Clinical characteristics of males with systemic lupus erythematosus (SLE) in an inception cohort of patients in Ghana

Abstract

BACKGROUND: Systemic Lupus Erythematosus (SLE) is said to be rare in Sub-Saharan Africa and even rarer in males worldwide. SLE is mostly considered a disease of women, though men may also be affected, and this may lead to a delay in diagnosis in men. The result is a greater burden of inflammation and subsequent organ damage over time.

METHOD: Data from the medical records of 13 male patients diagnosed with SLE at the Rheumatology Clinic of Korle- Bu Teaching Hospital between January 2014 and January 2017 was retrospectively analyzed.

RESULTS: A total of 13 male patients out of a total of 134 SLE patients were included in our analysis. The mean age was 30.62 ± SD 8.47 years (range of 17 to 46 years). All of them (100%) presented with constitutional features. The most common ACR criteria observed was 61.5 % rash, 54.5 % oral ulcers, 92.3% arthritis, 61.5 % serositis and 38.5% renal involvement, 46.2 % CNS involvement. Looking at their serological profile, 91.7 % had a positive antinuclear antibody (ANA). 33.3 % had positive anti-dsDNA and 58.3 % extractable nuclear antigens. The mean duration from onset of symptoms to diagnosis was 21.31 months. Five patients were diagnosed with lupus nephritis, all at the time of diagnosis. There were no mortalities.

CONCLUSION: Male SLE patients in Ghana are comparable to other populations, with arthritis and constitutional features being predominant early features and lupus nephritis being the main early indicator of organ damage. This should warrant aggressive management in male patients.