Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Epidemiology of Systemic Sclerosis in the Afro-Caribbean Population of Martinique, FWI: A Population-Based Study.
Deligny, Christophe, Goeb, Vincent, Elise Truchetet, Marie, Kahn, Valentine, Dehlinger, Veronique, Numeric, Patrick, Derancourt, Christian
Population-based studies of systemic sclerosis in African descent population are exceptional.
To retrospectively assess incidence, prevalence and characteristics of systemic sclerosis (SSc) in the Afro-Caribbean population of Martinique, FWI.
Martinique is a West Indian French part of European community, with high economical status and 400000 inhabitants. Health care is easily accessible and the same as in metropolitan France. We conducted in 2009 and 2010 a multiple-source study to retrieve all cases fulfilling ACR criteria before 1st January 2009. Three different sources were used: hospitalisation files from the Academic Hospital, specialist physicians in private and public practice (rheumatologist, dermatologist, internist and pneumologist)
89 patients (88 meeting the ACR criteria) were found (female 73, male 16, female/male ratio: 4.6) in a screening of more than 400000 medical reports. Onset of the disease was, for 38 cases between 1999 and 2008 (female 30, male 8). Prevalence on December 31, 2008 and mean annual incidence from 1999 to 2008 of SSc were respectively 19.1/105 inhabitants (confidence interval 95%: 14.5 25) and 1.33/105 inhabitants (CI 95%: 0.53.3) aged 20 years old and over (female 1.84/105, CI 0.55.1). In the 89 patients, the characteristics were: mean age at diagnosis 42.1 years old (range 1286); mean follow up: 9.4 years (range 133); diffuse cutaneous scleroderma: 59 (66.3 %) and limited form: 26 (29.2 %); deaths during the follow up: 16 patients. Relative proportion of antitopoisomerase I antibody (31.5 %) and anticentromere antibody (12.4%) were typical of black patients and different than for Caucasians. Another connective tissue disease was present for 29 patients (32.6%) and muscular involvement was found in 31 (34.8 %). Interstitial lung disease concerned 67.4 % of our patients. Pulmonary hypertension, found in 28 %, was implicated in 6 deaths (37.5% of all deaths). Small and large intestine involvement, present in 14 patients, was responsible for 4 deaths (25% of all deaths)). Scleroderma renal crisis was diagnosed in 2 patients. The frequency of diffuse cutaneous form, interstitial lung disease, pulmonary hypertension and hypopigmentation (50.6%) seen in our Afro-Caribbean patients, has already been described in South African and Afro-American populations.
This is the first population-based study devoted to SSc in an African-descent population outside of the USA. It suggests that SSc is more frequent in our population than in most Caucasians populations already studied, but less frequently encountered than in African American population. Mean clinical and biological manifestations are close to African descent populations and also seem characteristic of the disease in Black populations.
To cite this abstract, please use the following information:
Deligny, Christophe, Goeb, Vincent, Elise Truchetet, Marie, Kahn, Valentine, Dehlinger, Veronique, Numeric, Patrick, et al; Epidemiology of Systemic Sclerosis in the Afro-Caribbean Population of Martinique, FWI: A Population-Based Study. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :571