Objective.The aim of this study was to describe the prevalence of erectile dysfunction (ED), as well as associated demographic and clinical features, in men with systemic lupus erythematosus (SLE), by means of a systematic, standardized evaluation.Methods.We performed a transversal study in 8 tertiary care centers in Latin America. We included male patients ≥ 16 years who fulfilled ≥ 4 American College of Rheumatology criteria for SLE and had regular sexual activity, and evaluated them with the International Index of Erectile Function-5 questionnaire. Relevant demographic, clinical, and serological characteristics were recorded. We included 2 control groups: the first was made up of healthy men and the second of men with autoimmune diseases other than SLE (non-SLE group).Results.We included 590 subjects (174 SLE, 55 non-SLE, and 361 healthy controls). The prevalence of ED in the SLE group was 69%. Mean age in that group was 36.3 ± 1.03 years. Among SLE patients with and without ED, these factors were significantly different: the presence of persistent lymphopenia (p = 0.006), prednisone dose (9.3 ± 1.2 vs 5.3 ± 1.3 mg, p = 0.026), and the Systemic Lupus International Collaborating Clinics damage score (1.25 ± 0.14 vs 0.8 ± 0.16 points, p = 0.042). Independent risk factors for ED in patients with SLE were persistent lymphopenia (OR 2.79, 95% CI 1.37–5.70, p = 0.001) and corticosteroid use in the previous year (OR 2.15, 95% CI 1.37–3.37, p = 0.001).Conclusion.Regardless of comorbidities, treatment (excluding steroids), and type of disease activity, patients with SLE have a high prevalence of ED, especially considering that most patients are young. Recent corticosteroid use and persistent lymphopenia, which could be related to endothelial dysfunction, are risk factors for this complication in men with SLE.

Background:Cytopenias are common in systemic lupus erythematosus (SLE), and it is fundamental to determine their etiology in order to establish an adequate therapeutic strategy.Objectives:To describe the findings in the bone marrow aspirations (BMA) and biopsies of patients with SLE and cytopenias, as well as clinical and laboratory features associated with the etiology of the hematological abnormalities.Methods:We performed a retrospective study in a third-level hospital in Mexico City. We included patients who fulfilled ACR criteria for SLE, presented with cytopenias and had a BMA and biopsy performed between 2000 and 2016. We described the main aspirate and biopsy findings, and also analyzed the final diagnosis and its association with clinical, laboratory and serological features.Results:We included 101 patients; median age was 32 years and 81.2% were women. Leukopenia (<3000 cells/µl) was found in 47.5% of patients, with 29.7% having moderate or severe neutropenia (<1000 cells/µl). Lymphopenia (<1000 cells/μl) was a common finding (71.3% of patients). Moderate-to-severe thrombocytopenia (<50 K/µl) was present in 28.7% of patients. Finally, 25.8% of patients presented with pancytopenia.Regarding bone marrow findings, there was erythroid dysplasia in 50.5% of patients, granulocytic dysplasia in 28.7% and megakaryocytic dysplasia in 16%. Myelofibrosis was found in 2.6%. An increase in plasma cells (≥5%) was found in 21.8%.In 72.3% of patients, bone marrow interpretation was conclusive. The most common diagnoses were disease activity (24.8%) and drug-associated myelotoxicity (28.7%). When compared to other etiologies, in patients with cytopenias secondary to disease activity, it was more frequent for the bone marrow be hypercellular (56 vs 23%, p=0.006) and to have increased megakaryocytes (40 vs 17.4%, p=0.048). Conversely, granulocytic dysplasia was less common in this group of patients (17.4% vs 54.3%, p=0.036)We analyzed factors associated with both activity and toxicity as final diagnoses (Table 1). After multivariate analysis, a neutrophil count <1000 cells/µl was a protective factor for disease activity (OR 0.021; 95% CI 0.001-0.428, p 0.012). On the other hand, a history of renal activity (OR 4.3; 95% CI 1.3-14.2, p=0.024) and neutrophils less than 1000 cells/µl (OR 4.05; 95% CI 1.15-14.19, p=0.029) were found to be independent risk factors for myelotoxicity.Table 1CharacteristicDisease activity(N=25)Drug-associated toxicity(N=28)pHistory of disease activity- Mucocutaneous- Hematologic- Renal80%100%44%86%96.4%78.6%0.71910.012Neutrophils (cells/μl)- Mild neutropenia (1000-1499)- Moderate neutropenia (500-999)- Severe neutropenia (<500)16% 4% 4%17.9% 7.1% 39.3%0.004Lymphopenia (<1000 cells/µl)68%70%1Platelets (K/µl)- MIld thrombocytopenia (50-99)- Severe thrombocytopenia (<50)16%28%10.7%32.1%0.859SLEDAI score6 (0-23)6 (1-14)0.370SLICC damage index0 (0-5)0 (0-6)0.791Treatment- Azathioprine- Mofetil mycophenolate- Hydroxychloroquine- Prednisoneo ≤7.5 mgo 7.6-30 mgo >30 mg24%0%4%56%16%28%53.6%14.3%35.7%46.2%28...

BackgroundCytopenias are a common manifestation in systemic lupus erythematosus (SLE), and it is fundamental to determine their etiology in order to establish an adequate therapeutic strategy. The aim of this study was to determine the relevance of bone marrow aspirations (BMA) and biopsies while studying the cause of cytopenias in SLE patients, as well as describing associated clinical and laboratory features.MethodsWe performed a retrospective study in a third-level hospital in Mexico City. We included patients who fulfilled ACR criteria for SLE, presented with cytopenias and had a BMA and biopsy performed between 2000 and 2016. We described the main aspirate and biopsy findings, and also analyzed the final diagnosis and its association with clinical, laboratory and serological features.ResultsWe included 101 patients; 81.2% were women. Median age was 32 years. Leukopenia (<3000 cells/µl) was found in 47.5% of patients; with lymphopenia (<1000 cells/L) being a common finding (71.3% of patients). Moderate-to-severe thrombocytopenia (<50 K/µl) was present in 28.7% of patients. Finally, 25.8% of patients presented with pancytopenia.In 72.3% of patients, bone marrow interpretation, along with clinical and laboratory findings, lead to a conclusive diagnosis. The most common final diagnoses were disease activity (24.8%) and drug-associated toxicity (28.7%). The agreement between the initial diagnostic impression and the conclusion after BMA was performed was 45.5%.We analyzed factors associated with the most common etiologies (table 1). Regarding BMA findings, when cytopenias were secondary to disease activity, it was more frequent for the bone marrow to be hypercellular (56 vs 23%, p=0.006) and to have increased megakaryocytes (40 vs 17.4%, p=0.048). Conversely, granulocytic dysplasia was less common in this group of patients (17.4% vs 54.3%, p=0.036).After multivariate analysis, a neutrophil count <1000 cells/µl was a protective factor for disease activity (OR 0.021; 95% CI 0.001–0.428, p 0.012). On the other hand, a history of renal activity (OR 4.3; 95% CI 1.3–14.2, p=0.024) and neutrophils<1000 cells/µl (OR 4.05; 95% CI 1.15–14.19, p=0.029) were found to be independent risk factors for myelotoxicity.Abstract 142 Table 1Clinical and serologic characteristics of patients with SLE and cytopenias secondary to disease activity or drug-associated myelotoxicity at the time of the bone marrow aspirateCharacteristicDisease activity (n=25)Drug-associated myelotoxicity (n=28)p Time since SLE diagnosis (months) 12 (0–348) 54.5 (0–372) 0.038 History of disease activity- Mucocutaneous- Hematologic- Renal - Serositis80%100% 44% 28%86%96.4% 78.6% 32.1%0.7191 0.012 0.774Hemoglobin (g/dL)8.6 (3.9–15.4)9.5 (6.7–15.7)0.674 Neutrophils (cells/μl) - Normal (>1500) - Mild neutropenia (1000–1499) - Moderate neutropenia (500-999) - Severe neutropenia (<500) 76% 16% 4% 4% 35.7% 17.9% 7.1% 39.3% 0.004 Lymphopenia (<1000 cells/µl)68%70%1Platelets (K/µl)- Normal (>100)- MIld thrombocytopenia (50-99)- Severe thrombocytopenia (<5...

154 Table 1 Health related quality of life scores for the physical health and mental health domains of the SF-36 v2 questionnaire in patients with aSLE and cSLE Abstracts

Background:Whereas SLE is uncommon in men, the disease is usually more severe and requires more aggressive immunosuppression in male patients. There are multiple studies regarding sexual aspects in women with SLE, but information about sexual function in male patients is quite scant.Objectives:To determine the relationship between SLE and sexual function alterations in men, through the application of validated questionnaires.Methods:We performed a longitudinal study in a third-level referral center in Mexico City. We included men aged ≥16 years who fulfilled ACR criteria for SLE and who were sexually active. All subjects answered the International Index of Erectile Function-15 (IIEF-15), the SF-36 and the HAQ in two visits. Other clinical, serological and demographic variables were measured. Oxidized LDL was quantified by ELISA.Results:We included 108 male SLE patients. Mean age was 37.2±1.1 years and most patients (87%) were taking immunosuppressive therapy. Comorbidities were present in 58% of subjects, with dyslipidemia and hypertension being the most prevalent (34% and 28%, respectively).The prevalence of sexual dysfunction (SD) was 53%. In the basal visit, the only significant differences between the patients with SD and those without SD were a lower education degree (p=0.007) and persistent lymphopenia (p=0.01). There was a positive correlation between global IIEF-15 score and SF-36 score (r=0.46, p=0.001). The physical function domain had the highest correlation (r=0.50, p=0.001). Likewise, there was a weak negative correlation between IIEF-15 and HAQ score (r=-0.25, p=0.012). Also, the IIEF-15 had a weak correlation with the absolute lymphocyte count (r=0.27, p=0.005) and oxidized LDL (r=0.31, p=0.04).In the follow-up visit the only significant differences between the patients with SD when compared with subjects without SD was a low absolute lymphocyte count (1031±89 vs 1458±119, p=0.005); the correlations mentioned in the baseline visit remained significant. Regarding erectile function, 44% of the subjects had some degree of dysfunction. The rest of the variables are shown in Table 1.Abstract AB1250 Table 1Demographic, clinical and laboratory featuresVariableMean ± SEMDemographicAge (years)37.2 ± 1.1Body mass index (kg/m2)26.5 ± 0.4Less than 10 years of schooling (n,%)21/108 (19.4)Time since SLE diagnosis (years)9.1 ± 0.6Clinical FeaturesTotal score IIEF-1558.7 ± 1.3Erectile function23.9 ± 0.6Intercourse satisfaction10.9 ± 0.3Orgasmic function8.1 ± 0.2Sexual desire7.5 ± 0.1Overall satisfaction8.1 ± 0.1Total score SF-3669.2 ± 1.3Secondary antiphospholipid syndrome (n,%)16/108 (14.8)SLEDAI score (points)4.2 ± 0.4Others comorbidities (n,%)63/108 (58.3)Laboratory featuresHemoglobin (mg/dl)15.3 ± 0.2Leukocytes (mm3) (x103)5.9 ± 0.2Absolute lymphocyte count (mm3)1362.6 ± 76.0Serum creatinine (mg/dl)1.4 ± 0.1C3 levels104.1 ± 3.2C4 levels19.7 ± 1.2Anti-dsDNA antibodies208.2 ± 70.4Use of immunosuppressive treatment (n,%)95/108 (87.9)Prednisone (n,%)58/108 (53.7)Azathioprine (n,%)31/108 (28.7)Antimalarial (n,%)73/1...