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Racial Variation in Clinical and Immunological Manifestations
of Systemic Sclerosis
PAUL J. NIETERT, HOLLY C. MITCHELL, MARCY B. BOLSTER, STEPHANIE R. SHAFTMAN, BARBARA C. TILLEY, and RICHARD M. SILVER
ABSTRACT. Methods. The study included white and black patients with systemic sclerosis (SSc) treated at a university hospital rheumatology clinic between November 1997 and April 2003. Demographic, clinical, and immunological measurements were obtained on each subject. Using multivariable statistical techniques we assessed differences in disease manifestations between white and black patients after adjusting for gender and classification and duration of disease. Results. Two hundred sixty-three patients (199 whites, 64 blacks) were enrolled in the study. Blacks experienced an earlier age at disease onset than whites and were significantly more likely to have diffuse disease, digital ulcers, digital pitting, impaired lung function, and anti-RNP, and anti-Ro antibodies. Whites were significantly more likely to have anti-centromere antibodies. Conclusion. After adjusting for gender, disease classification, and disease duration, whites and blacks with SSc differ in some clinical and immunological manifestations of disease. Whether these differences can be attributed to genetic or environmental factors remains unknown. (J Rheumatol 2006;33:263-8) Key Indexing Terms:
SCLERODERMA
From the Department of Biostatistics, Bioinformatics, and Epidemiology, and the Department of Medicine and Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA. Supported in part by a grant (1 P60 AR049459-01), entitled "Multidisciplinary Clinical Research Center for Rheumatic Diseases in Blacks" from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. P.J. Nietert, PhD, Department of Biostatistics, Bioinformatics, and Epidemiology; H.C. Mitchell, MD; M.B. Bolster, MD, Department of Medicine and Division of Rheumatology and Immunology; S.R. Shaftman, MSc, MS; B.C. Tilley, PhD, Department of Biostatistics, Bioinformatics, and Epidemiology; R.M. Silver, MD, Department of Medicine and Division of Rheumatology and Immunology. Address reprint requests to Dr. P.J. Nietert, Center for Health Care Research, 135 Cannon St., Suite 403, P.O. Box 250837, Charleston, S.C. 29425, USA. E-mail: nieterpj@musc.edu Accepted for publication October 19, 2005.
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