[Symptomatic and prognostic differences according to ethnic group in systemic lupus erythematosus. A controlled study...

Systemic lupus erythematosus (SLE) has been found in all ethnic groups, but some of these groups--notably the black populations of the United States--seem to develop severe forms of the disease. We compared the signs and course of SLE in 20 black patients from the French West Indies, 20 patients of North African origin and 40 European Caucasians. At the onset of the disease, most of the West Indian and North African patients were living in France, and their social level was similar to that of the European patients. On the whole, our study confirmed that SLE is particularly severe in black populations. This severity is primarily due to renal involvement: 7 of the 13 renal biopsies we performed showed diffuse proliferative glomerulonephritis. In North African patients the severity of SLE was intermediate between that observed in West Indians and in European Caucasians. Five out of our 40 West Indian and North African patients died, as against only one female patient among the 40 European Caucasians. These differences seem to be ascribable to genetic factors rather than to environmental factors.