Systemic lupus erythematosus.
Descriptive epidemiologic studies of SLE have been conducted worldwide; the most extensive data are available for Scandinavia, especially Sweden, and the United States. In the United States, blacks have threefold higher incidence, prevalence, and mortality rates compared with whites; the reasons for this excess, however, remain unknown. Analytic and genetic epidemiologic studies suggest a multifactorial etiology of SLE; results support a polygenic mode of inheritance including important roles for an autosomal dominant "autoimmune" gene and female sex hormones. Although a viral etiology remains attractive, there is little evidence to support such a hypothesis. Rather, other environmental factors including chemical exposures may be important as "triggers" of disease. Finally, observational epidemiologic studies demonstrate an increasingly favorable prognosis for patients with SLE, allowing a better understanding of long-term morbidity and impact on overall health status. Future epidemiologic studies should focus on identifying noninfectious environmental etiologic factors and improving the quality of life for all patients with SLE.
Hochberg
M C
MC
Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000473:pathology; D011379:Prognosis