LUPUS-NEPHRITIS IN MALES - 8-YEAR EXPERIENCE AT SIRIRAJ-HOSPITAL

During 1984 to 1991, 54 out of 569 lupus nephritis patients at Siriraj Hospital were male (F:M sex ratio = 10:1). Mean age of the males was 29.8 +/- 14.6 years, range 12 to 69. The three most common extrarenal manifestations were anemia, cutaneous, and musculoskeletal involvement (74.5, 51.1, and 43.9%, respectively). The major renal manifestations were edema (75.9%) with heavy proteinuria over 3.5 g/day in 62.2% end nephrotic/nephritic findings in 51.9% of cases. Hypertension was foun d in 35.2%. Mean serum creatinine was 2.0 +/- 1.4 mg/dl while 60.5% of cases had creatinine clearance below 50 ml/minute. Mean serum albumin was 2.6 +/- 0.8 g/dl, cholesterol 262.8 +/- 129.5 and triglycerides 3 43.2 +/- 244.6 mg/dl. Interestingly, hypercholesterolemia (>250 mg/dl) was found only in 44.8% of cases with nephrotic syndrome. Antinuclear antibody was demonstrated in 91.5%, anti-dDNA antibody in 64.4% and L E cells in 40.4% of cases. Renal biopsy was done in 45 patients and 30 cases(66.7%) ware classified as diffuse proliferative nephritis (WHO type IV), 15.6% of type II, 6.7% each of type III and V, with the rest of type V plus IV (4.4%). Tubulointerstitial inflammation was found i n 77.3% of cases. During the follow-up period (42 +/- 35.8 months), 6 patients died. The causes of death were uremia in 3, infection in 2, a nd cardiac failure in 1. By life-table analysis, the probabilities of survival for 1 and 5 years were 89.5 and 80.6%, respectively. In compa rison between sexes, except for a higher amount of urinary protein exc retion (4.5 +/- 3.1 vs 3.5 +/- 3.0 g/day, p<0.05), there were no stati stically significant differences in clinical and pathological paramete rs, and probability of survival.