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American Journal of Epidemiology Vol. 140, No. 7: 632-642
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Shingles, Allergies, Family Medical History, Oral Contraceptives, and Other Potential Risk Factors for Systemic Lupus Erythematosus

Brian L. Strom1,, Marcus M. Reidenberg2, Suzanne West1,3, Ellen Sim Snyder1,3, Bruce Freundlich4 and Paul D. Stolley5

1Center for Clinical Epidemiology and Biostatistics and Division of General Internal Medicine, University of Pennsylvania School of Medicine Philadelphia, PA
2Departments of Pharmacology and Medicine, Cornell University Medical College New York, NY
3Department of Epidemiology, University of North Carolina School of Public Health Chapel Hill, North Carolina
4Division of Rheumatology, Department of Medicine, Graduate Hospital Philadelphia, PA
5Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine Baltimore, MD

Reprint requests to Dr. Brian L. Strom, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 221 L Nursing Education Building, 420 Service Drive, Philadelphia, PA 19104-6095

The authors undertook a case-control study to explore the many factors that have been postulated to be related to the etiology of systemic lupus erythematosus. A total of 195 cases of systemic lupus diagnosed in the Philadelphia, Pennsylvania, metro politan area between 1985 and 1987 were compared with 143 controls, friends of the cases matched to them according to age (±5 years) and sex. Through personal interviews and chart reviews, data were collected on demographic factors, personal and familial medical history, reproductive history, medication history, and environ mental exposures. Associations were found between systemic lupus erythematosus and having a family history of autoimmune disease (age-, sex-, and race-adjusted odds ratio (OR) = 2.3, 95% confidence interval (Cl) 1.2–4.6), a history of shingles (adjusted OR = 6.4, 95% Cl 1.4–28.0), a history of hives (adjusted OR = 1.8, 95% Cl 1.1–3.0), and a history of medication allergies (adjusted OR = 2.6, 95% Cl 1.5–4.5). No association was present between systemic lupus erythematosus and either any use or recent use of oral contraceptives (e.g., OR = 0.6(95% Cl 0.2–1.4) for use in the 3 years prior to diagnosis), family history of multiple other diseases, or a history of numerous other infections or various other types of allergies. Thus, these data indicate that systemic lupus erythematosus is associated with a family history of autoimmune diseases, a history of shingles, and a history of allergies. In contrast, if the develop ment 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.

allergy and immunology; contraceptives; oral; family characteristics; herpeszoster; lupus; lupus erythematosus; systemic; risk factors


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