Table 3.
Systemic lupus erythematosus organ manifestations in Canadian, American, Australian and New Zealand Indigenous Populations Compared to the Caucasian Population (where available)a
| Criteria | Aboriginal, Canada | First Nations, Canada | American Indian | Alaska Native | American Indian/Alaska Native | Australian Aborigine | New Zealand Maori |
|---|---|---|---|---|---|---|---|
| Photosensitivity | 41 vs 57% [73] | 75% [42] 39 vs 42% [5] |
69% [17] | 39% [57] | 53%# [85] | 14% [82] 11 vs 50%b [86] 11 vs 39%b [87] |
NR |
| Malar rash | 54 vs 64% [73] | 12.5% [42] 56 vs 50% [5] |
69% [17] | 46% [57] | 32% [85] | 27% [82] 44 vs 83%b [86] |
NR |
| Discoid rash | 13 vs 20% [73] | 24 vs 25% [5] | 0% [17] | 15% [57] | 8%# [85] | 9% [82] 28 vs 67%b [86] |
NR |
| Oral ulcers | 49 vs 58% [73] | 38% [42] 17 vs 33% [5] |
32% [17] | 15% [57] | 35%# [85] | 14% [82] 17 vs 50%b [86] |
NR |
| Serositis | 37 vs 32% [73] | 50% [42] 33 vs 27% [76] Pericarditis 22 vs 12% [5] Pleuritis 25 vs 26% [5] |
38% [17] | 62% [57] | 48% [85] | Pericarditis 32% [82] 22 vs 17% [86] Pleuritis 45% [82] 50 vs 83%b [86] |
NR |
| Arthritis | 74 vs 82% [73] | 90 vs 82% [5] 90 vs 67%b [77] |
88% [17] | 92% [57] | 80%# [85] | 64% [82] 78 vs 83% [86] 76 vs 90% [87] |
NR |
| Neurologic | 14 vs 6% [75] | 13% [42] 13 vs 9% [76] Seizures 10 vs 3% [5] Psychosis 10 vs 6% [5] |
32% [17] | 31% [57] | 3% [85] | 5% [82] 6 vs 17% [86] 34 vs 48% [87] |
NR |
| Hematologic | 60 vs 70% [73] | Leukopenia 70% [42] 33 vs 43% [5] Thrombocytopenia 29 vs 15% [5] Hemolytic anemia 13 vs 4% [5] Lymphopenia 60 vs 65% [5] |
44% [17] | 54% [57] | 90% [85] | Leukopenia 5% [82] 44 vs 33% [86] Thrombocytopenia 32% [82] 39 vs 17%b [86] Hemolytic anemia 9% [82] 14 vs 0% [86] Lymphopenia 64% [82] 77 vs 33%b [86] Anemia 38 vs 31% [87] |
NR |
| Renal |
Ever
Renal disease 39 vs 40% [73] |
At diagnosis
Proteinuria 22 vs 16% [5] Casts 17 vs 6%b [5] Ever Proteinuria 46 vs 25%a [5] Casts 35 vs 12%b [5] Nephritis 48 vs 29% [77] 57 vs 32%b [76] Renal disease 0% [42] |
At diagnosis
Nephritis 21 vs 12% [81] Ever Renal disease 32% [17] |
Ever
Renal disease 39% [57] |
Ever
40% [82] |
Ever
Proteinuria 22 vs 17% [86] 62% [82] Casts 11 vs 0% [86] 41% [82] Renal disease 46 vs 28% [87] |
At diagnosis
Nephritis 10 vs 4%b [79] Ever Nephritis 17 vs 19% [79]c |
| ANA positive | 96 vs 95% [73] | 88% [42] 100 vs 98% [5] |
69% [17] | 100% [57] | 98% [82] | 100% [82] 100 vs 100% [86] |
NR |
| Immunologic criteria | 89 vs 83% [73] | 38% [17] | 77% [57] | 61%# [82] | NR |
#Aggregate data presented. Publication provides combined rates and separated by region (Alaska, Phoenix, Oklahoma)—only arthritis, immunologic disorder, oral ulcers and discoid rash differ significantly between groups—with arthritis and discoid rash being more frequent in Phoenix, Immunologic disorder more frequent in Alaska, photosensitivity and oral ulcers being less common in Oklahoma
aIndigenous population % versus comparison population % if available; in all studies, the comparison population was Caucasian except for Bossingham [87] where the comparison was to the non-Indigenous Population
bStatistically significant difference
cAfter adjustment significant difference between groups [OR 8.47 (95% CI 2.11–33.96) vs all patients]