Which of the following is NOT associated with increased relative risk of developing systemic lupus erythematosus?
A. Female gender
B. Deficiency in complement protein C2
C. African-American ethnicity
D. Presence of HLA-DR3
E. Defect in B cell maturation
ANS: E. Systemic lupus erythematosus (SLE) is a chronic, remitting and relapsing, multisystem disease that affects predominantly women, with an incidence of 1 in 700 in women between the ages of 20 and 60 years. Incidence increases to about 1 in 250 in African-American women. The female-to-male ratio is 10:1. Deficiencies of classical complement proteins, especially C2 or C4, are seen in about 10% of patients with SLE; abnormal complement levels may result in defective clearance of immune complexes. Individuals with the class II DR2 or DR3 HLA allele have a five-fold higher probability of developing SLE. In contrast, patients with defects in B cell maturation would typically have impaired antibody synthesis; thus it is unlikely that these patients would develop an autoimmune disease characterized by the production of autoantibodies.
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