STUDIES OF RHEUMATIC DISEASE. III. FAMILIAL ASSOCIATION AND AGGREGATION IN RHEUMATIC DISEASE

Abstract

The siblings of 95 children admitted to the clinic because of rheumatic manifestation were studied with respect to the relationship of the occurrence of the disease among them to familial association with an acute episode of the disease in another member of the family. The attack rate increased after association with an acute episode; was higher among the children of rheumatic parents both before and after such association; and showed no tendency, following association with an acute episode, to be higher within a short proximal period as compared with a more remote later period. In the etiology of rheumatic disease there are both hereditary and environmental factors involved, and the environmental factor, to produce the disease, must act over a long period of time and/or the disease has a long period of subclinical development before becoming manifest.