fever(28.0%),joint pain(24.2%)were commonly seen as initial symptoms,(36.6%)was the most common symptom in the young group,while the elderly group had the most common symptoms of joint pain(32.0%),and the diagnosis of male LN patients was the most common symptom in the patients with different age groups.(2.5 ± 4.8)years old,and the difference was statistically significant(t = 5.456,P <0.01).The positive rate of ANA(75.8%),anti SSA(49.7%),anti-ds DNA(46.7%)were high in male SLE patients.Compared with patients with other age groups,elderly group of male SLE had lower occurrence of majority of auto-antibody,especially in terms of anti-ds DNA(?2=11.639,P<0.01)and nucleosome antibody(?2=10.541,P<0.01).However,the occurrence of Ro52 antibody in elderly group was higher(?2=9.353,P <0.01),the positive rate of anti-ribonucleoprotein antibody in LN group and non-LN group was significantly different(?2= 4.477,P <0.05).There was no significant difference in the distribution of other autoantibodies between the two groups(P> 0.05).Conclusions: The morbidity Male SLE is relatively low,with high rate of misdiagnosis.The clinical manifestations and auto-antibodies distribution of the several age groups are different,The anti-UARnp antibody positive in male LN patients was significantly higher than that in non-LN patients,but there was no significant difference between ANA,anti-SSA antibody and anti-ds-DNA antibody in male SLE patients,Male SLE patients more likely to involve the blood system and kidney,and the damage is heavier;should be alert to young male patients with infectious fever and elderly patients with joint pain,which should be considered in the clinical.