title: Development of systemic lupus erythematosus in a male-to-female transsexual: the role of sex hormones revisited.
abstract: Systemic lupus erythematosus (SLE) predominantly affects women of childbearing age. The infrequency of SLE in men and disease onset in prepubertal or postmenopausal women suggests a role of estrogen in the predisposition to the disease. Patients with hypergonadotrophic hypogonadism are prone to the development of SLE, and the use of exogenous estrogens in women increases the relative risk of SLE onset and disease flares. These observations provide indirect evidence for an opposite role of estrogens and androgens in the pathogenesis of SLE. We report on a male-to-female transsexual who developed SLE 20 years after sex-reassignment surgery and prolonged estrogen therapy. The role of sex hormones in SLE is revisited.
authors.affiliation: Department of Medicine, Tuen Mun Hospital, Hong Kong, China.
authors.forename: K L
authors.initials: KL
authors.lastname: Chan
authors.forename: C C
authors.initials: CC
authors.lastname: Mok
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D015551:Autoimmunity / Q000187:drug effects; D015415:Biomarkers / Q000097:blood; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004967:Estrogens / Q000008:administration & dosage / Q000009:adverse effects*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020945:Lupus Vasculitis, Central Nervous System / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D008297:Male; D012307:Risk Factors; D057830:Gender-Affirming Surgery / Q000009:adverse effects*; D013739:Testosterone / Q000378:metabolism*; D063106:Transgender Persons; D014189:Transsexualism / Q000097:blood / Q000601:surgery*
chemical_list: D014150:Antipsychotic Agents; D001323:Autoantibodies; D015415:Biomarkers; D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D007166:Immunosuppressive Agents; D013739:Testosterone
keywords: Sex hormone; androgen; estrogen; gender; lupus; male; transsexual