Journals / Uludağ Üniversitesi Tıp Fakültesi Dergisi / 2026 / Cilt: 52

Gender-Related Differences in the Clinical, Immunological, and Treatment Characteristics of Patients with Systemic Lupus Erythematosus

Sistemik Lupus Eritematozus Hastalarında Klinik, İmmünolojik ve Tedavi Özelliklerinde Cinsiyete Bağlı Farklılıklar

Nihal Lermi(University of Health Sciences, Istanbul Kartal Dr. Lütfi Kırdar Health Research Center, Rheumatology Department, İstanbul, Türkiye.)0000-0002-2774-5913
Belkis Nihan Coskun(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0003-0298-4157
Meysere Nur Akuç Sarı(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0003-4654-7223
Ulviyya Hasanzade(Istanbul Faculty of Medicine, Division of Hematology, İstanbul, Türkiye.)0000-0001-7546-2865
Ali Ekin(Van Yüzüncü Yıl University Faculty of Medicine, Division of Rheumatology, Van, Türkiye.)0000-0003-3692-1293
Burcu Yağız(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0002-0624-1986
Hüseyin Ediz Dalkılıç(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0001-8645-2670
Yavuz Pehlivan(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0002-7054-5351
Pages
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Publication Date
2026-09-18
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Although SLEDAI scores were higher in males, the difference was not statistically significant, and overall disease patterns were largely similar between sexes; however, male patients exhibited a higher frequency of renal involvement, accompanied by more frequent use of aggressive immunosuppressive treatment.

📌 3 Key Takeaways

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Objective & Hypothesis:This retrospective study aimed to evaluate sex-related differences in the clinical, laboratory, immunological, and treatment characteristics of patients with systemic lupus erythematosus (SLE) at a single tertiary center.
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Key Findings & Data:The study included 68 SLE patients (34 females and 34 males) of similar ages at diagnosis, whose data were retrieved from electronic medical records between 2010 and 2025.
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Conclusion & Impact:Although SLEDAI scores were higher in males, the difference was not statistically significant, and overall disease patterns were largely similar between sexes; however, male patients exhibited a higher frequency of renal involvement, accompanied by more frequent use of aggressive immunosuppressive treatment.
🔬Design:Araştırma Makalesi
📍Scope:2010 Verileri
⚙️Variables:Cinsiyet. · Erkek. · Sistemik Lupus Eritematozus.

Abstract

This retrospective study aimed to evaluate sex-related differences in the clinical, laboratory, immunological, and treatment characteristics of patients with systemic lupus erythematosus (SLE) at a single tertiary center. The study included 68 SLE patients (34 females and 34 males) of similar ages at diagnosis, whose data were retrieved from electronic medical records between 2010 and 2025. Clinical manifestations, comorbidities, serological profiles, organ involvement, disease activity (SLEDAI), and treatment regimens were analyzed, and statistical analyses were performed using R software. The most frequent initial complaints in males were constitutional, cutaneous, and musculoskeletal symptoms, whereas musculoskeletal and cutaneous symptoms predominated in females. Leg swelling, as an initial manifestation, and renal involvement during disease progression were more frequent in males (p=0.029). Serologically, anti-double-stranded DNA, anti-cardiolipin IgG, and lupus anticoagulant positivity were higher in males, while complement C3 and C4 levels were lower in females (p<0.05 for all). Additionally, sicca symptoms, Raynaud’s phenomenon, livedo reticularis, and musculoskeletal involvement were more common in females, and intravenous methylprednisolone and cyclophosphamide use was more frequent in males. Although SLEDAI scores were higher in males, the difference was not statistically significant, and overall disease patterns were largely similar between sexes; however, male patients exhibited a higher frequency of renal involvement, accompanied by more frequent use of aggressive immunosuppressive treatment. These findings emphasize the importance of considering sex-specific differences in the clinical assessment, monitoring, and management of SLE patients.

Özet

Bu çalışma, tek bir üçüncü basamak merkezde takip edilen sistemik lupus eritematozus (SLE) hastalarının klinik, laboratuvar, immünolojik ve tedavi özelliklerindeki cinsiyete bağlı farklılıkları değerlendirmek amacıyla yapılmıştır. Bu retrospektif çalışmaya, tanı anındaki yaşları benzer 68 SLE hastası (34 kadın, 34 erkek) dahil edilmiştir. Veriler, 2010 ile 2025 yılları arasında elektronik hasta kayıtlarından elde edilmiştir. Klinik belirtiler, komorbiditeler, serolojik profiller, organ tutulumları, hastalık aktivitesi (SLEDAI) ve tedavi rejimleri analiz edildi. İstatistiksel analizler R yazılımı kullanılarak gerçekleştirildi. En sık görülen ilk şikayetler erkeklerde konstitüsyonel semptomlar, cilt belirtileri ve kas-iskelet sistemi semptomları iken, kadınlarda kas-iskelet sistemi semptomları ve cilt belirtileri idi. Erkek hastalarda ilk semptom olarak bacak şişliği oranları anlamlı olarak daha yüksekti ve hastalık seyri boyunca böbrek tutulum sıklığı daha fazlaydı (p=0,029). Serolojik olarak, çift sarmallı DNA’ya karşı antikor, anti-kardiyolipin IgG ve lupus antikoagülan pozitifliği erkeklerde anlamlı olarak daha yüksekken, kompleman C3 ve C4 düzeyleri kadınlarda daha düşüktü (hepsi için p<0,05). Sikka semptomları, Raynaud fenomeni, livedo retikularis ve kas-iskelet sistemi tutulumları kadınlarda daha sık görüldü. İntravenöz metilprednizolon ve siklofosfamid kullanımı erkeklerde anlamlı olarak daha yüksekti. Klinik SLEDAI skorları erkeklerde daha yüksek olmasına rağmen, bu fark istatistiksel olarak anlamlı değildi. Genel hastalık paternleri cinsiyetler arasında büyük ölçüde benzer olsa da, erkek SLE hastalarında böbrek tutulum sıklığı daha yüksekti, bu da agresif immünosüpresif tedaviye olan ihtiyacı artırdı. Bu bulgular, SLE yönetimi ve takip stratejilerinde cinsiyete dayalı farklılıkların önemini vurgulamaktadır.

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Cite This Article

Lermi, N., Coskun, B. N., Sarı, M. N. A., Hasanzade, U., Ekin, A., Yağız, B., Dalkılıç, H. E., Pehlivan, Y., *, N. L. (2026). Gender-Related Differences in the Clinical, Immunological, and Treatment Characteristics of Patients with Systemic Lupus Erythematosus. Uludağ Üniversitesi Tıp Fakültesi Dergisi, Cilt: 52. https://doi.org/10.32708/uutfd.1942254

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References (20)

  1. Adwan MH, Qasem U, Atawnah SY, et al. Insights into systemic lupus erythematosus: a retrospective observational study of clinical features, autoantibodies, and gender-related differences. Rheumatol Int. 2024;44(7):1255-1263. doi:10.1007/s00296-024-05592-7
  2. Albrecht K, Troll W, Callhoff J, Strangfeld A, Ohrndorf S, Mucke J. Sex- and gender-related differences in systemic lupus erythematosus: a scoping review. Rheumatol Int. 2025;45(7):160. Published 2025 Jun 27. doi:10.1007/s00296-025-05910-7
  3. Rees F, Doherty M, Grainge MJ, Lanyon P, Zhang W. The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology (Oxford). 2017;56(11):1945-1961. doi:10.1093/rheumatology/kex260
  4. Kaul A, Gordon C, Crow MK, et al. Systemic lupus erythematosus. Nat Rev Dis Primers. 2016;2:16039. Published 2016 Jun 16. doi:10.1038/nrdp.2016.39
  5. Lee MH, Koh JWH, Ng CH, et al. A meta-analysis of clinical manifestations in asian systemic lupus erythematous: The effects of ancestry, ethnicity and gender. Semin Arthritis Rheum. 2022;52:151932. doi:10.1016/j.semarthrit.2021.12.004
  6. Riveros Frutos A, Casas I, Rúa-Figueroa I, et al. Systemic lupus erythematosus in Spanish males: a study of the Spanish Rheumatology Society Lupus Registry (RELESSER) cohort. Lupus. 2017;26(7):698-706. doi:10.1177/0961203316673728
  7. Zharkova O, Celhar T, Cravens PD, Satterthwaite AB, Fairhurst AM, Davis LS. Pathways leading to an immunological disease: systemic lupus erythematosus. Rheumatology (Oxford). 2017;56(suppl_1):i55-i66. doi:10.1093/rheumatology/kew427
  8. Boodhoo KD, Liu S, Zuo X. Impact of sex disparities on the clinical manifestations in patients with systemic lupus erythematosus: A systematic review and meta-analysis. Medicine (Baltimore). 2016;95(29): e4272. doi:10.1097/MD.0000000000004272
  9. Lu LJ, Wallace DJ, Ishimori ML, Scofield RH, Weisman MH. Review: Male systemic lupus erythematosus: a review of sex disparities in this disease. Lupus. 2010;19(2):119-129. doi:10.1177/0961203309350755
  10. Santamaría-Alza Y, Motta JZN, Fajardo-Rivero JE, Pineda CLF. Systemic lupus erythematosus, gender differences in Colombian patients. Clin Rheumatol. 2018;37(9):2423-2428. doi:10.1007/s10067-018-4161-8
  11. Pons-Estel GJ, Ugarte-Gil MF, Alarcón GS. Epidemiology of systemic lupus erythematosus. Expert Rev Clin Immunol. 2017;13(8):799-814. doi:10.1080/1744666X.2017.1327352
  12. Gorina Y, Kramarow EA. Health E-Stat 105: Chronic Conditions in Adults Age 85 and Older: United States, 2022–2023. In: NCHS Health E Stats. Hyattsville (MD): National Center for Health Statistics (US); June 2025.
  13. Ostchega Y, Fryar CD, Nwankwo T, Nguyen DT. Hypertension Prevalence Among Adults Aged 18 and Over: United States, 2017-2018. NCHS Data Brief. 2020;(364):1-8.
  14. Gui Y, Bai W, Xu J, et al. Sex differences in systemic lupus erythematosus (SLE): an inception cohort of the Chinese SLE Treatment and Research Group (CSTAR) registry XVII. Chin Med J (Engl). 2022;135(18):2191-2199. Published 2022 Sep 20. doi:10.1097/CM9.0000000000002360
  15. Mahmood SB, Aziz M, Malepati D, et al. Evaluating Sex Differences in the Characteristics and Outcomes of Lupus Nephritis: A Systematic Review and Meta-Analysis. Glomerular Dis. 2024;4(1):19-32. Published 2024 Jan 4. doi:10.1159/000535981
  16. Mihailovic J, Ribi C, Chizzolini C, et al. Worse cardiovascular and renal outcome in male SLE patients. Sci Rep. 2023;13(1):18628. Published 2023 Oct 30. doi:10.1038/s41598-023-45171-7
  17. Trentin F, Signorini V, Manca ML, et al. Gender differences in SLE: report from a cohort of 417 Caucasian patients. Lupus Sci Med. 2023;10(1): e000880. doi:10.1136/lupus-2022-000880
  18. Pan Y, Jin H, Zhou S, et al. Sex-based clinical and immunological differences across lupus erythematosus subtypes: a cross-sectional multicentre study from China. Lupus Sci Med. 2026;13(1):e001783. doi:10.1136/lupus-2025-001783
  19. Zhang S, Su J, Li X, et al. Chinese SLE Treatment and Research group (CSTAR) registry: V. gender impact on Chinese patients with systemic lupus erythematosus. Lupus. 2015;24(12):1267-1275. doi:10.1177/0961203315585813
  20. Fanouriakis A, Kostopoulou M, Anders HJ, et al. EULAR recommendations for the management of systemic lupus erythematosus with kidney involvement: 2025 update. Ann Rheum Dis. 2026;85(1):75-90. doi:10.1016/j.ard.2025.09.007