Læknablaðið : fylgirit - 01.05.1978, Blaðsíða 118

Ingvar Teitsson stud. med. and Jon Thorsteinsson
dosent.
From the Medical Clinic of Landspitalinn (The
National Hospital), University Hospital, Reykjavik.
Abstract:
By investigating hospital archives a total
of 52 definite and suspected SLE-cases were
found in the years 1956-*75. We estimated 31
of these as definite, 26 females and 5 males.
The incidence of definite SLE in Iceland in 1971-
'75 was 12,3/year/million inhabitants. By the
end of 1975 the prevalence was 86,9/million.
Age distribution at the time of diagnosis was
10-65 years. By Dec. 1975 12 of the definite
cases had deceased, six from uremia. Having
collected blood samples from 18 definite plus
six suspected SLE-patients we noted a statisti-
cally significant increase of HLA-B27 antigen
frequency among these. Also less significant
increase of HLA-A9 was noted.
Systemic Lupus Erythematosus (SLE) is a
disease which just some 30 years ago was only
badly defined. Gradually, with the description
of the LE-cell phenomenon (1948), the immuno-
fluorescent ANF-test (1957) and not least with
the publication of the ARA- preliminary criteria
for the classification of SLE’), the disease has
become better known. Increasing awareness
against SLE may explain in part the steadily
increasing reported incidence of this disease in
the Western World over the last decades.
The main aim of the present study which started
late in 1975 was to get an impression of the
incidence, prevalence and manifestations of SLE
in Iceland during the last decade or two. Also
it seemed interesting to get information about
some genetic aspects of the SLE-patients, esp.
their histocompatibility antigens, there being
currently great interest in the question about
assoeiation between HL-A and disease.
Materials and methods:
The archives of the major hospitals in Iceland
were investigated for SLE-diagnoses during the
last 10-20 years, depending on how early the
individual hospitals startet making indexes of thelr
diagnoses, see table 1.
All those case histories which at some time had
got the diagnosis SLE were carefully read through.
Thus we determined the number of the ARA-
;jreliminary criteria for the classification of
SYSTEMIC LUPUS
ERYTHEMATOSUS IN ICELAND
Hospital years investigated
Landspitalinn, the National Hospital, Reykjavik 1957-1975
Borgarspitalinn, the Reykjavik City Hospital, Reykjavik 1956-1975
Landakostsspitalinn, the St. Joseph's Hospital, Reykjavik 1965-1975
Fjordungssjukrahusid, the District Hospital, Akureyri 1962-1975
Table 1: Hospitals the archives of which were investigated
SLE2) which each patient seems to have fulfilied.
We classified the cases as definite SLE only if
they fulfilled at least four of the ARA-criteria.
We also included one case with just two criteria
because the patient had a renal biopsy with the
histological diagnosis: LE-nephritis. One case
with four criteria was excluded because the
patient has now developed a typical scleroderma.
We investigated the fate of each individual case
with help from the Statistical Bureau of Iceland.
For those dead we investigated the cause of death
but we have listed here only the main cause.
For instance one patient was listed as having
died from generalized peritonitis but as she was
then suffering from severe uremia, the latter is
listed here as the main cause.
Then we contacted all the definite cases stiU
alive and also those suspected ones that had a
history of positive LE-ceU preparations. From
each a blood sample was obtained for HL-A
antigen and properdin factor B phenotype deter-
minations2). These were carried out by Alfred
Arnason Ph. D. & al. in the Blood Bank in
Reykjavík. The method used by the HL-A
typing is mainly the one described by Terasaki,
i. e. two step microcytotoxicity test but with
some modifications derived mainly from the
method described by Kissmeyer-Nielsen.
The method used by the properdin factor B
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