Systemic lupus erythematosus in men: A retrospective analysis in a veterans administration healthcare system population

Systemic lupus erythematosus (SLE), a connective tissue disease of unknown etiology, is generally considered to occur in women of child-bearing age an d to be uncommon among men (1-5). Because of the female predominance in mos t studies, less is known about the disease in men. To begin to better under stand lupus in men, we retrospectively analyzed all the SLE patients from a ll the hospitals in the Department of Veterans Affairs (VA) system, a popul ation that is predominantly male, Between 1987 and 1996, 2614 SLE patients were retrieved from the VA databank; 2144 were male, making this the larges t group of male patients with SLE reported in United States of America. Age , racial and geographic distribution, comorbidities, and mortality of the S LE patients are reported. This study suggests that SLE men in this populati on are older at onset of disease, have different comorbidities, and have a higher mortality at I year than women with SLE. These findings suggest that men with SLE have a more complex clinical course than women, although the data do not illuminate whether the comorbidities are due to or coincident w ith SLE. On the basis of these data, practitioners are reminded to consider SLE in the differential diagnosis for older men and be attentive to the fr equent presence of comorbidities such as cardiac ischemia and neoplasms. Be cause of the identified regional variations in demographics, comorbidities, and mortality, this study suggests the need for future SLE studies to incl ude data from multiple geographic areas.