From the Journals

Lupus is quietly killing young women



Systemic lupus erythematosus (SLE) is a leading cause of death in young women but is underrecognized because it may not be included on death certificates, according to researchers at the University of California, Los Angeles.

SLE was either the underlying or a contributing cause of death for 28,411 females from 2000 to 2015, when it was one of the 20 most common causes of death among females aged 5-64 years in the United States, based on an analysis of the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research multiple cause-of-death database, the researchers said.

SLE was the 10th-leading cause of death in the 15- to 24-year age group (1,226 deaths), the 14th-leading cause among women aged 25-34 (2,431 deaths) and 35-44 (3,646 deaths), and the 16th-leading cause in those aged 45-54 (5,271 deaths), Eric Y. Yen, MD, and Ram R. Singh, MD, reported in Arthritis & Rheumatology.

Lupus-related deaths among females by age group, 2000-2015
Among women aged 15-24 years, SLE was the leading “chronic inflammatory disease, ranking higher than diabetes mellitus, human immune deficiency virus disease, chronic lower respiratory disease, nephritis, pneumonitis, and liver diseases,” they wrote.

The numbers for SLE could be higher, though, since it is underreported on death certificates – by as much as 40% in one study – and other causes may be overreported. “Patients with SLE die prematurely of complications such as cardiovascular events, infections, renal failure, and respiratory diseases [and] these proximate causes of death may be perceived to be unrelated to SLE, when in fact the disease or the medications used for it predispose to them,” the investigators said.

Dr. Yen was supported by the National Institutes of Health and UCLA Children’s Discovery and Innovation Institute. Dr. Singh was supported by the NIH, the Lupus Foundation of America, and the Rheumatology Research Foundation.

SOURCE: Yen EY and Singh RR. Arthritis Rheumatol. 2018 Apr 18. doi: 10.1002/art.40512.

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