Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort

Constance Jensina Ulff-Møller, Anders Jørgen Svendsen, Louise Nørgaard Viemose, Søren Jacobsen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins.

METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE codes were validated through medical chart review and information from the treating physicians. Twin pairs with at least one chart-validated SLE proband were invited to participate in a personal interview and clinical validation of the SLE diagnoses.

RESULTS: Twenty-two twins fulfilled the ACR criteria for SLE. The age- and sex-adjusted point SLE prevalence in the Danish twin cohort was 30.3 per 100,000 persons (95% CI: 19.2-46.5). Among seven monozygotic (MZ), eight same-sex dizygotic (DZss) and five opposite-sex dizygotic (DZos) twin pairs, one MZ and one DZss were concordant for SLE. This corresponded to probandwise concordance rates of 25.0% (95% CI: 7.15-59.1) and 7.7% (95% CI: 1.37-33.3), and pairwise concordance rates of 14.3% (95% CI: 2.57-51.3) and 7.7% (95% CI: 1.37-33.3) among MZ and DZ twins, respectively. An SLE diagnosis was clinically validated in 17 twins from 15 twin pairs. Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0% in MZ (95% CI: 21.5-78.5) and 23.1% in DZ twins (95% CI: 8.18-50.3).

CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins.

Original languageEnglish
JournalSeminars in Arthritis and Rheumatism
Volume47
Issue number4
Pages (from-to)538-544
ISSN0049-0172
DOIs
Publication statusPublished - 1. Feb 2018

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Dizygotic Twins
Monozygotic Twins
Registries
Interviews
Physicians
Population

Keywords

  • Journal Article
  • Recurrence risk
  • Systemic lupus erythematosus
  • Concordance
  • Twin study
  • Autoimmune disease

Cite this

Ulff-Møller, Constance Jensina ; Svendsen, Anders Jørgen ; Viemose, Louise Nørgaard ; Jacobsen, Søren. / Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort. In: Seminars in Arthritis and Rheumatism. 2018 ; Vol. 47, No. 4. pp. 538-544.
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abstract = "OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins.METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE codes were validated through medical chart review and information from the treating physicians. Twin pairs with at least one chart-validated SLE proband were invited to participate in a personal interview and clinical validation of the SLE diagnoses.RESULTS: Twenty-two twins fulfilled the ACR criteria for SLE. The age- and sex-adjusted point SLE prevalence in the Danish twin cohort was 30.3 per 100,000 persons (95{\%} CI: 19.2-46.5). Among seven monozygotic (MZ), eight same-sex dizygotic (DZss) and five opposite-sex dizygotic (DZos) twin pairs, one MZ and one DZss were concordant for SLE. This corresponded to probandwise concordance rates of 25.0{\%} (95{\%} CI: 7.15-59.1) and 7.7{\%} (95{\%} CI: 1.37-33.3), and pairwise concordance rates of 14.3{\%} (95{\%} CI: 2.57-51.3) and 7.7{\%} (95{\%} CI: 1.37-33.3) among MZ and DZ twins, respectively. An SLE diagnosis was clinically validated in 17 twins from 15 twin pairs. Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0{\%} in MZ (95{\%} CI: 21.5-78.5) and 23.1{\%} in DZ twins (95{\%} CI: 8.18-50.3).CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins.",
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Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort. / Ulff-Møller, Constance Jensina; Svendsen, Anders Jørgen; Viemose, Louise Nørgaard; Jacobsen, Søren.

In: Seminars in Arthritis and Rheumatism, Vol. 47, No. 4, 01.02.2018, p. 538-544.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort

AU - Ulff-Møller, Constance Jensina

AU - Svendsen, Anders Jørgen

AU - Viemose, Louise Nørgaard

AU - Jacobsen, Søren

N1 - Copyright © 2017 Elsevier Inc. All rights reserved.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins.METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE codes were validated through medical chart review and information from the treating physicians. Twin pairs with at least one chart-validated SLE proband were invited to participate in a personal interview and clinical validation of the SLE diagnoses.RESULTS: Twenty-two twins fulfilled the ACR criteria for SLE. The age- and sex-adjusted point SLE prevalence in the Danish twin cohort was 30.3 per 100,000 persons (95% CI: 19.2-46.5). Among seven monozygotic (MZ), eight same-sex dizygotic (DZss) and five opposite-sex dizygotic (DZos) twin pairs, one MZ and one DZss were concordant for SLE. This corresponded to probandwise concordance rates of 25.0% (95% CI: 7.15-59.1) and 7.7% (95% CI: 1.37-33.3), and pairwise concordance rates of 14.3% (95% CI: 2.57-51.3) and 7.7% (95% CI: 1.37-33.3) among MZ and DZ twins, respectively. An SLE diagnosis was clinically validated in 17 twins from 15 twin pairs. Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0% in MZ (95% CI: 21.5-78.5) and 23.1% in DZ twins (95% CI: 8.18-50.3).CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins.

AB - OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins.METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE codes were validated through medical chart review and information from the treating physicians. Twin pairs with at least one chart-validated SLE proband were invited to participate in a personal interview and clinical validation of the SLE diagnoses.RESULTS: Twenty-two twins fulfilled the ACR criteria for SLE. The age- and sex-adjusted point SLE prevalence in the Danish twin cohort was 30.3 per 100,000 persons (95% CI: 19.2-46.5). Among seven monozygotic (MZ), eight same-sex dizygotic (DZss) and five opposite-sex dizygotic (DZos) twin pairs, one MZ and one DZss were concordant for SLE. This corresponded to probandwise concordance rates of 25.0% (95% CI: 7.15-59.1) and 7.7% (95% CI: 1.37-33.3), and pairwise concordance rates of 14.3% (95% CI: 2.57-51.3) and 7.7% (95% CI: 1.37-33.3) among MZ and DZ twins, respectively. An SLE diagnosis was clinically validated in 17 twins from 15 twin pairs. Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0% in MZ (95% CI: 21.5-78.5) and 23.1% in DZ twins (95% CI: 8.18-50.3).CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins.

KW - Autoimmune disease

KW - Concordance

KW - Recurrence risk

KW - Systemic lupus erythematosus

KW - Twin study

KW - Journal Article

KW - Recurrence risk

KW - Systemic lupus erythematosus

KW - Concordance

KW - Twin study

KW - Autoimmune disease

U2 - 10.1016/j.semarthrit.2017.06.007

DO - 10.1016/j.semarthrit.2017.06.007

M3 - Journal article

C2 - 28755788

VL - 47

SP - 538

EP - 544

JO - Seminars in Arthritis and Rheumatism

JF - Seminars in Arthritis and Rheumatism

SN - 0049-0172

IS - 4

ER -