Lupus seems to result from an interaction between genetic, hormonal and environmental factors.5 SLE is known to be associated with the production of a large range of autoantibodies. In certain specific subsets, such as neonatal lupus, their role in pathogenesis is now clearly established. The greatest risk factor is female sex (the female:male ratio is 9:1), and the highest prevalence is in the child-bearing age group. There is now evidence to suggest that oestrogens stimulate the immune system, which may be the reason for this observation. The genetic hypothesis is supported by the familial clustering of lupus6 and the association of certain HLA types with particular subsets of lupus.7

Evidence for a viral aetiology has not been conclusive.8

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