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{{Systemic lupus erythematosus}}
{{Systemic lupus erythematosus}}


{{CMG}}; {{AE}} {{CZ}}; {{RT}}
{{CMG}}; {{AE}} {{MIR}}, {{CZ}}, {{RT}}


==Overview==
==Overview==
Worldwide, the [[prevalence]] of [[systemic lupus erythematosus]] is 60 per 100,000 persons. In North America, South America, Europe, and Asia, the incidence of systemic lupus erythematosus ranges from as low as 1 per 100,000 persons to as high as 20 per 100,000 persons, with an average prevalence of 12 per 100,000 persons. The overall [[mortality rate]] of lupus is very high, estimated at approximately 50,000 deaths per 100,000. Women are more commonly affected with [[systemic lupus erythematosus]] than men. [[Systemic lupus erythematosus]] flare-ups are more prevalent in women. [[Systemic lupus erythematosus]] is more prevalent in people of the African and Asian races.
==Epidemiology and Demographics==
==Epidemiology and Demographics==
===Prevalence===
===Prevalence===
* Worldwide, a conservative estimate states that over 5 million people have lupus.
*Worldwide, the prevalence of [[systemic lupus erythematosus]] is 60 per 100,000 persons.<ref name=":0" />
* In the United States the [[prevalence]] of the disease is 25 per every 100,000. In the United States alone, it is estimated that between 270,000 and 1.5 million people have lupus, making it more common than [[cystic fibrosis]] or [[cerebral palsy]].
*Worldwide, a conservative estimate suggests that over 5 million people have [[lupus]].
*Throughout the United States, the prevalence of [[systemic lupus erythematosus]] ranges from a low of 20 per 100,000 persons to a high of 150 per 100,000 persons with an average [[prevalence]] of 25 per 100,000 persons.<ref name=":0" />
 
=== Incidence ===
*In North America, South America, Europe, and Asia, the incidence of [[systemic lupus erythematosus]] ranges from as low as 1 per 100,000 persons to as high as 20 per 100,000 persons, with an average prevalence of 12 per 100,000 persons.<ref name=":0" />
*[[Systemic lupus erythematosus]] [[incidence]] has approximately tripled during the past 3-4 decades. The increase in incidence is mainly attributed to improvement in diagnostic tests that have led to [[SLE]] diagnosis in earlier stages of the [[disease]].
 
=== Case Fatality Rate ===
*The overall [[mortality rate]] of lupus is very high, estimated to have approximately 50,000 deaths per 100,000 cases.<ref name=":0" />
*Approximately one third of deaths from [[SLE]] occur among persons aged <45 years.
*Non-Causcasian race is a [[risk factor]] for death from [[SLE]].
 
*[[SLE]] [[mortality]] is mainly due to associated organ failures related to long term or more severe [[disease]] manifestations include, secondary [[infection]], [[end stage renal disease]] due to [[lupus nephritis]], and [[cardiovascular disease]] from accelerated [[atherosclerosis]].


===Age===
===Age===
* The prevalence of the disease is common in the young patient population even though it can occur at any age.
* The [[disease]] is more common in the young patient population even though it can occur at any age.
* Sixty-five percent of patients with [[SLE]] have [[disease]] onset between the ages of 16 and 55.


===Gender===
===Gender===
* [[Lupus]] occurs in both men and women but young women of the childbearing age are nine times more often diagnosed than men.
* Women are more commonly affected with [[systemic lupus erythematosus]] than men. [[Systemic lupus erythematosus]] flare ups are more prevalent in women.
** The female to male ratio is approximately 5 to 1.
* Men are more commonly affected with [[cutaneous lupus erythematosus]] than women.
** The male to female ratio is approximately 3 to 1.<ref name="pmid4418944">{{cite journal |vauthors=Aviles E |title=Rhabdomyosarcoma of the orbit |journal=Int Surg |volume=59 |issue=5 |pages=297–9 |year=1974 |pmid=4418944 |doi= |url=}}</ref>
* Complications of [[SLE]] such as [[renal]] disease, skin manifestations, [[Cytopenia|cytopenias]], [[serositis]], [[Neurological disease|neurologic involvement]], [[thrombosis]], [[cardiovascular disease]], [[hypertension]], and [[vasculitis]] are more common in men than in women.


===Race===
===Race===
* The disease appears to be more prevalent in women of African, Asian, Hispanic and Native American origin but this may be due to socioeconomic factors.
* [[Systemic lupus erythematosus]] is more prevalent in Africans and Asians.
* [[SLE]] occurs with much greater severity among African-American women, who suffer more severe symptoms as well as a higher mortality rate. <ref>[http://nmanet.org/images/uploads/Great_Imitator.pdf#search=%22lupus%20great%20imitator%22 Lupus and African-American women]</ref>
* The [[disease]] appears to be more common in urban than rural areas.
 
* Non-Caucasian race is a [[risk factor]] for death due to SLE.
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SLE is one of the more fatal forms of rheumatic diseases and non-Causcasian race is a risk factor for death from SLE
 
During 1979--1998, the annual number of deaths increased from 879 to 1,406, and the crude death rate increased from 39 to 52 per 10 million population, with 22,861 deaths reported during the study period
 
Of all SLE deaths, 36.4% occurred among persons aged 15--44 years. For each year, crude death rates increased with age, were >5 times higher among women than men, and were >3 times higher among blacks than whites. Among black women, death rates were highest and increased most (69.7%) among those aged 45--64 years, with little difference in rates among other age groups
 
''JJ Sacks, MD, CG Helmick, MD, G Langmaid, JE Sniezek, MD, Div of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.''
 
There are no recent studies to determine if SLE prevalence or incidence are changing over time.
 
The findings in this report document marked age-, sex-, and race-specific disparities in SLE deaths. Although SLE mortality is most frequently caused by active SLE or by associated organ failure, infection, or cardiovascular disease from accelerated atherosclerosis (''3''), some studies suggest that renal disease might account for excess SLE deaths among blacks (''4''). Differential ascertainment and reporting of SLE deaths by race is possible, but probably does not account for the magnitude of observed differences, especially among different age groups for white and black women.
 
SLE accounts for 14.5% of all deaths from arthritis (CDC, unpublished data, 1997) and represents one of these conditions that has premature mortality; approximately one third of deaths from SLE occur among persons aged <45 years. Of all deaths from arthritis, SLE accounts for 44.0% of deaths among persons aged <45 years (CDC, unpublished data, 1997).
 
Older national prevalence estimates vary widely due to differences in case definitions, small study populations, and study methods. A conservative estimate suggests a prevalence of 161,000 with definite SLE and 322,000 with definite or probable SLE.4
 
Results from the CDC Lupus registries estimated annual prevalence from 2002–2004 was much higher for blacks than whites in Michigan (Washtenaw and Wayne Counties) (111.6 vs 47.5 per 100,000 people)5 and in Georgia (DeKalb and Fulton Counties) (128.0 vs 39.9 per100,000 people).6 Annual prevalence from 2007–2009 for American Indians/Alaska Natives was 178 per 100,000.7 New registries in California (San Francisco County) and New York City (Manhattan) will soon provide annual prevalence estimates for Hispanics and Asians.
 
Annual prevalence estimates were much higher among women than men in Michigan (9.3 vs 1.5 per 100,000 people),5 in Georgia (145.8 vs 17.5 per 100,000 people),6 and in the American Indian/Alaska Native population (271 vs 54 per 100,000 people).7
 
===== SLE Incidence =====
Recent national incidence estimates are not available for SLE. National incidence data are difficult to obtain because it is relatively expensive to capture all diagnosed cases reliably (learn more about SLE Prevalence and Incidence) and the year of onset is hard to determine (slowly developing, non-specific symptoms and signs), so resource-intense studies must be done in small areas.1
 
SLE incidence estimates are available from the various CDC-funded lupus registries. Annual incidence for different racial/ethnic groups from 2002–2004 was much higher for blacks than whites in Michigan (7.9 vs 3.7 100,000 people)5 and in Georgia (9.4 vs 3.2 per 100,000 people).6 Annual incidence from 2007–2009 for American Indians/Alaska Natives was 7.4 per 100,000)7 New registries have begun in California (San Francisco County) and New York City (Manhattan), and will soon provide annual incidence estimates for Hispanics and Asians.
 
Annual incidence estimates were much higher for women than men in Michigan (9.3 vs 1.5 per 100,000),5 Georgia (10.6 vs 1.9 per 100,000)6 and the American Indian/Alaska Native population (unadjusted 8.4 vs 2.7 per 100,000).7
 
=== Mortality ===
Causes of premature death associated with SLE are mainly active disease, organ failure (e.g., kidneys), infection, or cardiovascular disease from accelerated atherosclerosis.8 In a large international SLE cohort with average follow-up of over 8 years during a 1958–2001 observation interval, observed deaths were much higher than expected for all causes, and in particular for circulatory disease, infections, renal disease, and some cancers. Those who were female, younger, and had SLE of short duration were at higher risk of SLE-associated mortality.9


Using death certificates for US residents, SLE was identified as the underlying cause of death for an average of 1,034 deaths from 2010–2014. SLE was identified as a contributing cause of death (one of multiple causes of death, including underlying cause of death) for an average of 1,803 deaths during that 4-year-period.10
* [[SLE]] is more severe among African-American women than others with a higher [[Mortality rate|mortality rate.]]<ref name=":0">[http://nmanet.org/images/uploads/Great_Imitator.pdf#search=%22lupus%20great%20imitator%22 Lupus and African-American women]</ref><ref name="urlTrends in Deaths from Systemic Lupus Erythematosus --- United States, 1979--1998">{{cite web |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5117a3.htm |title=Trends in Deaths from Systemic Lupus Erythematosus --- United States, 1979--1998 |format= |work= |accessdate=}}</ref>


==References==
==References==

Latest revision as of 22:48, 22 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2], Cafer Zorkun, M.D., Ph.D. [3], Raviteja Guddeti, M.B.B.S. [4]

Overview

Worldwide, the prevalence of systemic lupus erythematosus is 60 per 100,000 persons. In North America, South America, Europe, and Asia, the incidence of systemic lupus erythematosus ranges from as low as 1 per 100,000 persons to as high as 20 per 100,000 persons, with an average prevalence of 12 per 100,000 persons. The overall mortality rate of lupus is very high, estimated at approximately 50,000 deaths per 100,000. Women are more commonly affected with systemic lupus erythematosus than men. Systemic lupus erythematosus flare-ups are more prevalent in women. Systemic lupus erythematosus is more prevalent in people of the African and Asian races.

Epidemiology and Demographics

Prevalence

  • Worldwide, the prevalence of systemic lupus erythematosus is 60 per 100,000 persons.[1]
  • Worldwide, a conservative estimate suggests that over 5 million people have lupus.
  • Throughout the United States, the prevalence of systemic lupus erythematosus ranges from a low of 20 per 100,000 persons to a high of 150 per 100,000 persons with an average prevalence of 25 per 100,000 persons.[1]

Incidence

  • In North America, South America, Europe, and Asia, the incidence of systemic lupus erythematosus ranges from as low as 1 per 100,000 persons to as high as 20 per 100,000 persons, with an average prevalence of 12 per 100,000 persons.[1]
  • Systemic lupus erythematosus incidence has approximately tripled during the past 3-4 decades. The increase in incidence is mainly attributed to improvement in diagnostic tests that have led to SLE diagnosis in earlier stages of the disease.

Case Fatality Rate

  • The overall mortality rate of lupus is very high, estimated to have approximately 50,000 deaths per 100,000 cases.[1]
  • Approximately one third of deaths from SLE occur among persons aged <45 years.
  • Non-Causcasian race is a risk factor for death from SLE.

Age

  • The disease is more common in the young patient population even though it can occur at any age.
  • Sixty-five percent of patients with SLE have disease onset between the ages of 16 and 55.

Gender

Race

References

  1. 1.0 1.1 1.2 1.3 1.4 Lupus and African-American women
  2. Aviles E (1974). "Rhabdomyosarcoma of the orbit". Int Surg. 59 (5): 297–9. PMID 4418944.
  3. "Trends in Deaths from Systemic Lupus Erythematosus --- United States, 1979--1998".

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