Differences in Lupus Symptoms Between Races
People with lupus have more in common with each other than they have differences. However, it’s important to look at the differences to find the right treatment for each person.
African Americans (Afro-caribbean ancestry) were five times more likely to suffer from SLE than European Americans. SLE also occurs earlier and hits harder in African American populations compared to European Americans, with more kidney-related symptoms. And, although the mortality rate of SLE has greatly improved over the decades, people of African origin in the US continue to have higher mortality rates from SLE, with a survival rate of 57-78% over 5 years.
The symptoms of lupus are unique from patient to patient, but different groups have different patterns of symptoms that show up more frequently. For example, people of African and Asian origin in the US and Pacific Islanders have higher frequencies of blood-related symptoms such as thrombocytopenia, with African Americans having higher frequencies of neurological symptoms than any of these groups. Neurological symptoms of lupus include fatigue, depression, anxiety, and even seizures, and can range in severity from inconvenient to very serious. Brain fog, a cognitive issue that feels like struggling to think through a cloudy haze or fog, is an extremely common symptom.
Cutaneous (skin) lupus symptoms are also different between races and origins. European origin people have higher rates of photosensitivity and malar rash, while patients of African decent are more likely to have the circular lesions known as discoid lupus.
Lupus nephritis and cardiovascular disease are higher in all marginalized groups (including people struggling with poverty,) compared to patients of European origin and are among the top causes of eventual death for people in these groups with lupus. Lupus nephritis is a form of lupus that heavily affects the kidneys. You can read about Lupus nephritis and dialysis, a common treatment for severe lupus nephritis, here. Cardiovascular disease can affect the heart, lungs, kidneys, and blood vessels (and therefore other organs including the brain.) People with lupus are significantly more likely to have cardiovascular disease, though the risk is also heavily influenced by lifestyle and diet. Both of these are the leading causes of death in these populations.
Hispanic and Asian-origin women with lupus are 4-6 times more likely to die than people of European origin with lupus, and African American women with lupus are estimated to have a 20-year less life expectancy on average.
This implies that there are differences behind the presentation of SLE in different populations that are not fully understood. However, there may be a hint in the bloodstreams of people with lupus and those at high risk of developing lupus.