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.

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.