Autoimmune disease incidence among women prenatally exposed to diethylstilbestrol
Data shows no difference between rates of autoimmune diseases among the DES exposed and unexposed women.
Autoimmune disease is a class of diseases where antibodies usually meant to recognize foreign organisms instead react to a person's own cells and tissues. We studied four specific types of autoimmune disease to investigate whether prenatal Diethylstilbestrol (DES) exposure affects the occurrence of these diseases. Systemic Lupus Erythematosus, or lupus, is an inflammatory disease resulting from an antibody attack on tissues and organs resulting in skin rashes, arthritis (chronic joint swelling), renal failure, or nervous system disorders. Rheumatoid arthritis (RA), not to be confused with commonly occurring osteoarthritis, is a disorder resulting from an immune response to an individual's own connective tissue. The disease results in joint swelling and stiffness. Optic neuritis (ON) is a swelling of the optic nerve due to immune response resulting in vision loss in one eye, painful eye movement, and loss of color vision. Idiopathic Thrombocytopenia Purpura (ITP) is an unexplained decrease in the amount of platelets, cells designed to aid in blood clotting.
The rates of these diseases were compared among women who were and were not prenatally exposed to DES. Women who reported a diagnosis of any of these four diseases on the questionnaires sent in 1994, 1998, or 2001 were asked for permission to contact their doctors to verify the diagnosis. Considering all verified reports, there was no difference between the combined rates of these autoimmune diseases among the DES-exposed and unexposed women. Individually, there was also no difference in the rates of lupus and ON in these two groups. While there was no overall difference in RA between the two groups, there did appear to be a higher rate of RA among exposed women under the age of 45 compared to unexposed women of the same age. This difference however was based on a small number of cases (17 DES-exposed and 2 unexposed) and as a result there is some uncertainty as to the magnitude of this increase. Also there was no increase in RA among DES-exposed women 45 years and older compared with unexposed women of the same age. There were too few ITP cases to conclude whether or not there was a difference in the rate of this disease in the two groups.