Article

Lupus in Men: All in the Genes?

There may be genetic susceptibility factors for systemic lupus erythematosus (SLE) that act only in men. In about 1% of families with SLE, all the patients with SLE are male and the women universally have positive antinuclear antibodies; also, men with SLE have more children with SLE than do women with SLE.

There may be genetic susceptibility factors for systemic lupus erythematosus (SLE) that act only in men. In about 1% of families with SLE, all the patients with SLE are male and the women universally have positive antinuclear antibodies; also, men with SLE have more children with SLE than do women with SLE.

Aggarwal and associates examined the genetic profiles of 523 families chosen from a lupus registry. They identified all families in which all the SLE-affected persons were male.

All patients were male in 5 of the 523 families with SLE. The clinical features showed no clear pattern of more serious disease among men in these families than among men in families with SLE-affected women. Of patients with SLE who had children with SLE, 22% were fathers; white fathers had a child with SLE 4.9 times more often than white women, although there was no difference between African American men and women. No male patients with SLE in the all-male SLE families had the Toll-like receptor 7 gene translocated to the Y chromosome.

The authors noted that sorting out the notion that genetic susceptibility factors may act in a sex-specific manner in this genetically complex disease will be challenging.

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