Is there an increased risk of lupus in those patients with post traumatic stress disorder?

Post traumatic stress disorder may affect the risk for developing lupus

A new study examined the relationship between PTSD and the autoimmune disease lupus. Data to date suggests that individuals affected by PTSD are at slightly increased risk of developing lupus.

A recent well conducted study confirms observations that were suggested by previous studies that patients with post traumatic stress disorder are at increased risk to develop the autoimmune disease lupus.

To evaluate the prevalence of lupus, the authors chose to study a large, diverse population enrolled in Medicaid, (a U.S. government-sponsored health insurance program)..

The authors identified SLE cases and controls among patients 18-65 years old enrolled in Medicaid for more than 12 months from 2007 to 2010. SLE and PTSD case status were defined based on validated patterns of ICD-9 codes.

There were 10,942 incident SLE cases and these were matched to 109,420 controls. Prevalence of PTSD was higher in SLE cases at 10.74 cases of PTSD per 1,000 (95% CI 9.37-12.31) versus 7.83 (95% CI 7.42-8.27) in controls. The multivariable-adjusted odds ratio for SLE among those with PTSD was 2.00 (95% CI 1.64-2.46). Factors such as smoking, obesity, oral contraceptive use, and other covariates were controlled in the multivariate model.

The authors concluded that patients with prior PTSD diagnosis had twice the odds of a subsequent diagnosis of SLE. A particular advantage of this study over prior studies was its use of a large, racially and sociodemographic diverse study population.

The study was not designed to answer any of the reasons as to why patients with PTSD might be at increased risk for lupus. The authors remind us that patients with PTSD are known to have increased inflammatory markers in the blood including IL6 and CRP and that patients with PTSD are known to have multiple epigenetic and other changes in their DNA that could affect how the immune system functions.

The exact reasons why will need to wait. For now, though, it seems clear that patients with post traumatic stress disorder are at increased risk for lupus.

Reference
Case et al. Post-Traumatic Stress Disorder (PTSD) and Risk of Systemic Lupus Erythematosus (SLE) among Medicaid Recipients.Arthritis Care & Research 2021