Canadian pediatric lupus severity varies with ethnicity

(HealthDay)—While Canadian children with systemic lupus erythematosus (SLE) differ in disease characteristics and severity by ethnicity, treatment, disease activity, and irreversible organ damage are similar across ethnic groups, according to a study published in the January issue of Arthritis Care & Research.

Deborah M. Levy, M.D., from the Hospital for Sick Children in Toronto, and colleagues analyzed ethnicity, sociodemographics, and disease characteristics in 213 Canadian children with childhood-onset SLE. The ethnic composition was 31 percent white, 30 percent Asian, 15 percent South Asian, 10 percent black, 4 percent Latino/Hispanic, 4 percent Aboriginal, and 3 percent Arab/Middle Eastern.

The researchers found that disease manifestations (malar rash, arthritis, serositis, renal disease), autoantibody profiles, and severity of disease expression differed by ethnicity. Only 20 percent of whites had severe disease, compared with 51 percent of Asian patients and 41 percent of black patients. However, disease activity indices, irreversible organ damage, and treatment (76 percent receiving prednisone, 86 percent receiving antimalarials, and 56 percent requiring additional immunosuppressants) were similar across ethnicities.

"Canadian childhood-onset SLE patients reflect our multiethnic population, with differences in disease manifestations, autoantibody profiles, and severity of disease expression by ethnicity," Levy and colleagues write. "We did not observe differences in the measured outcomes of treatment, disease activity, and irreversible organ damage. These findings would suggest that universal access to health care in Canada is an important determinant of positive outcomes in childhood-onset SLE."