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 https://doi.org/10.47488/dhrp.v3iS2.82 

 

 
 

 
DHR Proceedings ǀ http://dhrproceedings.org 15 2023, Vol. 2 No. S2 15-18 

 

COMMENTARY 

The Progression of Lupus and its 

Manifestation in Women Throughout Age 
 

Sharlie Portales1,2, Casandra Gomez1,2, Hermelindo Rios1,2, Etziel Gonzalez1,3, Destiny Gonzalez1,4, 

Matthew Vela1,6, Saanvi Gottimukkala1,6, Mia Garcia1,7, Ryan Hernandez1,7 

 
1 3rdAnnual Junior Clinical Research Internship, South Texas Academy for Education & Training in Research, DHR Health  

   Institute for Research and Development 
2 Harlingen South High School, TX 
3 McAllen Memorial High School, TX 
4 PSJA Collegiate School of Health Professions, TX 
5 STISD Health Professions, TX 
6 STISD Science Academy, TX 
7 Iyford High School, TX 

 

Received: June 16, 2023 

Accepted for publication: October 25, 2023 

Published: November 16, 2023 

 
 

Introduction 

Lupus affects 1.5 million Americans 

annually, with 16,000 new cases being documented 

each year.1 However, it’s nine times more common in 

women than in men and it often strikes during 

childbearing years.2 Lupus is an inflammatory disease 

that occurs when the immune system targets and 

attacks its own tissues. It is a complex condition that 

can manifest in a lot of different ways, making 

diagnostics and treatment difficult. Skin, joints, 

kidneys, heart, lungs, and even the brain are some of  

the organs that Lupus disease can affect. It may result 

in organ damage, discomfort, and inflammation, 

which can cause a variety of symptoms and 

complications. Ovarian insufficiency or dysfunction 

can be a form of organ damage in women as well.3 The 

Centers for Disease Control estimate that 1.5 million 

Americans have lupus, which is especially common 

among women of color.4 With lupus affecting women 

of all ages, but more predominantly those who are 

older in age and of color, it is wise to look at the 

progression of the disease and the various symptoms 

they may experience as they become older in age. 

 

 

 

Pediatric and Neonatal Lupus Erythematosus 

During the early stages of pregnancy in 

women, certain autoantibodies that the fetus had 

exposure to via the placenta (passive mother to fetus), 

such as anti-La (SSB) and anti-Ro (SSA) resulted in 

Neonatal Lupus Erythematosus (NLE).5 Only 2% of 

NLE cases are estimated to affect fetuses where the 

mother had Sjogren Syndrome and came into contact 

with these antibodies.6 An infant with NLE can be 

born with low blood cell counts, liver problems and a 

skin rash. NLE can cause 80% to 95% of severe 

atrioventricular (AV) block cases where the fetus is 

younger than 28 days of life (neonatal period).7 

Casualties and mortality rate results in 20% to 30% of 

infants with cardiac NLE.7 Medication optimization, 

constant care, and critical monitoring are required to 

make sure the fetus is growing and is maintaining 

proper health. Children are also 15-20% of all 

Systemic Lupus Erythematosis (SLE) cases in the 

United States, this includes all ages below 18.8 The 

percentage of females suffering from pediatric 

systemic lupus erythematosus (pSLE) is around 60% 

or 70%.6 The symptoms of pSLE tend to have a more 

severe effect on the children diagnosed with pSLE 

because they are more susceptible to having problems 

with their kidney and nervous system due to the 

immunosuppressants given to suppress the lupus 



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flares.8 Since they start with the medications at an age 

where they are still growing compared to adults with 

SLE their bodies are stunted and aren't able to grow 

normally.9 The symptoms of lupus on children 

compared to adults with lupus are seen to have a more 

rapid onset of lupus, lymphadenopathy (the swelling 

of the lymph nodes), hematological abnormalities, and 

lupus nephritis.10 SLE stays within the children's body 

as they grow older.  

Lupus in Women and the Elderly 

According to the CDC, as of 2021, it is 

estimated that in 200,000 Americans diagnosed with 

SLE, 9 out of 10 of these patients are women ages 15 

to 44.11 Things that may seem regular to the general 

population pose a challenge to patients with lupus, 

such as fertility and pregnancy. Fertility in SLE 

patients does not appear to be altered by Lupus 

Erythematosus itself; however, problems such as fetal 

mutation and malformations can occur when women 

are exposed to cyclophosphamide.10 

Cyclophosphamide is an immunosuppressant drug 

used to treat patients with SLE. Compared to healthy 

women, patients with SLE are prone to danger in 

pregnancy, which puts the mother and baby at high 

risk. With pregnancy, a patient can expect for their 

SLE symptoms to flare up. Examples of these 

escalated symptoms include hypertension, built up 

fluid in the joints, and shortness of breath.12 According 

to UpToDate.com, there was a study conducted which 

included 385 women who were pregnant with SLE. 

These patients included women who were non-

Hispanic White, and had moderate SLE at the 

beginning of their pregnancy. The results of this study 

concluded that 81% of these patients who were 

pregnant with SLE had normal healthy pregnancies. 

This study also found that the results of patients 

without risk factors was 7.8% for adverse pregnancy 

rates. Those with risk factors had adverse pregnancy 

outcomes of 58% and mortality of the baby was 22%. 

The study population was limited, as it did not include 

women with high SLE activity.13 Patients with SLE 

are advised to go through an evaluation prior to 

contraception as well as a risk assessment to determine 

whether pregnancy would be suitable. As a woman 

with SLE ages and progresses in life, her Lupus 

erythematosus develops proportionally, and vice 

versa.14 One factor contributing to this is that as you 

age, you not only have to deal with your symptoms but 

also the effects of your disease’s prior activity and the 

harm it has caused. Women diagnosed with SLE may 

have earlier menopause, which ties in with bone and 

cardiovascular health.15 Lupus-related symptoms may 

improve with age, however the severity of the 

symptoms may also increase. For instance, SLE has a 

heavy effect on the kidneys of a patient. SLE can 

sometimes lead to lupus nephritis which is the 

inflammation of the kidneys resulting in kidney 

failure.16 Lupus nephritis is most commonly diagnosed 

in women ages 20-40, usually appearing within 5 years 

of your first lupus symptoms.17 Other effects of aging 

with Lupus include having to take part in multiple 

treatments for a symptom which was once controllable 

with one treatment. SLE can also advance into late 

onset SLE which represents the disorder beginning at 

the ages 55-60 years of age.18 

Treatment, is it preventable? If not, how can 

one manage this disease? 

Lupus is a common chronic autoimmune 

disease found mostly in women and with a general 

understanding of autoimmune diseases; we can infer 

that there is no possible cure. Therefore, lupus within 

itself is not preventable, but it can be manageable to 

contain and minimize the effects that come with it. 

Medications such as: hydroxychloroquine 

(antimalarial), corticosteroids, azathioprine and other 

immunosuppressants have been proven to reduce pain 

and inflammation within the kidneys, lungs, and 

heart.19 Typically, doctors normally use antimalarial to 

treat malaria, but these medications can also be useful 

for treating lupus.20 It can treat a variety of skin 

conditions as well as aid in the decrease of pain and 

swelling of arthritis, one of many common symptoms 

of lupus. Now certain medications may differ from 

prescriptions given to patients ranging from different 

age groups. This is because female teenagers 

commonly have concerns regarding socialization, 

body image, psychological state, and competitiveness 

in sports and in school. They are more likely to 

experiment with alternative treatments and illicit 

medications than adults.21 Before taking any 

medications, ask your doctor if it can increase light 

sensitivity. Some medications can make your skin 

more vulnerable to light, so it is recommended by 

dermatologists that you protect your skin from the sun. 

This disease can worsen due to the fact that it causes 

your skin to become sensitive to ultraviolet (UV) light. 

Use a protective sunscreen, if you have a darker skin 

tone consider using a tinted sunscreen, so that it will 

not leave a white cast on your skin.22 The goal is to 

control your symptoms and reduce any inflammation 

when it takes place. You can do this by suppressing 

your overactive immune system with 

immunosuppressants to prevent any flares if they may 

occur. 



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DHR Proceedings ǀ http://dhrproceedings.org 17 2023, Vol. 2 No. S2 15-18 

Conclusion 

As of 2023, Lupus is still very common 

affecting over 1.5 million Americans annually with 

studies showing it most commonly affects women 

disproportionately compared to men with a 9:10 ratio.1 

Lupus may present multiple symptoms and vary in 

complications, which can include organ damage, 

inflammation, and pregnancy difficulties. While there 

is no current cure for lupus, it can be regulated with 

medications such as: hydroxychloroquine 

(antimalarial) and corticosteroids to manage and 

minimize the effects of symptoms.20 Changes in 

lifestyle can also aid in the regulation of Lupus, which 

in turn has a positive effect on the patient’s lives.23 As 

of April 27, 2022 the understanding of lupus 

progresses, it is imperative to prioritize early detection 

and patient education to promote a higher quality of 

life for patients.24 Increased awareness and research 

efforts are necessary to address disparities in lupus 

prevalence and outcomes among different 

communities. Therefore, it is best to control your 

symptoms and reduce any inflammation if it may 

occur as age will not worsen the effects of your 

symptoms as long as you treat them in a timely 

manner.  

Acknowledgements 

Monica Betancourt-Garcia, MD, Program Director; 

Melissa Eddy, MS, Program Manager  

Funding 

Funded by DHR Health Institute for Research & 

Development; DHR Health; Region One ESC 

GEARUP College Ready, Career Set!; Region One 

ESC GEARUP College Now, Career Connected; 

Region One ESC PATHS; Region One ESC Upward 

Bound Math & Science; Benavides ISD; and Jubilee 

Academy-Brownsville  

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