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

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.