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Highly Accessed Review

Why are women predisposed to autoimmune rheumatic diseases?

Jacqueline E Oliver1 and Alan J Silman2*

Author Affiliations

1 University of Manchester, Oxford Road, Manchester, M13 9PL, UK

2 Arthritis Research Campaign, Copeman House, St Mary's Court, St Mary's Gate, Chesterfield S41 7TD, UK

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Arthritis Research & Therapy 2009, 11:252  doi:10.1186/ar2825

Published: 26 October 2009

Abstract

The majority of autoimmune diseases predominate in females. In searching for an explanation for this female excess, most attention has focused on hormonal changes - both exogenous changes (for example, oral contraceptive pill) and fluctuations in endogenous hormone levels particularly related to menstruation and pregnancy history. Other reasons include genetic differences, both direct (influence of genes on sex chromosomes) and indirect (such as microchimerism), as well as gender differences in lifestyle factors. These will all be reviewed, focusing on the major autoimmune connective tissue disorders: rheumatoid arthritis, systemic lupus erythematosus and scleroderma.