Document Detail

A clinical and serologic comparison of African American and Caucasian patients with systemic sclerosis.
MedLine Citation:
PMID:  22576620     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Epidemiology studies suggest that systemic sclerosis (SSc) is more common, occurs at a younger age, and is more severe in African Americans than Caucasians. However, the scleroderma autoantibody profile is very different between these 2 ethnic groups. This study was undertaken to examine the demographic and disease features, frequency and severity of internal organ system involvement, and survival in African American patients compared to Caucasian patients with SSc, giving particular attention to their serum autoantibody profiles.
METHODS: Demographic features, clinical characteristics, autoantibody profile, organ involvement, and survival were studied in consecutive African American and Caucasian patients with SSc whose visits were recorded between 1972 and 2007 as part of the Pittsburgh Scleroderma Database. The Medsger Severity Score for SSc was used to determine the severity of disease.
RESULTS: African American patients were more likely to have anti-topoisomerase I (anti-topo I), anti-U1 RNP, and anti-U3 RNP autoantibodies. In comparing African American and Caucasian patients with these antibodies, pulmonary fibrosis was found to be more frequent and more severe, and the rate of survival was decreased, in African American patients with anti-topo I antibodies compared to Caucasian patients with anti-topo I. Pulmonary fibrosis was also more severe in the anti-U1 RNP-positive patients, but this was not associated with a difference in survival between African Americans and Caucasians. Anti-U3 RNP was associated with more severe gastrointestinal involvement in African Americans compared to Caucasians.
CONCLUSION: African Americans with SSc have more severe disease complications compared to Caucasians with SSc, and this is associated with both the type of autoantibody present and the severity of interstitial lung disease. Thus, it is hoped that early aggressive intervention in African Americans with interstitial lung disease will improve outcomes.
Virginia Steen; Robyn T Domsic; Mary Lucas; Noreen Fertig; Thomas A Medsger
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  64     ISSN:  1529-0131     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-28     Completed Date:  2012-12-04     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2986-94     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 by the American College of Rheumatology.
Georgetown University School of Medicine, Washington, DC 20007, USA.
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MeSH Terms
African Americans
Autoantibodies / blood*,  immunology
European Continental Ancestry Group
Middle Aged
Pulmonary Fibrosis / blood,  ethnology*,  immunology,  mortality
Scleroderma, Systemic / blood,  ethnology*,  immunology,  mortality
Severity of Illness Index
Survival Rate
Grant Support
Reg. No./Substance:

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