(213) Sex Differences in Hematological and Immunological Features of Sarcoidosis

Introduction/Rationale:

Introduction: Sarcoidosis is a systemic granulomatous disease marked by immune dysregulation. While sex-related differences in clinical features are known, hematological and immunological differences remain poorly defined. This study aimed to assess immune and hematological parameters in adults with sarcoidosis, focusing on sex-based differences.

Methods:

Methods: This retrospective cohort study evaluated 74 patients with sarcoidosis treated at Hacettepe University Hospitals. Demographic characteristics, comorbidities, and laboratory data, including complete blood count, immunoglobulin levels (IgA, IgG, IgM, IgE), and lymphocyte subsets—were analyzed. Results were classified according to standard reference ranges, and group comparisons were performed using the t-test.

Results:

Results: Female/male ratio was 50/24 (32.4/67.6%). Concomitant autoimmune diseases were present in 24.3% of patients, most commonly Hashimoto thyroiditis and Sjögren syndrome. Hematological abnormalities were frequent: anemia was observed in 62.5%. High leukocyte levels were found in in 67.6% of the patients (above 10800 cells/µL). Neutrophil levels were high in 63.4% of patients (above 7000 neutrophils/uL). Lymphopenia was detected in 31.0%. Immunological assessment showed that IgM deficiency was the most common immunoglobulin abnormality (33.9%), followed by IgA deficiency (26%). Reduced CD19+ B-cell counts were observed in 44.4% of patients. Significant sex-based differences were identified: female patients had higher CD8+ T-cell counts (p=0.029) and IgE levels (p=0.034), while male patients had lower total lymphocyte counts compared to females (p=0.013).

Conclusion:

Conclusion: Sarcoidosis is associated with frequent hematological and immunological abnormalities. Distinct sex-specific immune patterns, particularly higher CD8+ T-cell and IgE levels in females, may contribute to disease heterogeneity.