Are there any major differences in clinical manifestations or autoantibody profiles in children with SLE based on ethnicity?

While there is some published data, including those from the Toronto pediatric lupus cohort (Hiraki et al., PMID 19833755), that suggest the prevalence of severe organ manifestations such as nephritis and central nervous system involvement may vary by race or ethnicity, it is difficult to know how delays in access or presentation to care play a role in that or what the drivers are.

Lupus nephritis is a very common manifestation in childhood-onset SLE (cSLE) where upwards of 50-60% of children with lupus have LN at presentation. LN has been reported as high as 80% and 90% in several international cohorts. Nevertheless, as was noted in our paper for this journal club, while morbidity and mortality are overall improving in cSLE, there is still a high risk for poor outcomes in children from minoritized groups, particularly Black cSLE patients. There is some data that potentially non-White patients with cSLE have a higher prevalence of Smith and U1-RNP antibodies. (Jurencák et al., PMID 19208567) However, these are not well correlated with the presence of nephritis. In addition, traditional biomarkers for LN such as C3/4 l...