Lupus: A silent war against Black women

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Black Women’s Health Imperative, a health education, research, advocacy and leadership development institution, declared recently that lupus is waging a silent war on Black women. This article uses data from the Centers for Disease Control and Prevention and from the National Institute of Arthritis and Musculoskeletal and Skin Diseases to answer frequently asked questions about the disease.

What is lupus? Lupus is a disease that causes the immune system to attack its own body cells. It can affect the joints, the skin, the kidneys, the lungs, the heart or the brain, causing severe joint and muscle pain, extreme exhaustion, fevers and skin rashes. It can also lead to organ failure and death.

Who gets lupus? People of all races may get lupus. However, it affects mainly young women, often starting between the ages of 15 and 44. Lupus is three times more common in Black women than in white women. It is also more common in women of Hispanic/Latina, Asian and American Indian descent. Black and Hispanic/Latina women tend to develop symptoms at an earlier age than other women. African-Americans have more severe organ problems, especially with their kidneys.

What causes lupus? The cause of lupus is not known. In some people, lupus becomes active after exposure to sunlight, infections or certain medications.

What are the signs of lupus? Signs of lupus tend to come and go. At times the disease quiets down, or goes into remission. At other times, it flares up, or becomes active. Lupus may be hard to diagnose. It is often mistaken for other diseases. For this reason, lupus has often been called the “great imitator.”

Common signs are:

  • Red rash or color change on the face, often in the shape of a butterfly across the bridge of the nose and the cheeks
  • Painful or swollen joints
  • Unexplained fever
  • Chest pain with breathing
  • Unusual loss of hair
  • Pale or purple fingers or toes from cold or stress
  • Sensitivity to the sun
  • Low blood count

These signs are more important when they occur together. Other signs of lupus can include mouth sores, unexplained “fits” or convulsions, hallucinations or depression, repeated miscarriages and unexplained kidney problems.

Is lupus contagious? No.

Does lupus run in families? Most relatives of lupus patients do not develop the disease, but in some families more than one member gets lupus.

Are there different kinds of lupus? There are three major types of lupus. The most serious is systemic lupus erythematosus, or S.L.E. It may affect parts of the body, such as the joints, skin, kidneys, lungs, heart or brain. Discoid, or cutaneous, lupus erythematosus (D.L.E.), affects mainly the skin. Drug-induced lupus is caused by medicines, the most common of which are procainamide, used for heart problems; hydralazine, used for high blood pressure; and dilantin used for seizures.

Do men get lupus? Yes. However, nine out of the ten people who have lupus are women.

Why is lupus more common in Black women than in white women? This is not known. Researchers are studying why minorities are more inclined to get lupus, what causes it to start and why it is mild in some and severe in others. Other researchers are studying why the signs of lupus differ between black women and white women. Between 1979 and 1998, death rates from S.L.E. increased nearly 70 percent among Black women between the ages of 45 and 64 years. Possible reasons include an increasing incidence of S.L.E., late diagnosis, less access to health care, less effective treatments and poorer compliance with treatment recommendations.

Is there a cure for lupus? At this point, there is no known cure for lupus, but there are effective treatments. Early diagnosis and the commencement of treatment are vital to reducing the physical and economic impact of lupus. With the correct medicine and by taking care of themselves, most lupus patients can hold a job, have children and lead a full life.

How is lupus treated? The four types of medications generally used are nonsteroidal anti-inflammatory drugs (NSAIDS), antimalarials, steroids and cytotoxics/immunosuppressants. Complementary alternative treatments include herbal and flower remedies, aromatherapy and homeopathy.

Where can I get further information? See your doctor or health clinic. Contact the following organizations:

Black Women’s Health Imperative
Washington, D.C.
202-548-2000
www.blackwomenshealth.org

Lupus Foundation of America Inc.
Rockville, Md.
301-670-9292; 800-558-0121
www.lupus.org

The American Lupus Society
Ventura, Calif.
805-339-0443; 800-331-1802