By Kiara Doyal, The Seattle Medium
Recent data from the Centers for Disease Control and Prevention (CDC) indicates that lupus, a chronic autoimmune disease, affects approximately 204,000 Americans. Although lupus can affect anyone, it disproportionately impacts Black communities, especially Black women, who are two to three times more likely to be diagnosed than white individuals. This disparity highlights the need for greater awareness, earlier diagnosis, and equitable healthcare access for those most affected.
Lupus causes the body’s immune system to become overactive and attack its own healthy tissues and organs. Normally, the immune system protects the body from infections, but in people with lupus, it mistakenly targets parts of the body such as the skin, joints, kidneys, heart, lungs, brain, and blood cells, which causes inflammation and damage to the body’s own organs.
According to the Lupus Foundation of America, doctors aren’t sure why lupus is more common in women, but they think that differences in their genes and hormones may play a role. In addition, the foundation found that animal studies show that estrogen contributes to the development of lupus and makes it more severe. In the meantime, researchers are continuing to work hard to learn more about lupus and why it affects women more often than men.
“We do actually know a lot about the causes for lupus, but certainly hormones are very important, because 9 out of 10 patients are female,” said Dr. Keith Elkon, professor emeritus in the Division of Rheumatology at the University of Washington School of Medicine. “If you were to sit down and do the math, it is about three times more frequent in Black patients compared to white patients, and the severity of the case is often worse.”
With the condition placing a burden on certain populations, particularly women of color, efforts to develop more effective treatment options are more urgent than ever.
“Lupus nephritis disproportionately affects younger women, mostly women of color, often leading to end-stage kidney disease,” said Levi Garraway, M.D., Ph.D., chief medical officer and head of Global Product Development. “Our goal is to address this urgent need by providing a more effective treatment option.”
While lupus can present with a wide range of signs and symptoms, Dr. Elkon said that a sudden spike in temperature is often a key warning sign. He also said that, although the severity of the disease can vary, especially with a higher risk of kidney disease in Black patients, the symptoms themselves are generally consistent across different ethnic groups.
“A sign of lupus could be anything from mild joint pain, skin rash, especially on the face, loss of hair, and where you would know that there is something seriously wrong is an unexplained fever,” Elkon said. “The one thing we do know, which is very important, is that kidney disease tends to be more severe in Black patients, so that is something that rheumatologists will be on the lookout for as well as a potential sign.”
Raising awareness about lupus can help lead people to earlier diagnoses and stronger support systems for those affected. When more people understand the symptoms, they’re more likely to seek medical attention sooner rather than later, potentially preventing serious complications. Elkon stressed the importance of knowing your family’s health history and staying alert to symptoms, even those that may not be immediately recognizable as signs of lupus.
“If a relative has lupus, it is very important to know, and you should be aware of that and what the symptoms are in case you might suspect you have lupus,” said Elkon. “Go to the doctor when you notice something, because there are a lot of things like hair loss and even mouth ulcers that can be symptoms that many people may not be aware of. We don’t always put that out there just because a doctor can very easily test blood and tell what is going on exactly.”
While family history and genetics are closely related, they are not entirely the same. Elkon says understanding the genes you inherit from your parents is important because some genes heighten your chances of being diagnosed with lupus. Although lupus is polygenic, meaning many genes contribute a small amount to overall risk, rather than one gene being solely responsible.
“We already know that genetics is very important because there is a large number of gene variants that are known to predispose to lupus,” said Elkon. “It is the same in all autoimmune diseases where many genes contribute, and the more genes you have then the more likely you are to get lupus.”
Despite the toll lupus can take on patients, Elkon said that living as normal a life as possible is one of the best ways to cope with the disease. He claims that advances in treatment have increased survival rates. He also pointed out that regular medical care, medication, and lifestyle changes are instrumental in helping to control the disease and its symptoms.
“Diet is important. That means lower amounts of animal fat and sugar to control your blood pressure, which is vital because that is what they call the silent killer, because you don’t have any symptoms,” said Elkon. “Stress reduction is also likely to be helpful because there is some evidence that stress does make the disease worse, but those would be the basic lifestyle changes. For management with medication, the standard medications for milder forms of lupus over the last 30 to 40 years have been relatively safe for patients, and there are many newer treatments that look very promising.”
