A revised estimate of twin concordance in systemic lupus erythematosus.
OBJECTIVE
Based on a small clinical series and previously published case reports, concordance for systemic lupus erythematosus (SLE) among monozygous (MZ) twins has been reported to be as high as 69%. Using a larger and less biased sample, we provide another estimate of this percentage.


METHODS
We established a registry of twins with SLE, based upon self-reports and information provided by the patients' physicians. We used DNA fingerprinting to validate the reported zygosity in a sample of these twins.


RESULTS
Of 107 twin pairs meeting the American College of Rheumatology 1982 revised criteria for the diagnosis of SLE, 24% of 45 MZ pairs and 2% of 62 dizygous (DZ) pairs were concordant. The frequency distributions of diagnostic criteria and disease symptoms in the SLE patients were similar to those in other published reports of SLE patients. Zygosity was confirmed by DNA fingerprinting in a subsample of 15 self-described MZ twins and 7 self-described DZ twins. All individuals had correctly predicted their zygosity.


CONCLUSIONS
MZ concordance for SLE is similar to that for other autoimmune diseases and is much lower than previously believed.
Deapen
D
D
Department of Preventive Medicine, University of Southern California School of Medicine 90033.
Escalante
A
A
Weinrib
L
L
Horwitz
D
D
Bachman
B
B
Roy-Burman
P
P
Walker
A
A
Mack
T M
TM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004200:Diseases in Twins / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D005260:Female; D006801:Humans; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D015053:Zygote