Skip to main content
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1993 Oct;52(10):720–724. doi: 10.1136/ard.52.10.720

Environmental factors predicting nephritis in systemic lupus erythematosus.

T McAlindon 1, L Giannotta 1, N Taub 1, D D'Cruz 1, G Hughes 1
PMCID: PMC1005168  PMID: 8257208

Abstract

OBJECTIVES--To evaluate social class, ethnic origin, and various endocrine variables as potential risk factors in the development of nephritis in patients with systemic lupus erythematosus (SLE). METHODS--A cross-sectional survey was carried out of all outpatients with SLE attending the lupus Clinic of St Thomas's Hospital from March to October 1992 using retrospective survival data. The main outcome measure was the duration of SLE before the onset of nephritis. RESULTS--Two hundred and ninety six women and 11 men were studied; the male patients were excluded from the analysis. Univariate analysis showed an increased risk of nephritis in patients with SLE of West Indian origin with 54 v 19% with nephritis at five years, in patients of lower social class, in patients who did not drink alcohol, and in those with a history of fetal loss after the onset of lupus. No significant effect of the age of onset of SLE, use of oral contraceptives, normal pregnancy, or smoking was seen. Multivariate analysis showed that ethnic origin did not influence the risk of nephritis independently of social class. CONCLUSIONS--Factors associated with socioeconomic deprivation may increase disease severity in patients with SLE.

Full text

PDF
722

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ginzler E. M., Diamond H. S., Weiner M., Schlesinger M., Fries J. F., Wasner C., Medsger T. A., Jr, Ziegler G., Klippel J. H., Hadler N. M. A multicenter study of outcome in systemic lupus erythematosus. I. Entry variables as predictors of prognosis. Arthritis Rheum. 1982 Jun;25(6):601–611. doi: 10.1002/art.1780250601. [DOI] [PubMed] [Google Scholar]
  2. Hochberg M. C., Boyd R. E., Ahearn J. M., Arnett F. C., Bias W. B., Provost T. T., Stevens M. B. Systemic lupus erythematosus: a review of clinico-laboratory features and immunogenetic markers in 150 patients with emphasis on demographic subsets. Medicine (Baltimore) 1985 Sep;64(5):285–295. [PubMed] [Google Scholar]
  3. Hochberg M. C. Systemic lupus erythematosus. Rheum Dis Clin North Am. 1990 Aug;16(3):617–639. [PubMed] [Google Scholar]
  4. Lahita R. G. Sex steroids and the rheumatic diseases. Arthritis Rheum. 1985 Feb;28(2):121–126. doi: 10.1002/art.1780280202. [DOI] [PubMed] [Google Scholar]
  5. Lockshin M. D., Reinitz E., Druzin M. L., Murrman M., Estes D. Lupus pregnancy. Case-control prospective study demonstrating absence of lupus exacerbation during or after pregnancy. Am J Med. 1984 Nov;77(5):893–898. doi: 10.1016/0002-9343(84)90538-2. [DOI] [PubMed] [Google Scholar]
  6. Masi A. T., Kaslow R. A. Sex effects in systemic lupus erythematosus: a clue to pathogenesis. Arthritis Rheum. 1978 May;21(4):480–484. doi: 10.1002/art.1780210413. [DOI] [PubMed] [Google Scholar]
  7. Nossent J. C., Bronsveld W., Swaak A. J. Systemic lupus erythematosus. III. Observations on clinical renal involvement and follow up of renal function: Dutch experience with 110 patients studied prospectively. Ann Rheum Dis. 1989 Oct;48(10):810–816. doi: 10.1136/ard.48.10.810. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Reveille J. D., Schrohenloher R. E., Acton R. T., Barger B. O. DNA analysis of HLA-DR and DQ genes in American blacks with systemic lupus erythematosus. Arthritis Rheum. 1989 Oct;32(10):1243–1251. doi: 10.1002/anr.1780321009. [DOI] [PubMed] [Google Scholar]
  9. Samanta A., Roy S., Feehally J., Symmons D. P. The prevalence of diagnosed systemic lupus erythematosus in whites and Indian Asian immigrants in Leicester city, UK. Br J Rheumatol. 1992 Oct;31(10):679–682. doi: 10.1093/rheumatology/31.10.679. [DOI] [PubMed] [Google Scholar]
  10. Smith R. "Without work all life goes rotten". BMJ. 1992 Oct 24;305(6860):972–972. doi: 10.1136/bmj.305.6860.972. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Studenski S., Allen N. B., Caldwell D. S., Rice J. R., Polisson R. P. Survival in systemic lupus erythematosus. A multivariate analysis of demographic factors. Arthritis Rheum. 1987 Dec;30(12):1326–1332. doi: 10.1002/art.1780301202. [DOI] [PubMed] [Google Scholar]
  12. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  13. Ward M. M., Studenski S. Clinical manifestations of systemic lupus erythematosus. Identification of racial and socioeconomic influences. Arch Intern Med. 1990 Apr;150(4):849–853. [PubMed] [Google Scholar]
  14. Ward M. M., Studenski S. Clinical manifestations of systemic lupus erythematosus. Identification of racial and socioeconomic influences. Arch Intern Med. 1990 Apr;150(4):849–853. [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES