Lupus can affect anyone. And although this is true, we do not want to ignore the fact that lupus disproportionately affects certain people. We have discussed how it affects young women, but we haven’t discussed how it affects young Black women. Lupus affects 1 in every 250 Black women and when compared to the white community, the prevalence of lupus in the Black community is 3-4x higher. It is well established that Black lupus patients tend to be sicker, need more aggressive medications and have worse outcomes. And despite the amazing advancements in testing and treatment, Black patients don’t benefit from those advances to the same extent as their white counterparts.
Searching for the “why”
Although the rheumatology community has acknowledged theses differences for years, the reasons are still unclear. There are many researchers who are looking into this and just as many theories. Genetic studies seemed like a natural next step. There have been genes isolated that confer higher risk of kidney disease in Black lupus patients, but this most likely does not explain everything. Moving alongside traditional genetic research (where the search is focused on finding “the gene”), is research into epigenetics. Epigenetics is the study of when and how certain genes get turned on or expressed. Just because an individual has a “bad gene” does not mean they are destined for any particular outcome. Of course the data on this is more nuanced. But suffice it to say, genes likely do not explain the disproportionate numbers of Black Americans with lupus.
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