Race Shown to Affect Severity of Lupus Disease

Systemic lupus erythematosus (SLE) is the most common form of lupus — a chronic inflammatory disease that can affect various parts of the body, especially the kidneys, joints, blood and nervous system.

The study, which appears in the summer issue of the journal Ethnicity & Disease, looked at how some factors might influence the severity of SLE in different patients, including race, age, sex, ethnicity and the method of payment for care.

The researchers used hospital discharge data from the Dallas-Fort Worth Hospital Council for nearly 15,000 patients hospitalized with SLE between 1999 and 2005. Ninety percent of these were adult women and patients were white, African-American or Hispanic.

The study showed that women were three times more likely to have SLE than men were, and that patients with SLE were more than five times as likely to have multiple autoimmune diseases. Race and ethnicity were indeed a factor in SLE, as the results showed that white patients were only about half as likely as others to have SLE.

“Ethnic minority populations have a higher incidence of severe SLE for several reasons, such as a lower socioeconomic status, barriers to adequate health care and genetic predisposition,” said lead author Katie Crosslin, from Children’s Medical Center in Dallas.

For patients with SLE, comorbidities — additional diseases — make their condition more severe and affect their treatment regimen. Crosslin and her colleague found that African-American and Hispanic patients were two times higher risk of having nephritis, kidney failure and pericarditis (swelling of the heart’s lining) than whites were.

Hispanic women suffer the most severe cases of SLE and comorbidities — they were 61 percent more likely to have nephritis and 55 percent more likely to have diabetes, for example.

“Rheumatologists are aware of the differences in severity and outcome of lupus among patients of different racial groups,” said Graciela Alarcón, M.D., a professor of epidemiology at the University of Alabama at Birmingham.

However, she said that these differences are not common knowledge among “general practitioners who are the ones more likely to encounter patients at disease onset when disease manifestations may not be so obvious.”
Alarcón added that delays in referring patients to a specialist for proper diagnosis might cause harmful setbacks in adequate treatment.

More information: Crosslin KL, Wiginton KL. The impact of race and ethnicity on disease severity in systemic lupus erythematosus. Ethnicity & Disease 19(3), 2009.

Provided by Health Behavior News Service (news : web)