Monthly, the Lupus Foundation of America (LFA) conducts online chats with healthcare professionals, answering questions from its audience regarding a variety of lupus-focused topics. This report focuses on June 10, 2008, Men’s Health chat with Dr. Jennifer Grossman
Can a man with lupus be a father?
How many African-American men discover they have lupus each year?
And what is “lupus fog”?
These are just a few of the questions that have been asked to Dr. Jennifer Grossman, a physician in the Division of Rheumatology and an Assistant Professor of Medicine at the UCLA Medical Center, by LFA participants during a June 10, 2008, online chat.
The answer to those questions?
- Yes, lupus men can father children, though some medications may affect sperm counts.
- There’s no exact number. A 1990 study conducted in San Francisco estimated 31,000 African-American males had lupus, while 2002 U.S. census data reports an estimated prevalence of 7,000 African-American men with lupus.
- “Lupus fog” doesn’t have a definition like lupus nephritis -– there is no diagnostic criteria for it. But if you have a “foggy feeling,” it’s best to check with your healthcare provider, as several factors could be contributing to your fog.
While much of the hour-long discussion focused on medical treatments and treatment effects, a number of participants wanted to know more about symptoms and diagnosis. One person with discoid lupus wondered if, though he has had three negative ANA tests, could he or she have systemic lupus erythematosus (SLE). “I have many symptoms,” he or she explained.
“ANA negative lupus does exist and is perhaps 2% to 5% of lupus patients,” Dr. Grossman replied. ANA negative lupus is a condition in which a patient lacks one or more of four features that unequivocally diagnose SLE, thus making the diagnosis presumptive, even in the presence of illness. “Some patients who are ANA negative have a positive SSA (Anti-ro) or SSB (Anti-La) antibody. Also, patients with discoid above and below the neck are at increased risk of having SLE, as compared with those patients who have discoid limited to the head and neck areas.”
Dr. Grossman dispelled the myth that some medicinal treatments work better based on gender and verified that lupus can cause circulation problems, including inflammation, vasculitis (inflammation of the body's blood vessels) and an increased risk of atherosclerosis, a condition in which fatty material collects along the walls of arteries.
“If hormones play a role in lupus,” one participant asked, “then why do men get it?”
“Hormones may play a role, but there are many other factors that are probably more important,” explained Dr. Grossman. “Although some animal models of lupus have shown that hormones can make the disease worse, the results are not consistent for all models. Also, a recent study called the SELENA study looked at the safety of estrogens in female lupus patients did not find any increased risk in severe flares for women who were given hormone replacement therapy or estrogen containing birth control pills.”
Dr. Grossman told those gathered that she believes stem cell treatment for lupus is a potential aggressive treatment with significant associated risks, but not a cure for lupus, and finished her chat by discussing whether pulmonary hypertension was common in SLE.
“That’s an interesting question,” she said. “It’s not clear how common it is and it depends on how one defines the condition. Typically only patients that have symptoms such as shortness of breath are checked for it. We hope soon to have research funds to look at this question and give you a better answer.”
Summary:
The complete Men’s Health Chat is available at LFA’s official site.
Source: Men’s Health Chat. Lupus Foundation of America. June 2008.
