Association between Endometriosis and Systemic Lupus Erythematosus - a systematic review

Introduction: Endometriosis (EMS) is a common and heterogeneous gynecological condition, presenting with a diverse range of symptoms and with inflammatory and immunologic abnormalities. Systemic Lupus Erythematosus (SLE) is an autoimmune disease that also primarily affects women of reproductive age. Therefore, we conducted a systematic review to investigate a possible association of these two conditions. Methods: Medline (PubMed), Scopus and Web of Science databases were searched for articles published until January 3, 2023, that reported on an association between EMS and SLE. Risk of bias in individual studies was evaluated following the National Heart, Lung, and Blood Institute Quality Assessment Tools (NHLBI-QAT). Results: From the 501 articles identified through our search, fifteen studies were included in this systematic review. Most of the studies presented an overall fair or poor quality rating. We observed a significant association between endometriosis and SLE. Discussion: Despite the limited quality of included studies, the results obtained suggest that endometriosis and systemic lupus erythematosus can be associated, whether it is by a shared etiology or by a causal relationship. These findings can help create awareness among clinicians to the appearance of clinical manifestations of EMS or SLE and contribute to a better medical assessment of these patients, particularly women of reproductive age.