Autoimmune Diseases Among Top Killers of Younger Women

Sept. 1, 2000 -- Most American women know that cancer and heart disease claim a high number of lives each year. But many would be surprised to learn that the so-called autoimmune diseases, which include lupus and multiple sclerosis, rank up there as well. In fact, a new studyshows they are among the top 10 causes of death of young and middle-aged women in the U.S.

The autoimmune diseases are a varied group of more than 80 chronic disorders. They affect virtually every organ system in the body, but in all of the diseases, the underlying cause is the same: For reasons not yet understood, the body's immune system goes haywire and attacks the body's own tissues.

"It's a different sort of disease in that it strikes all over the body," Patrick Dowling, MD, MPH, tells WebMD. "And that makes it harder to treat and harder to understand. But something sets off this reaction in that the system attacks itself, and we don't know why." Dowling, professor and chair of the department of family medicine at the UCLA School of Medicine, was not involved in the study.

About 75% of these illnesses occur in women. Many of the autoimmune diseases are rare, while others, such as lupus and rheumatoid arthritis, are much more common. But combined, they represent the fourth-largest cause of disability among U.S. women.

"The study is important in that it points out that autoimmune diseases as a group are problematic, and are an important cause of death in women," says Catherine MacLean, MD, an assistant professor of medicine in the division of rheumatology at UCLA. "It is important for the public to have more awareness about them." She was not involved in the study.

The study was conducted by researchers from the department of community medicine at the University of Connecticut Medical Center in Farmington. According to the data they reviewed, which included all deaths in females in 1995, the total number of deaths from autoimmune diseases placed them within the top 10 leading causes of death for all women under 65. For women ages 15 to 64, they were at least the eighth leading cause of death.

A major barrier to improving prevention, diagnosis, and treatment of these disorders is the fact that most medical centers don't have enough patients suffering from any one particular autoimmune disease to support appropriate research, says study co-author Stephen J. Walsh, ScD.

"One solution to this problem would be to create a system of regional registries of persons with autoimmune diseases," he says. "This would allow researchers to access a broader pool of patients and to conduct more definitive studies."

"The take-home message is that the public and researchers need to realize that [autoimmune diseases] are an important cause of death for women under the age of 65," says MacLean.

It's still a mystery why these illnesses strike women so much more frequently than men. "There may be some sort of hormonal factor or a pregnancy factor, or genetic components," Dowling says. "At this time, it's just not well understood."

The public needs to understand that, like cancer, autoimmune diseases frequently create related problems that all too often lead to disability and death, says Walsh.

"The perception is that, individually, these diseases are rare and, for unknown reasons, affect only an unfortunate few," he says. "Bringing more attention to the prevalence of the autoimmune diseases should shatter this common misconception."