Objective To examine the clinical pattern in male lupus patients in a tertiary multi-ethnic lupus centre in East London, UK.

Methods Male lupus patients were identified through review of a pre-existing database of lupus patients and clinic lists at Barts Trust. All patients’ electronic notes were reviewed prior to a telephone interview. All the participants fulfilled the ACR 1997 criteria for SLE. Descriptive data analysis was performed for all identified patients.

Results Fifty-one patients were identified.

Sample demographics showed that male lupus was more prevalent among Afro-Caribbeans (37%,n=19), followed by Asians (33%,n=17) and Caucasians (29%,n=15). The median age was 40.5 (IQR:32.5–52.7) years, with the median age at diagnosis 28 years (IQR:23–45).

Family history of autoimmune condition was seen in 25%, whilst 14% had a family history specifically of SLE. Possible significant stressor prior to diagnosis reported in 45% patients. Serological evidence of previous infection with EBV, VZV or parvovirus was found in 76%.

The majority of males had multiorgan involvement including renal (67%,n=34), cutaneous (55%,n=28), hematological (45%,n=23), musculoskeletal (31%,n=16), cardiac (27%,n=14), pulmonary (20%,n=10), and neurologic (14%,n=7). Renal biopsy was done in 33/34 renal cases and showed proliferative-class (III/IV) in 65%. Hypertension was a significant comorbidity in 39%, 47% had a concomitant AI condition.

Regarding serology, 94% were positive for antinuclear antibody, 40% speckled, 31%homogenous, and 8% for nucleolar and mixed pattern. In 2 patients ANA test was not recorded but they had confirmed renal/cutaneous biopsy findings.

Three-quarters were positive for anti-double stranded DNA (ds-DNA). Ro and La antigens were detected in 35% and 8%, whereas anti-Sm and anti-RNP antibodies were detected in 37% and 43%, respectively. Antiphospholipid antibodies were identified in less than a third, of which 40% presented with thrombotic events.

Conclusions Our dataset demonstrates a higher prevalence in Afro-Caribbean and Asians and a young age of onset (median 28 years) with presentation about 10-years earlier than most other reports. Over three-quarters of the patients had evidence of prior infection.

Most of the lupus males had multiorgan involvement and over two-thirds had renal involvement, proliferative class-III/IV. There was a high prevalence of dsDNA, ENA (anti-Ro) and APL.