SHINGLES, ALLERGIES, FAMILY MEDICAL HISTORY, ORAL-CONTRACEPTIVES, ANDOTHER POTENTIAL RISK-FACTORS FOR SYSTEMIC LUPUS-ERYTHEMATOSUS

The authors undertook a case-control study to explore the many factors that have been postulated to be related to the etiology of systemic l upus erythematosus. A total of 195 cases of systemic lupus diagnosed i n the Philadelphia, Pennsylvania, metropolitan area between 1985 and 1 987 were compared with 143 controls, friends of the cases matched to t hem according to age (+/-5 years) and sex. Through personal interviews and chart reviews, data were collected on demographic factors, person al and familial medical history, reproductive history, medication hist ory, and environmental exposures. Associations were found between syst emic lupus erythematosus and having a family history of autoimmune dis ease (age-, sex-, and race-adjusted odds ratio (OR) = 2.3, 95% confide nce interval (CI) 1.2-4.6), a history of shingles (adjusted OR = 6.4, 95% CI 1.4-28.0), a history of hives (adjusted OR = 1.8, 95% CI 1.1-3. 0), and a history of medication allergies (adjusted OR = 2.6, 95% CI 1 .5-4.5). No association was present between systemic lupus erythematos us and either any use or recent use of oral contraceptives (e.g., OR = 0.6 (95% CI 0.2-1.4) for use in the 3 years prior to diagnosis), fami ly history of multiple other diseases, or a history of numerous other infections or various other types of allergies. Thus, these data indic ate that systemic lupus erythematosus is associated with a family hist ory of autoimmune diseases, a history of shingles, and a history of al lergies. In contrast, if the development of systemic lupus is affected by use of oral contraceptives, this effect must be extremely modest. These findings may help clarify the possible pathogenesis of systemic lupus erythematosus, and they provide clues as to when the presence of systemic lupus should be suspected.