title: Population-based incidence and prevalence of systemic lupus erythematosus: the Michigan Lupus Epidemiology and Surveillance program.
abstract: OBJECTIVE
  To estimate the incidence and prevalence of systemic lupus erythematosus (SLE) in a sociodemographically diverse southeastern Michigan source population of 2.4 million people.
  
  
  METHODS
  SLE cases fulfilling the American College of Rheumatology classification criteria (primary case definition) or meeting rheumatologist-judged SLE criteria (secondary definition) and residing in Wayne or Washtenaw Counties during 2002-2004 were included. Case finding was performed from 6 source types, including hospitals and private specialists. Age-standardized rates were computed, and capture-recapture was performed to estimate underascertainment of cases.
  
  
  RESULTS
  The overall age-adjusted incidence and prevalence (ACR definition) per 100,000 persons were 5.5 (95% confidence interval [95% CI] 5.0-6.1) and 72.8 (95% CI 70.8-74.8). Among females, the incidence was 9.3 per 100,000 persons and the prevalence was 128.7 per 100,000 persons. Only 7 cases were estimated to have been missed by capture-recapture, adjustment for which did not materially affect the rates. SLE prevalence was 2.3-fold higher in black persons than in white persons, and 10-fold higher in females than in males. Among incident cases, the mean ± SD age at diagnosis was 39.3 ± 16.6 years. Black SLE patients had a higher proportion of renal disease and end-stage renal disease (ESRD) (40.5% and 15.3%, respectively) as compared to white SLE patients (18.8% and 4.5%, respectively). Black patients with renal disease were diagnosed as having SLE at younger age than white patients with renal disease (mean ± SD 34.4 ± 14.9 years versus 41.9 ± 21.3 years; P = 0.05).
  
  
  CONCLUSIONS
  SLE prevalence was higher than has been described in most other population-based studies and reached 1 in 537 among black female persons. There were substantial racial disparities in the burden of SLE, with black patients experiencing earlier age at diagnosis, >2-fold increases in SLE incidence and prevalence, and increased proportions of renal disease and progression to ESRD as compared to white patients.
authors: University of Michigan, Ann Arbor.
authors: Emily C
authors: EC
authors: Somers
authors: Wendy
authors: W
authors: Marder
authors: Patricia
authors: P
authors: Cagnoli
authors: Emily E
authors: EE
authors: Lewis
authors: Peter
authors: P
authors: DeGuire
authors: Caroline
authors: C
authors: Gordon
authors: Charles G
authors: CG
authors: Helmick
authors: Lu
authors: L
authors: Wang
authors: Jeffrey J
authors: JJ
authors: Wing
authors: J Patricia
authors: JP
authors: Dhar
authors: James
authors: J
authors: Leisen
authors: Diane
authors: D
authors: Shaltis
authors: W Joseph
authors: WJ
authors: McCune
mesh_terms: D000328:Adult; D000367:Age Factors; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology* / Q000208:ethnology*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups; D012189:Retrospective Studies; D012737:Sex Factors