Systemic Lupus Erythematosus: A Risk Analysis

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that attacks its own tissues. It is the most common lupus.

Systemic Lupus Erythematosus (“SLE”) is a chronic inflammatory disease that has a broad range of clinical manifestations and affects multiple organ systems. It is characterized by injury to the skin, joints, kidneys, nervous system, and mucous membranes. However, it can affect any organ of the body and usually has periods of remissions and exacerbations.[1] In my risk analysis, you’ll learn how a variety of factors such as hormones, genetics, and environment make contributions to SLE.

Cause or Possible Cause of SLE

To date, no definitive cause for SLE has been determined. Many scientists believe that SLE develops in response to a combination of factors that include hormones, genetics, and environment [2]:

Hormones: Because 90 percent of people diagnosed with SLE are women of childbearing age, there may be a relationship between estrogen and lupus. Women seem to exhibit more symptoms of SLE right before their monthly menstrual cycles and during pregnancy – when estrogen production is higher. Also, symptoms are greater in women who consume estrogen with either birth control pills or postmenopausal therapy. This may indicate that estrogen somehow contributes to symptom severity.

Genetics: Since 2016, researchers have identified more than 50 genes that are associated with SLE. These genes are more commonly seen in people diagnosed. While the genes may not have a direct cause to SLE, they have been shown to contribute to the disease. However, genes are not enough to cause SLE. This has been determined by family history. When one of two identical twins has SLE, the chance of the other twin being diagnosed is 30 percent while it’s five to 10 percent for fraternal twins.

Environment: Today, researchers think that environmental agents such as a virus or chemical could trigger SLE in a genetically susceptible individual. While a specific agent has not been identified to date, the most commonly cited are ultraviolet light from the sun and/or fluorescent light; infections such as the cold, flu, and Epstein-Barr virus; sun-sensitizing drugs such as sulfa and tetracycline; antibiotic drugs; as well as physical and emotional stress and exhaustion.

What SLE Does to the Body

SLE can affect any of the body’s major organ systems. As the name implies, SLE can also have systemic or constitutional symptoms which can mimic other autoimmune diseases, infectious diseases, endocrine abnormalities, fibromyalgia, and chronic fatigue.[3] The most common signs and symptoms include [4]:

  • Fatigue
  • Fever
  • Joint pain (stiffness, swelling)
  • Butterfly-shaped rash on the face that covers the cheeks and bridge of nose)
  • Skin lesions that appear or worsen after sun exposure (photosensitivity)
  • Fingers and toes that turn white or blue when exposed to cold or stress (Raynaud’s phenomenon)
  • Shortness of breath
  • Chest pain
  • Dry eyes
  • Headaches, confusion, and memory loss

What Happens as SLE Progresses

Inflammation caused by SLE can affect many areas of the body and may include major organs that can also lead to death [5]:

Kidneys: Serious kidney damage and failure.

Brain & Central Nervous System: Headaches, dizziness, vision problems, seizures, strokes, and behavioral changes.

Blood & Blood Vessels: Anemia, increased bleeding, and blood clots.

Lungs: Pleurisy, bleeding into the lungs, and pneumonia.

Heart: Inflammation of the heart muscle, arteries, or heart membrane; cardiovascular disease; and heart attacks.

Risk Influence for SLE

SLE can affect persons of all ages, genders, and ethnic groups. However, it is much more common in women. More than 90 percent of people who are diagnosed with SLE are women in childbearing years. According to a longitudinal outcome study called LUMINA (Lupus in Minority Population, Nature versus Nurture), the ethnic breakdown is as follows:

African American: 44 percent

Latin American: 23 percent

Caucasian American: 32 percent

The diagnoses of SLE must be based on the proper constellation of clinical findings and laboratory evidence. Patients with SLE almost uniformly present with a positive antinuclear antibody (ANA) test. A positive ANA of 1:60 or higher with leukopenia or lymphopenia, anemia, or thrombocytopenia suggests a diagnosis of SLE.[6] According to Systemic Lupus International Collaborating Clinics, the classification criteria for a SLE diagnoses includes a patient biopsy-proven lupus nephritis with ANA or anti-dsDNA antibodies or four of 11 criteria originated by the 1982 American College of Rheumatology which includes at least one clinical and one immunologic criterion [7]:

  1. Serositis (pleurisy, pericarditis)
  2. Oral ulcers (oral or nasopharyngeal)
  3. Arthritis (non-erosive, 2+ peripheral joints)
  4. Photosensitivity (unusual skin reaction to light exposure)
  5. Blood disorders (leukopenia, lymphopenia, thrombocytopenia, hemolytic anemia)
  6. Renal involvement (based on presence of proteinuria or cellular casts)
  7. Antinuclear antibodies (high ANA titers more than 1:160)
  8. Immunologic phenomena (dsDNA, anti-Smith or antiphospholipid antibodies)
  9. Neurologic disorder (seizures or psychosis in the absence of other causes)
  10. Malar rash (fixed erythema over the cheeks and nasal bridge, flat or raised)
  11. Discoid rash

Conventional Treatment for SLE

Lupus is a chronic disease, and the conventional medicine objective is to induce remission. Allopathic treatment depends on the type of symptoms and how serious they are. Common treatment includes nonsteroidal drugs (NSAIDs), antimalarial drugs, corticosteroids and immune suppressants, biologics, and a combination of any of these.[8]

Conclusion

Because most pharmaceuticals have side effects that may cause other health problems, holistic or alternative medicine encourages a combination of lifestyle changes. This includes a nutrient-dense diet, botanical medicine, and supplements that help repair biological cells within the body and heal the immune system.

References

[1] Lupus Erythematosus (n.d.) The Free Dictionary by Farlex (Medical Dictionary). Retrieved from .

[2] What Causes Lupus. (2016, November 28). National Resource Center on Lupus by Lupus Foundation of America. Retrieved from .

[3] Lupus Erythematosus (n.d.) The Free Dictionary by Farlex (Medical Dictionary). Retrieved from .

[4] Mayo Clinic Staff. (2017, October 25). Lupus. Mayo Clinic Patient Care & Health Information: Diseases & Conditions. Retrieved from .

[5] Ibid.

[6] Wright, B. & Bharadwaj, S. (2010, August). Systemic Lupus Erythematosus. Cleveland Clinic Center for Continuing Education: Disease Management. Retrieved from .

[7] Bartels, C. & Diamond, H. (2017, November 14). Systemic Lupus Erythematosus (SLE) Workup. Medscape Drugs & Diseases: Rheumatology. Retrieved from .

[8] Paz, Z. (2017, March). Lupus. American College of Rheumatology. Retrieved from

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