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Literature Review: Lupus

Viki Lemus

California State University, Channel Islands

HLTH 499, Sec 001

Dr. Winans

10 August 2022
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Lupus

Lupus can be defined as a chronic autoimmune disease that is known to affect an

individual's organs and tissues. Factors such as genetics, environmental triggers, and hormones

have a role in the overall development and activity of the disease (Fava & Petri, 2018).

Autoimmune diseases are when the body’s defense system attacks its own cells, tissues, and

organs because they don’t recognize them and consider them to be foreign. There are four types

of lupus, these are systemic lupus erythematosus (SLE), drug-induced lupus, cutaneous lupus,

and Neonatal lupus. SLE affects different parts of the body. Drug-induced lupus is similar to

SLE and is caused by an overreaction to certain medications, symptoms of drug-induced lupus

often disappear after a medication is stopped. Cutaneous lupus causes rashes or skin lesions,

which often occur when an individual is exposed to sunlight. Lastly, there is Neonatal lupus,

which occurs in infants after they are born to a mother with SLE. In this scenario, an infant

acquires autoantibodies from its mother with SLE. Autoantibodies are immune proteins that

target and react to a person’s own tissues or organs. The good thing is that this issue will most

likely resolve on its own within six months, however, if an infant develops a congenital heart

block they will require a pacemaker (Lupus Research Alliance). Overall, I will be discussing the

four types of lupus and their symptoms as well as other information such as statistics and a brief

overview of who is more often diagnosed with lupus.

Symptoms

The interesting thing about lupus is that individuals may experience periodic flares that

come and go and which vary in the severity of symptoms, as well as there are times when there

are no symptoms or signs that an individual even has lupus because the disease isn’t active

(Maidhof & Hilof, 2012). When a person has lupus their organs like the skin, brain, lungs, and
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kidneys are most affected; blood vessels and joints are affected too (Lupus Research Alliance).

When a person has skin lupus they begin to develop irritating rashes which could cause long-

term damage if left untreated, such as permanent hair loss, skin discoloration, and scarring. More

than 90% of individuals with SLE often face health issues in the central nervous system such as

cardiovascular disease and possibly stroke (Arnaud & Tektonidou, 2020). Cardiovascular

disease is widespread in people with SLE, and CVD is one of the leading causes of morbidity

and mortality in SLE (Arnaud & Tektonidou, 2020). There are also other less common issues

such as severe cognitive dysfunction, acute confusional state, psychosis, and peripheral nervous

disorders (Arnaud & Tektonidou, 2020). Individuals with SLE eventually show signs of

involvement in the lungs, pulmonary vasculature, pleura, or diaphragm. Symptoms will include

coughing, dyspnea, and pleurisy which is inflammation of the liver (Dellaripa, et al., 2022).

Joints are also affected and can become swollen, and stiff, and create painful joints. Blood

vessels can become inflamed (vasculitis) making it difficult for blood to be delivered to organs

(Lupus Foundation of America).

Statistics

Who is more likely to be diagnosed with lupus? Although both males and females could

be diagnosed with lupus, it is most commonly seen in females specifically between the ages of

15-44 (Fava & Petri, 2018). Having lupus raises health problems compared to women who do

not have lupus. About 1 in 10 people that have lupus are males. Males that develop lupus often

encounter the same symptoms as women, however, they can be more severe (Lupus Foundation

of America). Certain races are more susceptible to lupus as well. For example, according to

CDC: Lupus in Woman, African- American women are three times more likely to get lupus than

women that are white. Hispanic, Asian, Native American, and Alaska Native women are also
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more likely to be diagnosed with lupus. It is interesting to read that women of African-American

and Hispanic descent are often diagnosed earlier at a younger age and have more serious

symptoms, such as kidney problems, unlike women of other races. Hispanic women usually have

more heart problems. While African-American women develop more symptoms such as seizures,

strokes, and myocarditis (CDC: Lupus in Women). A possibility in which women may be more

susceptible to developing SLE is because of the hormone estrogen. Another factor is women who

have had early menarche or have used oral contraceptives have had an increase in the

development of SLE (Maidhof & Hilof, 2012).

Treatment

What types of treatments are available for lupus and is there a cure? Unfortunately, there

is no cure for lupus, but there are treatments that may help control symptoms. It has been proven

that just like any disease, early diagnosis, and treatment advances have shown improved

outcomes over the years (Arnaud & Tektonidou, 2020). The goals of treatments are to ensure

long-term patient survival, prevent flares and organ damage and improve the quality of life of an

individual (Fanouriakis, et al., n.d.). Organ or life-threatening treatments of SLE include a period

of high-intensity immunosuppressive therapy that is meant to control the disease activity and is

followed by a less intensive therapy to prevent any relapses (Fanouriakis, et al., n.d.). An

individual with lupus can manage the disease through lifestyle changes, use medications such as

immunomodulators, and immunosuppressants, and participate in targeted therapies (Fava &

Petri, 2018).
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Conclusion

In conclusion, Lupus can be defined as a chronic autoimmune disease that is known to

affect an individual's organs and tissues. There are factors like genetics, environmental triggers,

and hormones that play a role in the overall development and activity of the disease. There are

four types of lupus, with SLE being the most common. Both males and females can be diagnosed

with lupus, however, it is most common in women between the ages of 15 and 44. Race also

plays a role and so lupus is more commonly seen in minorities of African-American and

Hispanic groups. Lupus affects the brain, heart, kidneys, lungs, skin, joints, and blood vessels

and can cause very life-threatening issues. There is no cure for lupus, however, there are

treatments that can help manage symptoms and possibly prevent flares. Overall, lupus is a very

serious disease that can be life-threatening and therefore individuals with lupus must be checked

regularly and keep up with a treatment that is best suitable for them.
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References

About lupus - what is Lupus?: Lupus research alliance. Lupus Research. (2021, July 6).

Retrieved July 24, 2022, from

https://www.lupusresearch.org/understanding-lupus/what-is-lupus/about-lupus/?

gclid=Cj0KCQj

w2_OWBhDqARIsAAUNTTFUJmZttzru82rHRDxREXRSWEGIQ9on9z44xL228u5-

Dr4Pvf8nlkAaAsT7EALw_wcB

Arnaud, L., Tektonidou,M.G., (December 2020). Long-term outcomes in systemic lupus

erythematosus: trends over time and major contributors, Rheumatology, 59(5), 29–38.

https://doi.org/10.1093/rheumatology/keaa382

Centers for Disease Control and Prevention. (2022, June 28). Lupus in women. Centers for

Disease Control and Prevention. Retrieved July 24, 2022, from

https://www.cdc.gov/lupus/basics/women.htm

Dellaripa, P. F., Danoff, S. K., Pisetsky, D. S., Dieffenbach, P., & Ramirez Curtis, M. (n.d.).

Pulmonary manifestations of systemic lupus erythematosus in adults. Retrieved July 24,

2022, from https://www.uptodate.com/contents/pulmonary-manifestations-of-systemic-

lupus-erythematosus-in-adults#:~:text=At%20some%20time%20during%20the,to

%20SLE%20itself%20%5B5%5D.
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Does lupus occur in men? Lupus Foundation of America. (n.d.). Retrieved July 24, 2022, from

https://www.lupus.org/resources/does-lupus-occur-in-men#:~:text=Research%20suggests

%201%20in%2010,in%20men%20than%20in%20women.

Fanouriakis, A., Tziolos, N., Bertsias, G., et al. Update οn the diagnosis and management of

systemic lupus erythematosus. Annals of the Rheumatic Diseases. 2021;80:14-25.

https://ard.bmj.com/content/80/1/14

Fava, A., Petri, M., (Jan 2019). Systemic lupus erythematosus: Diagnosis and clinical

management. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310637/

Lupus and the heart, lungs, and blood. Lupus Foundation of America. (n.d.). Retrieved July 24,

2022, from https://www.lupus.org/resources/how-lupus-affects-the-heart-and-circulation

Maidhof, W., Hilas, O., (April 2012). Lupus: an overview of the disease and management

options. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3351863/