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Systemic lupus erythematosus risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2], Raviteja Guddeti, M.B.B.S. [3]

Overview

Overview

The most potent risk factor in the development of systemic lupus erythematosus is gender; females are more likely to develop SLE.[1] Other risk factors include HLA genetic mutations; being African American, Asian, or non-Causcasian; and previous exposure to certain infections.

Risk Factors

Risk Factors

The underlying cause of this autoimmune disease is not clear. Clinical data suggests that the onset of systemic lupus erythematosus is associated with the following factors:

  • Infections can stimulate some antigen specific cells and lead to SLE disease:
  • Ultraviolet (UV) light
  • Cigarette smoking[6]
  • Crystalline silica exposure in work environment (e.g. cleaning powders, soil, pottery materials, cement, etc.)[7]
  • Drug allergy[8]
  • Caring for a pet (especially a dog)
  • This table must include the cardinal manifestations of differential diagnosis and the list of diseases must be prioritize based on mortality rate and prevalences of the diseases. For example, if you want to write a differential diagnosis table for heat stroke, sepsis, malignant hyperthermia, neuroleptic malignant syndrome, and serotonin syndrome first, you need to mention the cardinal manifestations for these conditions as, hyperthermia and altered mental status. Second, prioritize your list based on disease mortality or prevalence then, create the table. You can find the example here.
Differential Diagnosis Similar Features Differentiating Features
Differential 1
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 2
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 3
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 4
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 5
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
  • On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
References

References

  1. Grimaldi CM (2006). “Sex and systemic lupus erythematosus: the role of the sex hormones estrogen and prolactin on the regulation of autoreactive B cells”. Curr Opin Rheumatol. 18 (5): 456–61. doi:10.1097/01.bor.0000240354.37927.dd. PMID 16896282.
  2. “NIH Fact Sheets – Lupus”.
  3. Grimaldi CM (2006). “Sex and systemic lupus erythematosus: the role of the sex hormones estrogen and prolactin on the regulation of autoreactive B cells”. Curr Opin Rheumatol. 18 (5): 456–61. doi:10.1097/01.bor.0000240354.37927.dd. PMID 16896282.
  4. McCarty DJ, Manzi S, Medsger TA, Ramsey-Goldman R, LaPorte RE, Kwoh CK (1995). “Incidence of systemic lupus erythematosus. Race and gender differences”. Arthritis Rheum. 38 (9): 1260–70. PMID 7575721.
  5. Lossius A, Johansen JN, Torkildsen Ø, Vartdal F, Holmøy T (2012). “Epstein-Barr virus in systemic lupus erythematosus, rheumatoid arthritis and multiple sclerosis—association and causation”. Viruses. 4 (12): 3701–30. PMC 3528287. PMID 23342374.
  6. Ghaussy NO, Sibbitt WL, Qualls CR (2001). “Cigarette smoking, alcohol consumption, and the risk of systemic lupus erythematosus: a case-control study”. J. Rheumatol. 28 (11): 2449–53. PMID 11708417.
  7. Parks CG, Cooper GS, Nylander-French LA, Sanderson WT, Dement JM, Cohen PL, Dooley MA, Treadwell EL, St Clair EW, Gilkeson GS, Hoppin JA, Savitz DA (2002). “Occupational exposure to crystalline silica and risk of systemic lupus erythematosus: a population-based, case-control study in the southeastern United States”. Arthritis Rheum. 46 (7): 1840–50. doi:10.1002/art.10368. PMID 12124868.
  8. Cooper GS, Dooley MA, Treadwell EL, St Clair EW, Gilkeson GS (2002). “Risk factors for development of systemic lupus erythematosus: allergies, infections, and family history”. J Clin Epidemiol. 55 (10): 982–9. PMID 12464374.

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