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Stories for Reprint
Lupus Mortality Worse in Men
By Ferdous Al-Faruque, MARRTC Staff
Systemic lupus erythematosus or lupus is often thought of as a woman's disease since women are nearly 10 times more afflicted by it than men. However, despite its increased prevalence in women, men with the disease are at greater risk of dying earlier.
An autoimmune disease in which the body's immune system mistakenly attacks healthy cells and tissues, lupus varies in severity for each individual, but in worst-case situations can result in organ failure and death.
Researchers analyzed data from the Carolina Lupus Study, a database of 265 recently diagnosed lupus patients and 355 people without the disease from North and South Carolina. Thirty-two people with lupus died five years after being diagnosed with the disease. In comparison, 3 people without the disease died during the same period. To the surprise of some of the researchers, men with lupus were almost three times more likely to die of the disease compared to women.
Dr. Robert Campbell, Jr. understands how devastating lupus can be. He has lost a sister who suffered from discoid lupus, the skin form of the disease, and also has an aunt currently suffering from lupus. As an epidemiologist in the Department of Rheumatology and Immunology at the Medical University of South Carolina, Campbell has made it his life's work to identify factors associated with lupus to help researchers develop new drugs and therapies.
Campbell says he was astonished to find men with the disease were more likely to die. "Women have a higher prevalence of the disease and so you would expect them to have a higher mortality rate for the disease," he says. "But they didn't."
One of the main problems according to Campbell is that men generally avoid getting medical help. "In many cases we believe they are presenting (their problems) to the doctor late when considerable damage has already been done to the organs," he says. Another problem is that sometimes primary care physicians fail to detect lupus earlier in men because it is considered to be a woman's disease. Campbell says primary care physicians who think a patient may have lupus should immediately refer them to a rheumatologist or conduct tests to diagnose whether patients have the disease regardless of their gender.
According to Campbell, researchers and clinicians don't know why more men die from lupus. He says one theory is that estrogen, a hormone only found in women, can protect them against inflammation.
The study also found the risk of death increased with each passing year that people lived with lupus. "With the new treatments it's allowing individuals to live longer," says Campbell. However, he adds that lupus drugs given over a long period of time can have side effects, which result in other diseases such as diabetes and hypertension. Campbell points out that the leading cause of death in patients with lupus in his study was heart related diseases, which could be attributed to certain drugs used to treat lupus over an extended period of time.
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