Open AccessRacial differences in scleroderma among women in Michigan
Author(s) -
Laing Timothy J.,
Gillespie Brenda W.,
Toth Mary B.,
Mayes Maureen D.,
Gallavan Robert H.,
Burns Carol J.,
Johanns Jewel R.,
Cooper Brenda C.,
Keroack Brian J.,
Wasko Mary Chester M.,
Lacey James V.,
Schottenfeld David
Publication year - 1997
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.1780400421
Subject(s) - medicine , scleroderma (fungus) , incidence (geometry) , cohort , negroid , medical record , epidemiology , pathology , physics , optics , inoculation
Objective. To examine racial differences in disease onset, extent, manifestations, and survival among women with scleroderma. Methods. A retrospective cohort study of women with scleroderma, diagnosed in Michigan between 1980 and 1991, was conducted. Clinical, laboratory, and demographic data were abstracted from the patients' medical records. Results. A total of 514 women with scleroderma were identified: 117 (23%) were black and 397 (77%) were white. Among black women, the mean age at diagnosis was lower (44.5 years versus 51.5 years; P < 0.001) and diffuse disease was more common (49.6% versus 24.9%; P < 0.001) than among white women. The overall incidence of scleroderma was 14.1 per million per year: 22.5 per million per year in black women versus 12.8 per million per year in white women ( P < 0.001). Pericarditis ( P = 0.009), pulmonary hypertension ( P < 0.001), pleural effusions ( P = 0.01), myositis ( P = 0.02), and an erythrocyte sedimentation rate >40 mm/hour ( P < 0.001) were more frequent among black women, while white women were more likely to have digital infarctions ( P < 0.001). Survival at 7 years from diagnosis was 72.5% among black women and 77.6% among white women. Age‐adjusted survival was significantly reduced among black women ( P = 0.033), most likely because of increased diffuse involvement. Survival among those with renal or pulmonary involvement was also significantly reduced. Conclusion. Black women with scleroderma were significantly more likely than white women to develop diffuse disease, be diagnosed at a younger age, have a higher incidence of inflammatory features, and have a worse age‐adjusted survival rate.