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SLE can occur at any age, but most often arises between the ages of 16 and 55 years. It occurs more frequently in women. In children, the female to male ratio is 4:1; in adults, it ranges from 8:1 to 13:1; and in older individuals, the ratio is 2:1. The highest frequencies and severity are in women of Afro-Caribbean, Chinese, Asian and South American Indian ancestry.
SLE occurs with greatest frequency and severity in women of Afro-Caribbean, Chinese, Asian, and South American Indian ancestry. |
The cause of SLE remains unknown, although it is thought that genetic, hormonal, immune and environmental factors have a role. The reasons that support this are:
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Relatives of patients with SLE are at increased risk of developing the disease. |
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The disease is more often seen in both of a pair of identical twins than it is in fraternal (non-identical) twins. |
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Prevalence of the disease in certain races also implies a genetic (inherited) influence in the occurrence of SLE. |
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Evidence for hormonal abnormalities is based primarily on the observation that SLE is much more common among women in their childbearing years. |
Many abnormalities of the immune system occur in patients with SLE. The reason for this remains unclear and it is not known which are primary and which are secondary causes. These abnormalities in immune regulation are thought to result from loss of "self" (substances belonging to the body) tolerance. This means that SLE patients are no longer totally tolerant of all their self-antigens and consequently an immune response develops to these antigens.
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Click here to see the causes of SLE from a TCM perspective
From the traditional Chinese medicine (TCM) viewpoint, the major cause of SLE is an inborn insufficiency that disturbs the balance of yin and yang. SLE may be acquired when environmental pathogens (dryness, dampness, cold, summer-heat, wind and fire evils) affect this balance. Inborn insufficiencies or acquired disorders also lead to depletion of vital energy (qi) and yin fluid. This can cause impaired functioning of the body and a defect in resistance to illness.
Ancient TCM classics like the Jinkui Yaolue (Summary from the Golden Chest) refer to diseases that poison the yin-yang balance. Constitutional or bodily weakness enables environmental pathogens to invade the body. This disturbs the harmonious balance of yin and yang and illness results. As an example, over-exposure to sunlight, considered to be a heat evil, causes the accumulation of heat and toxic pathogens in the body, and this in turn triggers organ system damage. Diseases where yang is dominant in the body present with yang-type symptoms, such as flushing of the face, high fever, dislike of heat, dark-colored urine or constipation. Diseases dominated by yin present with yin-type symptoms, such as pallor, cold limbs, an aversion to cold, pale urine or watery stools.
Parallels can be made with Western medicine's understanding of SLE. For example, SLE is a result of the malfunction of the body's immune system, which in TCM can be interpreted as a yin and yang imbalance. Genetic and environmental factors are also known to play a role in the development of SLE. It has been suggested that a virus may be partially responsible for its cause. This thinking is in line with the TCM concepts of environmental pathogens and an inborn deficiency being linked to the occurrence of SLE.
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