Investigating the Predisposition of Women to Develop Lupus: Examining Factors Contributing to Gender-Based Risk
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Lupus: The Hidden Killer Masquerading as Common Symptoms
Imagine this: a chick's visit to the doc, complete with fatigue, joint pain, and anemia. The doc tells her she's just bleeding like a period. She needs some iron, and voila! She'll feel better. Or perhaps she's just wiped out because she's got two rugrats to run after and work full-time. If she catches some Z's, she'll feel like a powerhouse again.
But what's this? Nothing's working. She hits up another doc, who says she's clinically depressed, battling an infection, or struggling with chronic fatigue. The dreaded lupus isn't even on the radar, not until she's really sick—like kidney disease, debilitating arthritis, or a bad skin situation. Dr. Grant Hughes, a rheumatologist at Harborview Medical Center, lays it all down: this is a common story for women who end up diagnosed with lupus, months—sometimes years—after they first start experiencing symptoms.
So, What Exactly is Lupus?
Lupus is an autoimmune disease that doesn't play by the rules—unlike other autoimmune disorders, it blasts healthy tissues instead of protecting them. It's super sneaky that way. Systemic Lupus Erythematosus, the most common form of lupus, is a beast, with no national registry to track the disease. But the Centers for Disease Control and Prevention (CDC) estimates there are at least 322,000 Americans struggling with it. There are other forms, too, like cutaneous lupus, drug-induced lupus, and neonatal lupus.
At its root, lupus is an autoimmune disorder where the immune system starts attacking cell nuclei. It's unique because it's a systemic disease, going after nuclei in cells all over the body, rather than zeroing in on a particular organ.
Lupus is like a wrecking ball, sending antibodies into circulation to clean up dead and dying cells. These antibodies, called anti-nuclear antibodies (ANA), find dead cells and tissues throughout the body—in the blood, skin, liver, gastrointestinal tract, you name it. They load up with components from these dead cells, and when they deposit in the joints, kidneys, skin, and other tissues, they trigger inflammation and damage. This low-key immune system activation can make people with lupus feel sick all the time.
ANA Testing
95% of people with lupus test positive for ANA, making it one of the most accurate ways to diagnose the disease. But testing positive for ANA by itself doesn't mean you have Systemic Lupus Erythematosus (SLE). There are plenty of people out there with positive tests who are as healthy as horses.
To be diagnosed with SLE, you've gotta meet four of 17 clinical and immunological lupus classification criteria. These criteria are crucial for research and ensure everyone in studies actually has the disease, but their extreme specificity can make it tough for doctors, especially those who aren't lupus experts, to make a diagnosis. Dr. Hughes puts it bluntly: "Unfortunately, there's no widely-accepted diagnostic criteria for SLE, and doctors are left using these classification criteria and their best judgment."
Genetic Factor
Lupus is one heck of a complicated beast. Genetics account for about 70% of a person's risk, but that doesn't mean your parents or grandparents have to have lupus for you to get it. More likely, a family member will have another autoimmune condition with similar genetic risk factors. Sometimes, family members will test positive for ANA but be perfectly healthy. And sometimes, there's no trace of lupus or autoimmunity at all in the family.
Hormones Fuel the Fire
Research hints that hormones, particularly estrogen—found in both the body and birth control—play a role in the onset of lupus symptoms, especially for women who are genetically predisposed to the disease. It's a delicate balance that can tip in favor of lupus if you have other risk factors.
Lupus Affects Women of Color More
Lupus doesn't pick sides, but it does seem to target women of color more often than white women, who are usually diagnosed later in life than their counterparts. Women of color are also more likely to have severe lupus—Black, Hispanic, Asian, and American Indian/Native American women all have higher rates of the disease.
Singer Selena Gomez shed some light on the severity of the disease in the Latinx community when she announced in September 2017 that she had a kidney transplant due to lupus. Another study published in Michigan found that Black women develop lupus at a younger age than white women, experience more life-threatening complications, and have a higher risk of kidney disease and kidney failure.
Hispanic and Asian women also have a higher risk for lupus than white women, especially in urban areas like Manhattan. These women are more likely to have severe lupus and organ complications, mirroring the trends observed in Black women.
Researchers are still trying to unravel the mystery behind why sex, race, and ethnicity can change the likelihood, severity, and outcomes of lupus. But one thing is for sure: early diagnosis and treatment are crucial for managing lupus and preventing the most severe complications. Talk to your doctor if you have concerns about your health.
- Science has found a link between hormones, particularly estrogen, and the onset of lupus symptoms, suggesting a potential role for mental health and women's health research in understanding this autoimmune disease.
- In the realm of health and wellness, lupus affects women of color more frequently, leading to earlier onset, more life-threatening complications, and a higher risk of kidney disease and kidney failure, as observed in studies involving Black, Hispanic, Asian, and American Indian/Native American women.
- Chronic diseases, such as lupus, often display symptoms that can imitate common medical conditions like anemia or depression, making it crucial for those experiencing prolonged fatigue, joint pain, or skin issues to consult a specialist like Dr. Grant Hughes for proper diagnosis and treatment.
