Young, black women at highest risk for lupus, suffer more life-threatening complications

Young, black women have the highest rate of developing lupus and are most likely to be diagnosed at a younger age than whites and during childbearing years, according to a new University of Michigan study of lupus in Southeastern Michigan.

In Michigan, lupus prevalence was three times higher than previous estimates, reaching one in 537 black female Michiganders in the region, compared to one in 1,153 white women, according to the findings that appear in Arthritis and Rheumatism.

In addition to experiencing the disease earlier in life - which can mean living with the condition over more years - black females with lupus also faced a higher degree of serious health complications, such as kidney failure requiring dialysis or a transplant.

The U-M research, which covered roughly a quarter of the state's population, is part of a landmark epidemiology study (which examines disease patterns and associated risk factors) - and the largest of its kind ever performed in the U.S. focusing on lupus. Lupus (technically known as systemic lupus erythematosus or SLE) is a chronic, autoimmune disease that may cause such symptoms as extreme fatigue, headaches, painful or swollen joints, hair loss, anemia, rashes and abnormal blood clotting. Serious organ damage can also occur, including kidney, neurologic, and cardiovascular complications. Like most autoimmune diseases, risk of lupus is significantly higher for females than males.

The findings, which are based on data collected as part of a public health initiative in conjunction with the Michigan Department of Community Health, dovetail with a sister project from Emory University in Atlanta, Ga. that found that the incidence rate for lupus was three times higher for black women than for white women in Georgia. Both studies appear in Arthritis and Rheumatism, along with an accompanying editorial on the research's implications. (Read more on all of the findings here).

"There is a very poor understanding of what causes lupus. Identifying the population and dynamics involved helps us target our resources more effectively and better recognize risk factors for the development and progression of the disease," says lead author Emily Somers, Ph.D., Sc.M, an assistant professor in the departments of Internal Medicine in the division of Rheumatology, Environmental Health Sciences, and Obstetrics & Gynecology at the U-M Medical and Public Health Schools.

What is Lupus?

Lupus is an autoimmune disease where the body's immune system becomes hyperactive and attacks normal, healthy tissue. This results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs.

Under normal function, the immune system makes proteins called antibodies in order to protect and fight against antigens such as viruses and bacteria. Lupus makes the immune system unable to differentiate between antigens and healthy tissue. This leads the immune system to direct antibodies against the healthy tissue - not just antigens - causing swelling, pain, and tissue damage.(* An antigen is a substance capable of inducing a specific immune response.)