Systemic Lupus Erythematosus - Risk Factors

Risk Factors

The number of people diagnosed with lupus has more than tripled over the past 4 decades. Some experts believe this may simply indicate a greater degree of doctor training in recognizing the syndrome.

Gender

About 90% of lupus patients are women, most of whom are diagnosed when they are in their childbearing ages, a fact that may be explained by hormones. After menopause, women are only 2.5 times as likely as men to contract SLE. Flares also become somewhat less common after menopause in women who have chronic SLE.

Ethnicity

African-Americans are three to four times more likely to develop the disease than Caucasians and to have severe complications. Hispanics and Asians are also more susceptible to the disease.

Family History

A family history plays a strong role in SLE. A brother or sister of a patient with the disorder has 20 times the risk as someone without an immediate family member with SLE.

Risk Factors in Children

The disease is rare in childhood. When it does occur, it is often associated with thrombotic thrombocytopenia purpura, a condition resulting from abnormally low levels of blood platelets. SLE in children may also be caused by certain medications, including minocycline and zafirlukast.

The Presence of Other Autoimmune Disorders

Rheumatoid Arthritis. One study investigated the relationship between hormones, SLE, and rheumatoid arthritis, another autoimmune disease. Higher levels of estrogen are associated with SLE, while lower levels are associated with rheumatoid arthritis. The study found that some patients, in fact, progress from one disease to the other, and that such transitions occur during major hormonal shifts, such as the onset of menopause or pregnancy.

Rheumatoid arthritis is a systemic autoimmune disease that initially attacks the lining, or synovium, of the joints.

Fibromyalgia. Fibromyalgia, which some experts believe may be another autoimmune disorder, is also a common co-condition in patients with SLE.

Click the icon to see an image of fibromyalgia.

Drug-Induced Lupus

Many prescription drugs can cause lupus-like skin symptoms. In one study, the most common drugs causing these symptoms were hypertension medications, including hydrochlorothiazide, angiotensin-converting-enzyme inhibitors, and calcium-channel blockers. About 40 different drugs have been linked to lupus onset. Anyone diagnosed with cutaneous lupus erythematosus should be sure to tell their doctors all the medications (including herbs and supplements) that they are taking.

Lifestyle Factors

Smoking. A 2004 review found a small association between current smoking and SLE development. No association was observed for past cigarette use.