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. 1995 Nov;54(11):891–895. doi: 10.1136/ard.54.11.891

Distribution of cases of systemic lupus erythematosus at time of first symptom in an urban area.

N D Hopkinson 1, K R Muir 1, M A Oliver 1, M Doherty 1, R J Powell 1
PMCID: PMC1010039  PMID: 7492238

Abstract

OBJECTIVES--To determine the geographical distribution of cases of systemic lupus erythematosus (SLE) in a defined geographical area in the East Midlands, UK, and, in particular, to search for spatial variation in cases that may implicate the role of environmental factors in SLE aetiology. METHODS--Six methods of case ascertainment were used. The postcode of the patient's domicile at time of first definite symptom of SLE was used for analysis which included case mapping, probability mapping by electoral ward, and variogram analysis. RESULTS--The study area population of 613,700 contained 200 SLE patients, 188 of whom experienced their first symptom whilst residing in the area. Case mapping revealed 12 SLE patients residing within an area of one square mile, including four men and six patients with RNP antibodies. The use of probability mapping showed five wards in close proximity to each other to have a greater number of SLE cases than would be expected by chance (p < 0.1). The 'cluster' of patients seen on the case map fell into two wards which showed a significant excess of cases only when combined (p = 0.006). The variogram of the incidence rates for each ward did not confirm any structure or pattern to the distribution of cases for the whole area. CONCLUSIONS--Some areas have a greater than expected prevalence of SLE. The normal result from variogram analysis suggests that the cause(s) for these excess number of cases does not have an effect across the whole study area.

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Selected References

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  1. Barnes N., Cartwright R. A., O'Brien C., Roberts B., Richards I. D., Bird C. C. Spatial patterns in electoral wards with high lymphoma incidence in Yorkshire health region. Br J Cancer. 1987 Aug;56(2):169–172. doi: 10.1038/bjc.1987.179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Fessel W. J. Systemic lupus erythematosus in the community. Incidence, prevalence, outcome, and first symptoms; the high prevalence in black women. Arch Intern Med. 1974 Dec;134(6):1027–1035. [PubMed] [Google Scholar]
  3. Fielder A. H., Walport M. J., Batchelor J. R., Rynes R. I., Black C. M., Dodi I. A., Hughes G. R. Family study of the major histocompatibility complex in patients with systemic lupus erythematosus: importance of null alleles of C4A and C4B in determining disease susceptibility. Br Med J (Clin Res Ed) 1983 Feb 5;286(6363):425–428. doi: 10.1136/bmj.286.6363.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Frank A. O. Apparent predisposition to systemic lupus erythematosus in Chinese patients in West Malaysia. Ann Rheum Dis. 1980 Jun;39(3):266–269. doi: 10.1136/ard.39.3.266. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Freni-Titulaer L. W., Kelley D. B., Grow A. G., McKinley T. W., Arnett F. C., Hochberg M. C. Connective tissue disease in southeastern Georgia: a case-control study of etiologic factors. Am J Epidemiol. 1989 Aug;130(2):404–409. doi: 10.1093/oxfordjournals.aje.a115348. [DOI] [PubMed] [Google Scholar]
  6. Hopkinson N. D., Doherty M., Powell R. J. The prevalence and incidence of systemic lupus erythematosus in Nottingham, UK, 1989-1990. Br J Rheumatol. 1993 Feb;32(2):110–115. doi: 10.1093/rheumatology/32.2.110. [DOI] [PubMed] [Google Scholar]
  7. Lee S. L., CHase P. H. Drug-induced systemic lupus erythematosus: a critical review. Semin Arthritis Rheum. 1975 Aug;5(1):83–103. doi: 10.1016/0049-0172(75)90024-4. [DOI] [PubMed] [Google Scholar]
  8. Loomis D., Wing S. Is molecular epidemiology a germ theory for the end of the twentieth century? Int J Epidemiol. 1990 Mar;19(1):1–3. doi: 10.1093/ije/19.1.1. [DOI] [PubMed] [Google Scholar]
  9. Oliver M. A., Muir K. R., Webster R., Parkes S. E., Cameron A. H., Stevens M. C., Mann J. R. A geostatistical approach to the analysis of pattern in rare disease. J Public Health Med. 1992 Sep;14(3):280–289. [PubMed] [Google Scholar]
  10. Openshaw S., Craft A. W., Charlton M., Birch J. M. Investigation of leukaemia clusters by use of a Geographical Analysis Machine. Lancet. 1988 Feb 6;1(8580):272–273. doi: 10.1016/s0140-6736(88)90352-2. [DOI] [PubMed] [Google Scholar]
  11. Serdula M. K., Rhoads G. G. Frequency of systemic lupus erythematosus in different ethnic groups in Hawaii. Arthritis Rheum. 1979 Apr;22(4):328–333. doi: 10.1002/art.1780220403. [DOI] [PubMed] [Google Scholar]
  12. Siegel M., Lee S. L. The epidemiology of systemic lupus erythematosus. Semin Arthritis Rheum. 1973;3(1):1–54. doi: 10.1016/0049-0172(73)90034-6. [DOI] [PubMed] [Google Scholar]
  13. 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]

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