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Table of Contents | |
- AUTOIMMUNE DISEASE
INCIDENCE RATES OF AUTOIMMUNE DISEASE
Clin Immunol Immunopathol 1997 Sep;84(3):223-43 |
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Epidemiology and estimated population burden of selected
autoimmune diseases in the United States.
Jacobson DL, Gange SJ, Rose NR, Graham NM
School of Hygiene and Public Health, The Johns Hopkins University,
Baltimore, Maryland, 21205, USA.
Autoimmune diseases cause significant and chronic morbidity and disability.
The actual number of persons in the United States that are affected by
autoimmune diseases and the resultant magnitude of their impact on the
public's health are limited to a few specific diseases. In order to
understand the clinical, public health and economic importance of these
diseases it is necessary to have estimates of incidence and prevalence rates
in the population. In this analysis, we estimate the number of persons
affected by 24 autoimmune diseases in the United States by applying mean
weighted prevalence and incidence rates obtained from published articles to
U. S. Census data. The study was restricted to 24 autoimmune predefined
diseases for which there was direct or indirect evidence for autoimmune
pathogenesis. Subsequently, we used computerized search software and
ancestry searching (bibliographies) to conduct a comprehensive search of
articles published from 1965 to the present. Eligible studies included those
which adhered to standard disease definitions and which included
population-based estimates of incidence or prevalence rates. Mean weighted
incidence and prevalence rates were calculated from eligible published
studies with greater weight proportionately given to larger studies. The
mean rates were then applied to the U.S. Census population figures to
estimate the number of persons currently afflicted with each disease and the
number of new cases occurring each year in the United States. Only U.S. and
European studies were used to estimate prevalence and incidence rates when
there were at least six eligible studies available for a disease. When there
were fewer than six studies, all available studies were included, regardless
of country of origin. The number of eligible incidence and prevalence
studies found in the literature varied considerably between the 24
autoimmune diseases selected. The largest number of eligible prevalence
studies were conducted on multiple sclerosis (MS), rheumatoid arthritis, and
systemic lupus erythematosus (SLE) (>/=23), followed by insulin-dependent
diabetes (IDDM), myasthenia gravis, primary biliary cirrhosis, and
scleroderma (>/=7). There were only one to four eligible studies done on
11 other diseases, and no prevalence studies on 6 diseases. Incidence
studies were less frequent but the largest number of studies were conducted
on IDDM (n = 37) and MS (n = 28), followed by Graves'
disease/hyperthyroidism, glomerulonephritis, primary biliary cirrhosis,
rheumatic fever, rheumatoid arthritis, scleroderma, and SLE (>/=9). On
the other 11 diseases, there were one to six eligible studies, and no
studies on 5 diseases. There were no eligible incidence or prevalence
studies on Goodpasture's syndrome, idiopathic thrombocytopenia purpura, or
relapsing polychondritis. Overall we estimate that 8,511,845 persons in the
United States or approximately 1 in 31 Americans are currently afflicted
with one of these autoimmune diseases. The diseases with the highest
prevalence rates were Graves'/hyperthyroidism, IDDM, pernicious
anemia, rheumatoid arthritis, thyroiditis, and vitiligo,
comprising an estimated 7,939, 280 people or 93% of the total number
estimated. Glomerulonephritis, MS, and SLE added an estimated 323,232
people. The prevalence of the other diseases reviewed were rare, less than
5.14/100,000. Most diseases were more common in women. From the incidence
data we estimate that 237,203 Americans will develop an autoimmune disease
in 1996 and that approximately 1,186,015 new cases of these autoimmune
diseases occur in the United States every 5 years. Women were at 2.7 times
greater risk than men to acquire an autoimmune disease. After reviewing the
medical literature for incidence and prevalence rates of 24 autoimmune
diseases, we conclude that many autoimmune diseases are infrequently studied
by epidemiologists. As a result the total burden of disease may be an
underestimate.
Date: 10/10/00 9:41:12 AM Pacific Daylight Time
From: Mooredaisyelaine@aol.com
Reply-to: hyperthyroidism@egroups.com
To: hyperthyroidism@egroups.com
According to the American Association of Autoimmune and Related Diseases
(AARDA), it takes an average of 7 years and 5 docs before most autoimmune
diseases are properly diagnosed. Scary, huh, especially considering my
diagnosis took about 20 years.
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