Primär systemische vaskulitiden. Geschlechtsspezifische unterschiede

The incidence of primary systemic vasculitides is characterized by a constant North-South decline, but the sex ratio is almost identical throughout the world. However, the risk of giant cell arteritis (GCA) in women is known to be 3-4 times that in men, whereas the rates for ANCA-associated vasculitides (AAV) are similar in women and men. Associations of varies alleles with some vasculitides and their specific courses are already known, and a sex-specific genetic association seems to be possible at least for GCA. A detectable dysfunction of the hypothalamus-pituitary-adrenal gland cycle could be responsible for the initiation of an autoimmune inflammatory response, which can ultimately also lead to varicosities of the major vessels. In addition to the elevated incidence of GCA in women, a sex-specific course of the disease has also been described for this condition; this difference is less pronounced in the case ofAAV. The sex-specific course directly influences what treatment is recommended.