Systemic Lupus Erythematosus: some Epidemiological and Clinical Aspects

Angel Justiz-Vaillant^1, , Patrick E. Akpaka¹ and Peter Poonking²

¹Department of Paraclinical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago

²San Fernando General Hospital, San Fernando, Trinidad and Tobago

Cite this paper

Angel Justiz-Vaillant, Patrick E. Akpaka and Peter Poonking. Systemic Lupus Erythematosus: some Epidemiological and Clinical Aspects. American Journal of Public Health Research. 2015; 3(2):46-50. doi: 10.12691/AJPHR-3-2-2

Abstract

Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with a wide array of clinical manifestations including rash, photosensitivity, oral ulcers, arthritis, serositis, glomerulonephritis among others clinical findings. In this paper we globally summarized the most important epidemiological and clinical aspects to bear in mind, when the time comes to make the diagnosis of this rheumatic disorder and its management. Factor that are involved in the SLE pathogenesis and novel treatment options are mentioned.

Keywords

systemic lupus erythematosus, epidemiology, prevalence, incidence, mortality, immunology

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Pisetsky, D.S., Buyon, J.P. and Manzi, S., Chapter 17. “Systemic lupus erythematosus”. In: Klippel, J.H., Crofford, L.J., Stone, J.H. and Weyand, C.M., Primer on the Rheumatic Diseases. Edition 12. Arthritis Foundation, Atlanta, GA., 2001.
[2]	Rus, V., Hajeer, A. and Hochberg, M.C., Chapter 7. “Systemic lupus erythematosus”. In: Silman, A.J. and Hochberg, M.C., (eds.) Epidemiology of the Rheumatic Disease. 2nd edition. Oxford University Press, New York, 2001.
[3]	Lawrence, R.C., Felson, D.T., Helmick, C.G., Arnold, L.M., Choi, H., Deyo, R.A., Gabriel, S., Hirsch, R., Hochberg, M.C., Hunder, G.G., Jordan, J.M., Katz, J.N., Maradit Kremers, H. and Wolfe, F. for the National Arthritis Data Workgroup. “Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II”, Arthritis Rheum, 58 (1). 26-35. Jan. 2008.
[4]	Helmick, C.G., Felson, D.T., Lawrence, R.C., Gabriel, S., Hirsch, R., Kwoh, C.K., Liang, M.H., Maradit Kremers, H., Mayes, M.D., Merkel, P.A., Pillemer, S.R., Reveille, J.D. and Stone, J.H., for the National Arthritis Data Workgroup. “Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I”, Arthritis Rheum, 58 (1). 15-25. Jan. 2008.
[5]	Lawrence, R.C., Helmick, C.G., Arnett, F.C., Deyo, R.A., Felson, D.T., Giannini, E.H., Heyse, S.P., Hirsch, R., Hochberg, M.C., Hunder, G.G., Liang, M.H., Pillemer, S.R., Steen, V.D. and Wolfe, F., “Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States”, Arthritis Rheum, 41 (5). 778-799. May. 1998.
[6]	Chakravarty, E.F., Bush, T.M., Manzi, S., Clarke, A.E. and Ward, M.M., “Prevalence of adult systemic lupus erythematosus in California and Pennsylvania in 2000: estimates obtained using hospitalization data”, Arthritis Rheum, 56 (6). 2092-2094. Jun. 2007.
[7]	Pons-Estel, G.J., Alarcón, G.S., Scofield, L., Reinlib, L. and Cooper, G.S., “Understanding the epidemiology and progression of systemic lupus erythematosus”. Semin Arthritis Rheum, 39 (4). 257-268. Feb. 2010.
[8]	Uramoto, K.M., Michet, C.J. Jr., Thumboo, J., Sunku, J., O'Fallon, W.M., Gabriel, S.E., “Trends in the incidence and mortality of systemic lupus erythematosus, 1950-1992”. Arthritis Rheum, 42 (1). 46-50. Jan. 1999.
[9]	Danchenko, N., Satia, J.A. and Anthony, M.S., “Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden”, Lupus, 15 (5). 308-318. 2006.
[10]	Rus, V., Maury, E.E. and Hochberg, M.C, “The epidemiology of systemic lupus erythematosus”. In: Dubois' Lupus Erythematosus, Wallace DJ, Hahn BH (Eds), Lippincott Williams and Wilkins, Philadelphia 2002.
[11]	Peschken, C.A. and Esdaile, J.M., “Rheumatic diseases in North America's indigenous peoples”, Semin Arthritis Rheum, 28 (6). 368-391. Jun. 1999.
[12]	Petri, M., “Epidemiology of systemic lupus erythematosus”, Best Pract Res Clin Rheumatol, 16 (5). 847-858. Dec. 2002.
[13]	Hochberg, MC., The incidence of systemic lupus erythematosus in Baltimore, Maryland, 1970-1977, Arthritis Rheum, 28 (1). 80-86. Jan. 1985..
[14]	Serdula, M.K. and Rhoads, G.G., “Frequency of systemic lupus erythematosus in different ethnic groups in Hawaii”, Arthritis Rheum, 22 (4). 328-233. Apr. 1979.
[15]	Symmons, D.P., “Frequency of lupus in people of African origin”, Lupus, 4 (3). 176-178. Jun. 1995.
[16]	Hart, H.H., Grigor, R.R. and Caughey, D.E., Ethnic difference in the prevalence of systemic lupus erythematosus, Ann Rheum Dis, 42 (5). 529-532. Oct. 1983.
[17]	Chung, S.A., Tian, C., Taylor, K.E., Lee, A.T., Ortmann, W.A., Hom, G., Graham, R.R., Nititham, J., Kelly, J.A., Morrisey, J., Wu, H., Yin, H., Alarcón-Riquelme, M.E., Tsao, B.P., Harley, J.B., Gaffney, P.M., Moser, K.L., Manzi, S., Petri, M., Gregersen, P.K., Langefeld, C.D., Behrens, T.W., Seldin, M.F. and Criswell, L.A., “European population substructure is associated with mucocutaneous manifestations and autoantibody production in systemic lupus erythematosus”, Arthritis Rheum, 60 (8). 2448-2456. Aug. 2009.
[18]	Cooper, G.S., Dooley, M.A., Treadwell, E.L., St Clair, E.W., Parks, C.G. and Gilkeson, G.S., “Hormonal, environmental, and infectious risk factors for developing systemic lupus erythematosus”, Arthritis Rheum, 41 (10). 1714-1724. Oct. 1998.
[19]	Costenbader, K.H., Feskanich, D., Stampfer, M.J. and Karlson, E.W., “Reproductive and menopausal factors and risk of systemic lupus erythematosus in women”, Arthritis Rheum, 56 (4). 1251-1262. Apr. 2007.
[20]	Lahita, R.G., “The role of sex hormones in systemic lupus erythematosus”, Curr Opin Rheumatol, 11 (5). 352-356. Sep. 1999.
[21]	Uramoto, K.M., Michet, C.J. Jr., Thumboo, J., Sunku, J., O'Fallon, W.M. and Gabriel, S.E., “Trends in the incidence and mortality of systemic lupus erythematosus, 1950-1992”. Arthritis Rheum, 42 (1). 46-50. Jan. 1999.
[22]	Sacks, J.J., Helmick, C.G. and Langmaid, G., “Deaths from arthritis and other rheumatic conditions, United States, 1979-1998”, J Rheumatol, 31(9). 1823-1828. Sep. 2004.
[23]	Biswas, P.S., Kang, K., Gupta, S., Bhagat, G. and Pernis, A.B., “A murine autoimmune model of rheumatoid arthritis and systemic lupus erythematosus associated with deregulated production of IL-17 and IL-21”, Methods Mol Biol, 900. 233-251. 2012.
[24]	Pawlak, C.R., Witte, T., Heiken, H., Hundt, M., Schubert, J., Wiese, B., Bischoff-Renken, A., Gerber, K., Licht, B., Goebel, M.U., Heijnen, C.J., Schmidt, R.E. and Schedlowski, M., “Flares in patients with systemic lupus erythematosus are associated with daily psychological stress”, Psychother Psychosom, 72 (3). 159-165. May-Jun. 2003.
[25]	Williams, E.M., Penfield, M., Kamen, D. and Oates, J.C., “An Intervention to Reduce Psychosocial and Biological Indicators of Stress in African American Lupus Patients: The Balancing Lupus Experiences with Stress Strategies Study”, Open J Prev Med, 4 (1). 22-31. Jan. 2014.
[26]	Williams, D.R., “The health of men: structured inequalities and opportunities”, Am J Public Health, 93 (5). 724-731. May. 2003.
[27]	Arkema, E.V. and Simard, J.F., “Perinatal risk factors for future SLE: a population-based nested case-control study”, Lupus, 10. Feb. 2015. [Epub ahead of print]
[28]	Simard, J.F., Karlson, E.W., Costenbader, K.H., Hernán, M.A., Stampfer, M.J., Liang, M.H. and Mittleman, M.A., “Perinatal factors and adult-onset lupus”, Arthritis Rheum, 59 (8). 1155-1161. Aug. 2008.
[29]	29. Gilbert, E.L. and Ryan, M.J., “Estrogen in cardiovascular disease during systemic lupus erythematosus”, Clin Ther, 36 (12). 1901-1912. Dec. 2014.
[30]	Rojas-Villarraga, A., Torres-Gonzalez, J.V. and Ruiz-Sternberg, A.M., “Safety of Hormonal Replacement Therapy and Oral Contraceptives in Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis”, PLoS One, 9 (8). Aug. 2014.
[31]	Quintero, O.L., Amador-Patarroyo, M.J., Montoya-Ortiz, G., Rojas-Villarraga, A. and Anaya, J.M., “Autoimmune disease and gender: plausible mechanisms for the female predominance of autoimmunity”, J Autoimmun, 38 (2-3). 109-119. May. 2012.
[32]	Schwarz, E.B. and Lohr, P.A., “Oral contraceptives in women with systemic lupus erythematosus”, N Engl J Med, 354 (11). 1203-1204. Mar. 2006.
[33]	Carvalho, C., Marinho, A., Leal, B., Bettencourt, A., Boleixa, D., Almeida, I., Farinha, F., Costa, P.P., Vasconcelos, C. and Silva, B.M., “Association between vitamin D receptor (VDR) gene polymorphisms and systemic lupus erythematosus in Portuguese patients”, Lupus, Feb 6. 2015. [Epub ahead of print]
[34]	Anselm, M. and Sen Hee, T., “Environmental Factors, Toxicants and Systemic Lupus Erythematosus”, Int J Mol Sci, 15 (9). 16043-16056. Sep. 2014.
[35]	Hewagama, A. and Richardson, B., “The genetics and epigenetics of autoimmune diseases”, J Autoimmun, 33 (1). 3-11. Aug. 2009.
[36]	Lisnevskaia, L., Murphy, G. and Isenberg, D., “Systemic lupus erythematosus”, Lancet, 384 (9957). 1878-1888. Nov. 2014.
[37]	Bijl, M. and Kallenberg, C.G., “Ultraviolet light and cutaneous lupus”, Lupus, 15 (11). 724-727. Nov. 2006.
[38]	Somers, E.C. and Richardson, B.C., “Environmental exposures, epigenetic changes and the risk of lupus”, Lupus, 23 (6). 568-576. May. 2014.
[39]	Piotrowski, P., Wudarski, M., Sowińska, A., Olesińska, M. and Jagodzinski, P.P., “TNF-308 G/A polymorphism and risk of systemic lupus erythematosus in the Polish population”, Mod Rheumatol, 9. 1-20. Feb. 2015. [Epub ahead of print]
[40]	da Silva Fonseca, A.M., de Azevedo Silva, J., Pancotto, J.A., Donadi, E.A., Segat, L., Crovella, S. and Sandrin-Garcia, P., “Polymorphisms in STK17A gene are associated with systemic lupus erythematosus and its clinical manifestations”, Gene, 527 (2). 435-439. Sep. 2013.
[41]	Ben-Zvi, I., Aranow, C., Mackay, M., Stanevsky, A., Kamen, D.L., Marinescu, L.M., Collins, C.E., Gilkeson, G.S., Diamond, B. Hardin, J.A., “The impact of vitamin D on dendritic cell function in patients with systemic lupus erythematosus”, PLoS One, 5 (2). Feb. 2010.
[42]	Hou, Y., Zhang, C., Xu, D. and Sun, H., “Association of KIR and HLA-Cw genes combinations with systemic lupus erythematosus”, Clin Exp Immunol, Jan. 2015. [Epub ahead of print]
[43]	Fenton, K., “The effect of cell death in the initiation of lupus nephritis”, Clin Exp Immunol, 179 (1). 11-16. Jan. 2015.
[44]	Petri, M., Bello, K.J., Fang, H. and Magder, L.S., “Vitamin D in systemic lupus erythematosus: modest association with disease activity and the urine protein-to-creatinine ratio”, Arthritis Rheum, 65 (7). 1865-1871. Jul. 2013.
[45]	Mok, M.Y., “Tolerogenic dendritic cells: role and therapeutic implications in systemic lupus erythematosus”, Int J Rheum Dis, Dec. 2014. [Epub ahead of print]
[46]	Mackern-Oberti, J.P., Llanos, C., Vega, F., Salazar-Onfray, F., Riedel, C.A., Bueno, S.M. and Kalergis, A.M., “Role of dendritic cells in the initiation, progress and modulation of systemic autoimmune diseases”, Autoimmun Rev, 14 (2). 127-139. Feb. 2015.
[47]	Rao, V. and Gordon, C., “Evaluation of epratuzumab as a biologic therapy in systemic lupus erythematosus”, Immunotherapy, 6 (11). 1165-1175. Nov. 2014.
[48]	Wallace, D.J., Gordon, C., Strand, V., Hobbs, K., Petri, M., Kalunian, K., Houssiau, F., Tak, P.P., Isenberg, D.A., Kelley, L., Kilgallen, B., Barry, A.N., Wegener, W.A. and Goldenberg, D.M., “Efficacy and safety of epratuzumab in patients with moderate/severe flaring systemic lupus erythematosus: results from two randomized, double-blind, placebo-controlled, multicentre studies (ALLEVIATE) and follow-up”, Rheumatology (Oxford), 52 (7). 1313-1322. Jul. 2013.
[49]	Sakthiswary, R. and D'Cruz, D., “Intravenous immunoglobulin in the therapeutic armamentarium of systemic lupus erythematosus: a systematic review and meta-analysis”, Medicine (Baltimore), 93 (16). e86. Oct. 2014.
[50]	Mulhearn, B. and Bruce, I.N., “Indications for IVIG in rheumatic diseases”, Rheumatology (Oxford), Nov. 2014. [Epub ahead of print]
[51]	Qian, J., Wang, L., Yuan, X., Wang, L. and Chen, T., “Dose-related regulatory effect of intravenous immunoglobulin on dendritic cells-mediated immune response”, Immunopharmacol Immunotoxicol, 36 (1). 33-42. Feb. 2014.
[52]	Camara, I., Sciascia, S., Simoes, J., Pazzola, G., Salas, V., Karim, Y., Roccatello, D. and Cuadrado, M.J., “Treatment with intravenous immunoglobulins in systemic lupus erythematosus: a series of 52 patients from a single centre”, Clin Exp Rheumatol, 32 (1). 41-47. Jan-Feb. 2014.
[53]	Hartung, H.P., Mouthon, L., Ahmed, R., Jordan, S., Laupland, K.B. and Jolles, S., “Clinical applications of intravenous immunoglobulins (IVIg)--beyond immunodeficiencies and neurology”, Clin Exp Immunol, 158 Suppl 1. 23-33. Dec. 2009.
[54]	Justiz Vaillant, A.A., Ramirez, N., Cadiz, A. and Akpaka, P.E., “Case Reports on the Use of Intravenous Immunoglobulins (IVIG) in the Treatment of Systemic Lupus Erythematosus (SLE)”, J Clin Case Rep, 3. 263. 2013.
[55]	Lim, E., Tao, Y., White, A.J., French, A.R. and Cooper, M.A., “Hypogammaglobulinemia in pediatric systemic lupus erythematosus”, Lupus, 22 (13). 1382-1387. Nov. 2013.
[56]	Sciascia, S., Cuadrado, M.J. and Karim, M.Y., “Management of infection in systemic lupus erythematosus”, Best Pract Res Clin Rheumatol, 27 (3). 377-389. Jun. 2013.
[57]	Kirou, K.A. and Gkrouzman, E., “Anti-interferon alpha treatment in SLE”, Clin Immunol, 148 (3). 303-312. Sep. 2013.
[58]	Sardesai, V.V., Sardesai, V.R. and Agarwal, T.D., “Steroid-resistant autoimmune thrombocytopenia in systemic lupus erythematosus treated with rituximab”, Indian J Dermatol, 60 (1). 106. Jan-Feb. 2015.
[59]	Tambralli, A., Beukelman, T., Cron, R.Q. and Stoll, M.L., “Safety and Efficacy of Rituximab in Childhood-onset Systemic Lupus Erythematosus and Other Rheumatic Diseases”, J Rheumatol, Jan. 2015. [Epub ahead of print]
[60]	Braun-Moscovici, Y., Butbul-Aviel, Y., Guralnik, L., Toledano, K., Markovits, D., Rozin, A., Nahir, M.A. and Balbir-Gurman, A., “Rituximab: rescue therapy in life-threatening complications or refractory autoimmune diseases: a single center experience”, Rheumatol Int, 33 (6). 1495-1504. Jun. 2013.