Low sulpho-conjugated steroid hormone levels in systemic lupus erythematosus (SLE)

Clin Exp Rheumatol. Nov-Dec 1989;7(6):583-8.

Abstract

In a clinical study the blood levels of dehydroepiandrosterone sulphate (DHEAS), pregnenolone sulphate (5-PS), testosterone sulphate (TS) and their respective unconjugated steroids were measured in: 20 patients with systemic lupus erythematosus (SLE) who were receiving either no treatment (11 patients) or else treatment with chloroquine (9 patients), in some cases combined with non-steroidal anti-inflammatory drugs (NSAIDs); in 26 patients receiving corticosteroid (Prednisolone) treatment; and in healthy men and women. The patients not on corticosteroid exhibited substantially reduced DHEAS, 5-PS and TS levels (geom. mean: 2300 vs. normal 4300 nmol/l DHEAS; 200 vs. 320 nmol/l 5-PS; and 120 vs. 360 nmol/l TS; p less than 0.001), irrespective of the difference in sex, age or chloroquine treatment. The patients on corticosteroid treatment displayed a similar pattern of levels, but the reduction was much more marked than in the patients not on the steroid (geom. mean: 610 nmol/l DHEAS, 55 nmol/l 5-PS; and 35 nmol/l TS; p less than 0.001). No consistent changes were observed in the unconjugated steroid levels, although they were also reduced by the treatment with prednisolone. The data indicate that a deficiency in sulpho-conjugated steroids is a permanent feature of patients with SLE and that this is accentuated by the administration of corticosteroid derivatives. Further studies are needed to establish the pathophysiological significance of these findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Dehydroepiandrosterone / analogs & derivatives*
  • Dehydroepiandrosterone / blood
  • Dehydroepiandrosterone Sulfate
  • Diflunisal / therapeutic use
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / blood*
  • Lupus Erythematosus, Systemic / drug therapy
  • Male
  • Middle Aged
  • Prednisolone / therapeutic use
  • Pregnenolone / blood*
  • Testosterone / blood*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • pregnenolone sulfate
  • Testosterone
  • Dehydroepiandrosterone
  • Dehydroepiandrosterone Sulfate
  • Pregnenolone
  • Diflunisal
  • Prednisolone