PT  - JOURNAL ARTICLE
AU  - WILLIAM C. STROHSNITTER
AU  - KENNETH L. NOLLER
AU  - REBECCA TROISI
AU  - STANLEY J. ROBBOY
AU  - ELIZABETH E. HATCH
AU  - LINDA TITUS-ERNSTOFF
AU  - RAYMOND H. KAUFMAN
AU  - JULIE R. PALMER
AU  - DIANE ANDERSON
AU  - ROBERT N. HOOVER
TI  - Autoimmune Disease Incidence Among Women Prenatally Exposed to Diethylstilbestrol
AID  - 10.3899/jrheum.091092
DP  - 2010 Oct 01
TA  - The Journal of Rheumatology
PG  - 2167--2173
VI  - 37
IP  - 10
4099  - http://www.jrheum.org/content/37/10/2167.short
4100  - http://www.jrheum.org/content/37/10/2167.full
SO  - J Rheumatol2010 Oct 01; 37
AB  - Objective. Animal studies have suggested that prenatal diethylstilbestrol (DES) exposure may alter immune system development and function including antigen self-recognition. A cohort study was conducted to investigate whether prenatal DES exposure might influence the incidence of at least some specific autoimmune diseases in women. Methods. A group of women who were and were not prenatally exposed to DES have been followed for more than 25 years for numerous health outcomes including autoimmune disease. To verify diagnoses, medical records or physician abstracts were requested for all women who reported a diagnosis of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), optic neuritis (ON), and idiopathic thrombocytopenic purpura (ITP). Incidence rates of these autoimmune diseases were compared between women who were and who were not prenatally DES-exposed. Results. Overall, there was no increase in verified autoimmune disease among DES-exposed women relative to those who were not exposed (RR 1.2; 95% CI 0.7, 2.1). There was, however, a positive association between prenatal DES exposure and RA among women younger than 45 years (RR 4.9; 95% CI 1.1, 21.6) and an inverse association among women who were 45 years and older (RR 0.1; 95% CI 0.01, 0.7). Conclusion. Overall, these data provide little support for an association between prenatal DES exposure and development of autoimmune disease. The implication that such exposure may be related to RA in an unusual age-related manner is based on small numbers of cases and warrants further study.