title: Familial clustering of systemic lupus erythematosus in the cayman islands.
abstract: OBJECTIVE
  To describe the unusual clustering of systemic lupus erythematosus (SLE) in a family from the Cayman Islands.
  
  
  METHODS
  An observational retrospective study of SLE was done following an index case of mixed connective tissue disease in a 51-year old West Indian woman of African descent. Her two daughters of the same father, who is of Cayman Islands origin, were also diagnosed with SLE. A family tree was subsequently drawn up to 1890 to identify other cases in the same family.
  
  
  RESULTS
  There were 13 cases identified and all occurred between the 6th and the 8th generation. A family tree linked all cases to a man from the Cayman Islands who died in 1890. The nine cases with full medical records showed eight females and one male (8:1). The mean age at diagnosis was 29 years; polyarthritis occured in all nine patients (100%), kidney involvement in 6/9 (66.6%), skin rash in 6/9 (66.6%), pleuritis and pericarditis in 6/9 (66.6%) and anaemia in 6/9 (66.6%). The autoantibodies were mainly ANA in all patients (100%) and anti-dsDNA in 8/9 (88.8%).
  
  
  CONCLUSIONS
  The unusual extensive familial clustering in this study represents the first to be described in a West Indian population where SLE is most prevalent and may suggest a genetic predisposition.
authors.affiliation: Department of Medicine, Cayman Islands Hospital, Georgetown, Cayman Islands; Adult Disease Specialist Medical Clinic, George Town, Cayman Islands. oadedayo@hotmail.com.
authors.forename: O
authors.initials: O
authors.lastname: Adedayo
authors.affiliation: Department of Medicine, Cayman Islands Hospital, Georgetown, Cayman Islands.
authors.forename: C
authors.initials: C
authors.lastname: Cummings
authors.affiliation: Department of Medicine, Cayman Islands Hospital, Georgetown, Cayman Islands.
authors.forename: N
authors.initials: N
authors.lastname: Iheonunekwu
authors.affiliation: Primary Healthcare, Cayman Islands Hospital, Georgetown, Cayman Islands.
authors.forename: J
authors.initials: J
authors.lastname: Wallace
authors.affiliation: Primary Healthcare, Cayman Islands Hospital, Georgetown, Cayman Islands.
authors.forename: T
authors.initials: T
authors.lastname: Mclaughlin
authors.affiliation: Primary Healthcare, Cayman Islands Hospital, Georgetown, Cayman Islands.
authors.forename: J
authors.initials: J
authors.lastname: Merren
authors.affiliation: Anaesthesia and Intensive Care, Cayman Islands Hospital, Georgetown, Cayman Islands.
authors.forename: D
authors.initials: D
authors.lastname: Jefferson
authors.affiliation: Anaesthesia and Intensive Care, Cayman Islands Hospital, Georgetown, Cayman Islands.
authors.forename: G
authors.initials: G
authors.lastname: Smith
authors.affiliation: Emergency Unit, Cayman Islands Hospital, Georgetown, Cayman Islands.
authors.forename: G
authors.initials: G
authors.lastname: Bell