title: The prevalence and incidence of systemic lupus erythematosus in children and adults: a population-based study in a mountain community in northern Italy.
abstract: OBJECTIVE
  To estimate prevalence and incidence of systemic lupus erythematosus (SLE) in paediatric and adult populations in Italy.
  
  
  METHODS
  The study was carried out in Valtrompia, a valley in northern Italy, where a relatively close community lives, in 2009-2012. The only referral centre for SLE in the area is the Rheumatology Unit of the University Hospital of Brescia. The ascertainment of SLE cases was performed through the integration of three sources: 1) hospital database; 2) database of the Rheumatology laboratory; 3) database of general practitioners and general paediatricians practicing in the area. Each patient was evaluated by a rheumatologist for confirmation of SLE classification based on the presence of at least 4 criteria according to the American College of Rheumatology.
  
  
  RESULTS
  Forty-four SLE patients (39 females, 89%) were identified. The prevalence of SLE at 31st December 2012 was 39.2 (95% C.I. 28.5-52.6) cases per 100,000 individuals in all subjects, and 42.3 (30.5-57.2) and 15.3 (1.8-55.1) in adults and children, respectively. Nine new cases of SLE were diagnosed over the 4 years of the study period, with an annual incidence rate of 2.0 (0.9-3.8) per 100,000 individuals.
  
  
  CONCLUSIONS
  This is the first study estimating the prevalence and incidence of SLE in Italy in both adult and paediatric population. Prevalence and incidence rates in line with those reported in other Mediterranean European countries. The accurate assessment of the SLE frequency is supported by the choice of a well-defined area, the integration of multiple data sources and the revision of each case by a rheumatologist.
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Tsioni
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Andreoli
authors.affiliation: Paediatric Rheumatology and Immunology, Children's Hospital, Spedali Civili, University of Brescia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Meini
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Micol
authors.initials: M
authors.lastname: Frassi
authors.affiliation: Institute for Epidemiology and Public Health, University of Brescia, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Raffetti
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Airò
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Allegri
authors.affiliation: Institute for Epidemiology and Public Health, University of Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Donato
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Tincani
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012423:Rural Health; D013997:Time Factors; D055815:Young Adult