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Clinical spectrum of males with primary antiphospholipid syndrome and systemic lupus erythematosus: a comparative study of 73 patients

Hospital General de Zona No 76 Mexico City, Mexico

O Vera-Lastra

Department of Internal Medicine, Hospital de Especialidades, Centro Médico La Raza, Mexico City, Mexico

L Barile

Clinical Research Unit, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico

M Salas

Caro Research Institute, Concord, MA, USA

L J Jara

Clinical Research Unit, Hospital de Especialidades, Centro Médico La Raza, Mexico City, Mexico, luis_jara_quezada{at}hotmail.com

The objective of this study was to compare the clinical findings, laboratory data, functional outcome and chronic damage in male patients with primary antiphospholipid syndrome (PAPS) and systemic lupus erythematosus (SLE). We studied 29 male patients with PAPS and 44 with SLE. Clinical findings, laboratory data, lupus damage index (SLICC/ACR DI), and functional outcome in PAPS, were analysed in each group. The mean age at diagnosiswas 29.8 + 10.4 years in patientswith PAPS and 26 + 10.1 years in SLE patients. The duration of disease was 4.5 + 2.6 versus 5.2 + 3.8 years in patients with PAPS and SLE, respectively(P NS). In patients with PAPS the most frequent clinical manifestations were venous thrombosis, thrombocytopenia, and pulmonary thromboembolism. Patients with SLE had joint, skin and renal involvement more frequently than those with PAPS (P 0.0001). All PAPS patients had anticardiolipin antibodies (aCL), and 14 patients (48%) had lupus anticoagulant (LA). All SLE patients had antinuclear antibodies (ANAs). Anti-dsDNA antibodies were positive in 39% of SLE patients. Five patients died: one with ‘catastrophic’ APS and four with SLE. SLICC/ACR-DI score in SLE patients was 1.9 (SD 1). In PAPS patients poor functional outcome was due to myocardial infarction, pulmonary thromboembolism, stroke and mesenteric thrombosis. Lupus nephritis was the principal organ damage in SLE. In conclusion, in male patients with PAPS and SLE, the clinical manifestations were significantly different. Arterial thrombosis was the major cause of functional impairment and permanent organ damage in PAPS. Renal involvement was the major cause of chronic damage in SLE.

Key Words: antiphospholipid syndrome • damage index • functional outcome • males • systemic lupus erythematosus

Lupus, Vol. 13, No. 1, 11-16 (2004)
DOI: 10.1191/0961203304lu482oa


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