ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2622

Systemic LUPUS Erythematosus in Spanish Males

Anne Riveros-Frutos1, Irma Casas2, Iñigo Rúa-Figueroa3, José Maria Pego-Reigosa4, M. Jesús García de Yebenes5, Alejandro Olivé6, Jose Rosas7, Paloma Vela8, Monica Ibanez Barcelo9, Vicente Torrente10, Ivan Castellvi11, Javier Narváez12, Mireia Moreno13, R. Blanco Alonso14, Víctor Martínez Taboada15, Jaime Calvo-Alen16, Mª Angeles Aguirre17, Mercedes Freire18, Enrique Raya19, Celia Erausquin20, Esther Uriarte21, Elvira Díez Álvarez22, Tomás Vázquez Rodríguez23, Antonio Fernández Nebro24, Eva Tomero25, Paloma García de la Peña26, Ana Sánchez Atrio27, Monica Fernández de Castro28, Antonio Zea29, Patricia Richi30, Francisco Lopez Longo31, María Galindo-Izquierdo32, Patricia Carreira33, Gema Bonilla34, Carlos Marras Fernández Cid35, Maria Loreto Horcada36, Carlos Montilla37, Blanca Hernández-Cruz38, José Marenco de la Fuente39, Marian Gantes40, Olaia Fernández Berrizbeitia41, Juan J. Alegre42, Ángela Pecondón Español43, Manuel Rodríguez-Gómez44, Victor Quevedo45, José Hernández Beiraín46 and Lucía Silva Fernández47, 1Rheumatology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain, 2Preventive Medicine, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain, 3Rheumatology, Hospital Doctor Negrin, Las Palmas de Gran Canaria, Spain, 4Rheumatology, Hospital Meixoeiro, Vigo, Spain, 5Rheumatology, Research Unit of the SER, Madrid, Spain, 6Rheumatology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain, 7Rheumatology, Hospital Marina Baixa. Villajoyosa, Villajoyosa, Spain, 8Rheumatology, Hospital General de Alicante. Spain, Alicante, Spain, 9H. Son Llatzer, Palma de Mallorca, Spain, 10Rheumatology, Hospital Moisès Broggi, Barcelona, Spain, 11Unitat de Reumatologia., Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, 12Rheumatology, Hospital Universitario de Bellvitge. Barcelona. Spain, Barcelona, Spain, 13Rheumatology, Hospital Parc Taulí, Sabadell, Spain, 14Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Spain, 15Rheumatology, Marqués de Valdecilla, Santander, Spain, 16Rheumatology, Hospital de Sierrallana. Torrelavega. Spain, Torrelavega, Spain, 17Rheumatology, IMIBIC-Reina Sofia Hospital, Cordoba, Spain, 18Rheumatology, Hospital Universitario Juan Canalejo, La Coruña, Spain, 19Rheumatology, University Hospital San Cecilio, Granada, Spain, 20Rheumatology, Hospital Dr, Negrín, Las Palmas Gran Canarias, Spain, 21Rheumatology, Hospital de Donosti, San Sebastian, Spain, 22Rheumatology, Hospital de León. Spain, León, Spain, 23Rheumatology, Hospital Lucus Augusti, Lugo, Spain, 24Rheumatology, Hospital Carlos Haya. Malaga, Malaga, Spain, 25Rheumatology, Hospital Universitario de La Princesa. IIS La Princesa, Madrid, Spain, 26Rheumatology, Hospital Norte Sanchinarro, Madrid, Spain, 27Hospital Príncipe de Asturias, Immune System Diseases/Rheumatology department, Alcalá de Henares, Madrid, Spain, 28Hospital Puerta del Hierro, Madrid, Spain, 29Rheumatology, Hospital Universitario Ramon y Cajal, Madrid, Spain, 30Hospital Infanta Sofía, Madrid, Spain, 31Rheumatology, Hospital Gregorio Marañón, Madrid, Spain, 32Rheumatology, Hospital 12 de octubre, Madrid, Spain, 33Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain, 34Rheumatology, Hospital La Paz, Madrid, Spain, 35Hospital Virgen de la Arrixaca, Murcia, Spain, 36Rheumatology, Complejo Hospitalario de Navarra, Pamplona, Spain, 37Rheumatology, Hospital Clínico Universitario de Salamanca, Salamanca, Spain, 38Rheumatology, University Hospital Virgen Macarena, Sevilla, Spain, 39Rheumatology, Hospital de Valme, Sevilla, Spain, 40Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain, 41Rheumatology, Hospital de Basurto, Bilbao, Spain, 42Rheumatology, Hospital Universitario Dr Peset, Valencia, Spain, 43Rheumatology, Hospital Miguel Servet, Zaragoza, Spain, 44Rheumatology, Complejo Hospitalario Universitario de Ourense, Ourense, Spain, 45Rheumatology, Hospital de Monforte, Lugo, Spain, 46Rheumatology, Hospital Insular de Gran Canaria, Las palmas Gran Canarias, Spain, 47Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment: Epidemiology, Women's Health, Cardiovascular and CNS

Session Type: Abstract Submissions (ACR)

Background/Purpose: To describe the demographic, clinical and immunological manifestations in male patients with Systemic Lupus Erythematosus(SLE)

Methods: Patients diagnosed of SLE that were in the RELESSER data base (National Registry of Patients with Systemic Lupus Erythematosus of the Spanish Society of Rheumatology) were included. This is a multicenter retrospective cross-sectional study. We analyzed 3658 patients with SLE. All met the ACR criteria. Socio- demographic variables, comorbidities, classification, clinical and immunological manifestations were evaluated. Pearson´s chi–square test, t-Student, ANOVA and multivariate logistic regression analysis were performed

Results: A total of 3658 patients were included: 353 men (9.7%) and 3298 women (90.2%), with an average onset of symptoms of 37 ± 17 and 32 ± 14 years of age respectively. In 7(0.1%) the gender was unknown. The male/female ratio was 9/1.The age of onset of symptoms and age at diagnosis was higher in men than in women (P<0.0001). Diagnosis in males was sooner than in females (P=0.04).The most common age range at diagnosis in both genders was 21-49 years(P<0.0001).Table 1 Clinical manifestations

MISSING N

MALE(N:353)
N(%)

WOMEN(N:3298)
N(%)

VALUE OF P

Systemic Manifestations

Weight loss

68

48 (13,7%)

309 (9,5%)

0,01

Lymphadenopathy

74

49 (14%)

320 (9,9%)

0,02

Splenomegaly

108

19 (5,5%)

99 (3,1%)

0,02

Cutaneous manifestations

Exanthema

62

190 (54,3%)

2180 (67,1%)

<0,0001

Alopecia

86

54 (15,8%)

1229 (38%)

<0,0001

Osteoarticular manifestations

Erosive arthritis

60

20 (5,8%)

342 (10,5%)

0,01

Avascular bone necrosis

67

30 (8,5%)

121 (3,7%)

<0,0001

Fibromyalgia

94

1 (0,3%)

223 (6,9%)

<0,0001

Pulmonary Manifestations

Pleural fibrosis

43

8 (2,3%)

25 (0,8%)

<0,0001

Pulmonary thromboembolism

33

18 (5,1%)

86 (2,6%)

0,01

Cardiovascular manifestations

Libman Sachs endocarditis

103

7 (2%)

28 (0,9%)

0,04

Angina or coronary bypass

52

19 (5,4%)

50 (1,5%)

<0,0001

Acute myocardial infarction

61

24 (6,9%)

47 (1,4)

<0,0001

Cardiomyopathy

79

20 (5,8%)

84 (2,6%)

<0,0001

Pericarditis

52

15 (4,3%)

59 (1,8%)

<0,0001

Peripheral vascular manifestations

Claudication for more than 6 months

45

8 (2,3%)

23 (0,7%)

<0,0001

Deep vein thrombosis

50

24 (6,9%)

119 (3,7%)

<0,0001

Raynaud

142

80 (23,7%)

1114 (35%)

<0,0001

Renal manifestations

Lupus nephritis

89

156 (44,8%)

933 (29%)

<0,0001

HTA in the first outbreak

182

68 (20,1%)

330 (10,5%)

<0,0001

Hematuria

247

130 (38,70%)

908 (29,5%)

<0,0001

Creatinine clearance = 50 irreversible

112

31 (9%)

161 (5%)

<0,0001

Proteinuria = 3,5g/24hs

126

21 (6,1%)

114 (3,6%)

0,02

Terminal renal insufficiency

146

16 (4,7%)

82 (2,6%)

0,03

Neuro psychiatric manifestations

Lupus headache

89

10 (2,9%)

204 (6,3%)

<0,0001

Seizures

76

32 (9,2%)

156 (4,8%)

<0,0001

Depression

89

36 (10,3%)

574 (17,8%)

<0,0001

Immunology

Ac anti DNA positive

99

271 (78,6%)

2342 (72,9%)

0,02

AC anti RO positive

96

94 (27,5%)

1300 (40,8%)

<0,0001

Positive lupus anticoagulant

1007

86 (34,11%)

547 (22,8%)

<0,0001

Women had more frequently a history of autoimmune thyroid disease (P<0.001). Males have more cardiovascular comorbidities (P<0.001).Comparing comorbidities in men with SLE by age range, it was found that SLE patients over 50 years of age had more comorbidity with p<0.05. A total of 68%(236) of males with SLE required hospitalization in comparison with 53%(1713) female (P< 0.001). During follow-up 208 patients died, 30(9.3%) were male and 178(5.9%) women (P=0.02).On multivariate analysis, the only statistically significant variable was age. It was seen that patients over 50 year-old had a higher mortality than those under 50 year-old, regardless of gender, delay in diagnosis, risk factors and clinical features OR: 5.32 (CI: 3.61 to 7.84)P<0.001

Conclusion: Patients with SLE older than 50 years old are at increased risk of mortality. In male patients with SLE: the age at diagnosis and the onset of symptoms is higher than in women. The diagnostic delay is lower in men than in women. Men have more cardiovascular comorbidities, especially those over 50 years-old and also more serositis, renal and cardiovascular involvement than women

Disclosure:

A. Riveros-Frutos,
None;

I. Casas,
None;

I. Rúa-Figueroa,
None;

J. M. Pego-Reigosa,
None;

M. J. García de Yebenes,
None;

A. Olivé,
None;

J. Rosas,
None;

P. Vela,
None;

M. Ibanez Barcelo,
None;

V. Torrente,
None;

I. Castellvi,
None;

J. Narváez,
None;

M. Moreno,
None;

R. Blanco Alonso,
None;

V. Martínez Taboada,
None;

J. Calvo-Alen,
None;

M. A. Aguirre,
None;

M. Freire,
None;

E. Raya,
None;

C. Erausquin,
None;

E. Uriarte,
None;

E. Díez Álvarez,
None;

T. Vázquez Rodríguez,
None;

A. Fernández Nebro,
None;

E. Tomero,
None;

P. García de la Peña,
None;

A. Sánchez Atrio,
None;

M. Fernández de Castro,
None;

A. Zea,
None;

P. Richi,
None;

F. Lopez Longo,
None;

M. Galindo-Izquierdo,
None;

P. Carreira,
None;

G. Bonilla,
None;

C. Marras Fernández Cid,
None;

M. L. Horcada,
None;

C. Montilla,
None;

B. Hernández-Cruz,
None;

J. Marenco de la Fuente,
None;

M. Gantes,
None;

O. Fernández Berrizbeitia,
None;

J. J. Alegre,
None;

Pecondón Español,
None;

M. Rodríguez-Gómez,
None;

V. Quevedo,
None;

J. Hernández Beiraín,
None;

L. Silva Fernández,
None.

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