Is familial lupus different from sporadic lupus? Data from LUMINA (LXXIII), a multiethnic US cohort

Abstract

Purpose To characterize the clinical features of familial lupus, and determine its influence on damage accrual and survival using data from LUMINA, a longitudinal multiethnic US cohort. Method Familial lupus was defined as patients with a first degree relative with SLE. Relative risks were estimated by logistic regression; odds ratios (OR) and their 95% confidence intervals (CI) were the measure of association for familial lupus. Hazard Ratios (HR) were calculated using Cox proportional hazard adjusted for potential confounders for damage and survival. Results Thirty-two of 644 patients had familial and 612 had sporadic lupus; both groups were of comparable age (~ 36 years). Familial lupus patients were in decreasing order of frequency siblings, parents and children. In multivariable analyses, mucosal ulcers (OR=1.92, 95% CI 0.65–5.70), mitral valve prolapse (OR=1.74, 95% CI 0.50–6.10), cerebrovascular disease (OR=4.18, 95% CI 0.98–17.76) and oral contraceptive use (ever/never; OR=2.51, 95% CI 0.88–7.19) were more likely in familial lupus but a history of low platelet count (<150,000/mm3; OR=0.31, 95% CI 0.08–1.17) and pulmonary disease activity (OR=0.39, 95% CI 0.14–1.20) were less likely. However, none of these associations reached statistical significance. Familial lupus was not significantly associated with a shorter time to either damage accrual or death (HR=0.77, 95% CI 0.37–1.59, p = 0.4746 and HR=0.20, 95% CI 0.03–1.47, p = 0.2020, respectively). Conclusions Although some clinical differences were observed in patients with familial and sporadic lupus, familial lupus was not associated with a significantly greater disease burden (damage, survival) than sporadic lupus.

Clinical features, damage accrual, and survival in patients with familial systemic lupus erythematosus: data from a multi-ethnic, multinational Latin American lupus cohort

“…Familial SLE in the GLADEL cohort occurred in 5.6% of our patients, which is similar to data from other published studies 10–12 but lower than in patients with a high rate of consanguinity such as the Kuwaiti and the Sultanate of Oman populations. 13,14 Higher frequencies of familial SLE (>50%) were also observed in the study by Sestak et al., 15 which included 554 European Americans (EA), 373 African Americans (AA), 193 Hispanics (HI), and 237 patients of other ethnic groups.…”

“…Burgos et al. 12 also showed a higher frequency of cerebrovascular disease in patients with familial than with sporadic SLE from the LUMINA cohort (3.8% vs. 12.5%; p = 0.039). Similar to publications from other investigators, 11,13,16 no association between familial SLE and APS or aPL antibodies was demonstrated in this study.…”

Social support and health in patients with systemic lupus erythematosus: A literature review

“…ethnicity) 10 but not with the familiarity and the onset (acute and insidious) of the disease. 13,55 In the next paragraphs we present the research findings about the relationship between social support and the health of SLE patients separately for the dimensions of disease activity, damage and quality of life (see also Table 2).…”

“…For example, in almost half of the studies, an Interpersonal Support Evaluation List (ISEL) is the instrument used to assess social support. 5,[9][10][11][12][13][14][15][16][17] ISEL is a questionnaire designed to measure the perceived availability of four specific resources: (1) tangible support, the perceived availability of material aid; (2) appraisal support, the perceived availability of someone with whom the individual can discuss issues of personal importance; (3) self-esteem support, the presence of others with whom the individual feels he/she compares favourably; and (4) belonging support, the perception that there is a group with which one can identify and socialize. 18 Sometimes only the overall scale was chosen for the analyses.…”

The American College of Rheumatology and the Systemic Lupus International Collaborating Clinics Classification criteria for systemic lupus erythematosus in two multiethnic cohorts: a commentary

“…Both the LUMINA and GLADEL cohorts have been amply described in the literature. [8][9][10][11] Suffice it to say that the LUMINA patients were recruited based on the updated 1997 ACR classification criteria whereas those of GLADEL were recruited based on the physicians' diagnosis; most patients fulfilled the ACR criteria although that was not a requisite. Of note, also, some clinical and immunological manifestations had not been collected in one or both of these cohorts and thus could not be included in these analyses (some acute and chronic forms of cutaneous lupus, non-scarring alopecia, toxic epidermal necrolysis, mononeuritis multiplex and complement values).…”