Sex differences in the immune profile and its relation to clinical manifestations in systemic lupus erythematosus patients

Background Systemic lupus erythematosus (SLE) is a heterogeneous, multisystemic autoimmune disease of unknown etiology. Men and women may show variable clinical and laboratory features, which may affect the prognosis. Several studies showed a relation between the immune profiles and the clinical and laboratory features in such patients. Objective To study the sex differences in the immune profile in a cohort of SLE patients. Patients and methods Medical records of 199 patients, 147 female SLE patients (group 1) and 52 male SLE patients (group 2), attending the Rheumatology and Rehabilitation Outpatient Clinic of Cairo University Hospitals were reviewed and compared retrospectively for demographic data, clinical features of the disease, laboratory features and immune profile. Results The prevalence of alopecia was significantly higher in group 1, whereas the prevalence of nephritis was significantly higher in group 2. There was a significant increase in the mean level of serum creatinine, and a tendency towards a lower mean platelet count in group 2. The positivity for antinuclear antibody and antidouble-stranded DNA (anti-dsDNA) was higher in group 2, whereas the positivity for anti-Ro, anti-La and anticardiolipin was higher in group 1. Low complement 3 (C3) and complement 4 (C4) were observed more often in group 1. None of these differences was statistically significant except for C3. A significant association was found between nephritis and anti-dsDNA in both groups, between photosensitivity and anti-Ro in group 1 and between photosensitivity and anti-La in group 2. Conclusion Although the immune profile may show some differences between male and female lupus patients, most of these differences were however nonsignificant, apart from a low C3 in female patients with SLE.