The pathogenesis of autoimmune diseases(AIDs)is characterized by a female preponderance.The causes for this sex imbalance are based on several hypotheses.One of the most intriguing hypotheses is related to an X chromosome inactivation(XCI)process.Females are mosaics for two cell populations,one with the maternal and one with the paternal X as the active chromosome.Skewed XCI is often defined as a pattern where 80%or more of the cells show a preferential inactivation of one X chromosome.The role of skewed XCI has been questioned in the pathogenesis of several AIDs,such as autoimmune thyroid diseases and rheumatoid arthritis.