SYSTEMIC LUPUS-ERYTHEMATOSUS - SEX-HORMONES IN MALE-PATIENTS

Systemic lupus erythematosus (SLE) is a rare disease in males. There i s evidence that a functional state of hypoandrogenism is important in the pathogenesis of the disease. We analysed the levels of several hor mones (follicle stimulating hormone (FSH), luteinizing hormone (LH), t estosterone (T), estradiol (E2), free estradiol (FE2) and prolactin (P RL)) in 17 male SLE patients and 17 male healthy controls with similar age distribution. Three lupus patients were excluded from the analysi s due to previous cyclophosphamide therapy or pre-puberty. Thus 14 mal e lupus patients were eligible for the study. Six of the 14 SLE patien ts (43%) showed at least one abnormal level of FSH, LH or T. There wer e no abnormalities in these hormones in the 17 controls. This differen ce was significant (P < 0.01). In five of these 6 male patients (36% o f all lupus patients) the hormonal profile was compatible with a funct ional state of hypoandrogenism (high LH and/or low T). The ratio E2/T (estradiol/testosterone:pmol/nmol) was also significantly higher in th e SLE group (average = 6.5; SD 4.3) when compared with that of the con trol group (average 4.2; SD 1.2; Mann-Whitney rank sum test: P < 0.03) . There were no significant differences in E2, FE2 or PRL between lupu s patients and controls. We did not confirm the notion that left-hande dness is frequent in male lupus as all our patients were right-handed. We found a significantly higher prevalence of sex hormone abnormaliti es in male lupus patients when compared with healthy controls with a s imilar age distribution. These abnormalities were consistent with a fu nctional state of hypoandrogenism although the levels of FE2 were not different between male lupus and controls.