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Familial autoimmunity as a risk factor for systemic lupus erythematosus and vice versa: a case-control study

Divisione di Reumatologia, Dipartimento di Terapia Medica Applicata, Universitàdegli Studi ‘La Sapienza’, Rome, Italy, rob.pri{at}libero.it

E Medda

Laboratorio di Epidemiologia e Biostatistica, Istituto Superiore di Sanità, Rome, Italy

F Conti

Divisione di Reumatologia, Dipartimento di Terapia Medica Applicata, Universitàdegli Studi ‘La Sapienza’, Rome, Italy

E AM Cassara

Divisione di Reumatologia, Dipartimento di Terapia Medica Applicata, Universitàdegli Studi ‘La Sapienza’, Rome, Italy

M G Danieli

Istituto di Clinica Medica, Ematologia ed ImmunologiaClinica, Universitàdegli Studi di Ancona, Italy

R Gerli

Unitàdi Reumatologia, Dipartimento di Medicina Clinica e Sperimentale, Universitàdegli Studi di Perugia, Italy

R Giacomelli

Dipartimento di Medicina Interna e SanitàPubblica, Universitàdegli Studi de L’Aquila, Italy

F Franceschini

Unitàdi Immunologia Clinica, Spedali Civili, Brescia, Italy

A Manfredi

Unitàdi Reumatologia ed Immunologia Clinica IRCCS H. San Raffaele, Milan, Italy

M Pietrogrande

U.O. Medicina Interna, Policlinico San Marco, Zingonia, Bergamo, Italy

M A Stazi

Laboratorio di Epidemiologia e Biostatistica, Istituto Superiore di Sanità, Rome, Italy

G Valesini

Divisione di Reumatologia, Dipartimento di Terapia Medica Applicata, Universitàdegli Studi ‘La Sapienza’, Rome, Italy

The objective of this multicentric case-control study was to investigate if a history of autoimmune disease (AD) in first-degree relatives (FDR) is a risk factor for systemic lupus erythematosus (SLE) and to evaluate the risk of AD among FDR of SLE patients. Cases were Italian SLE patients consecutively enrolled. Controls were orthopaedic inpatients without any autoimmune diseases.The strength of the association between family history of AD and SLE was measured as an odds ratio (OR) calculated from the coefficient of an unconditional regression model. To calculate the risk of AD among FDR of SLE patients, the extended generalized estimating equation technique was used. In total, 154 SLE cases and 140 controls were enrolled. A family history of AD was reported by 22.7% of SLE patients and by 5.7% of the controls. The risk of SLE increased with the number of FDR with AD (one FDR affected, OR 4.1; two or more, OR 11.3). The probability of having AD was higher among FDR of SLE cases in comparison to FDR of controls (RR 4.6; 95%CI 1.9-11.1). A female SLE patient conferred an increased risk of AD to her FDR; this risk is doubled in females (OR 10.3; 95% CI 3.1-34.4).

Key Words: autoimmune diseases • family history • genetic factors • risk factors • SLE

Lupus, Vol. 12, No. 10, 735-740 (2003)
DOI: 10.1191/0961203303lu457oa


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