OBJECTIVE: To examine the extent of organ damage among recently diagnosed patients with systemic lupus erythematosus (SLE), and to assess the association between sociodemographic variables and total damage and organ-specific damage scores. METHODS: We evaluated damage in 132 patients with SLE (70 African Americans and 62 whites), 2-6 years (median 4 years) after diagnosis, using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. The associations between demographic characteristics and total damage and organ-specific damage measures were evaluated using logistic regression, adjusting for age, income, and ethnicity. RESULTS: A total of 61% of patients scored >or=1 point on the damage index. Damage was most prevalent in the musculoskeletal (28%), skin (20%), neuropsychiatric (16%), and renal (12%) subscales. African American ethnicity and lower household income were independently associated with total damage scores (score >or=2: adjusted odds ratio [95% confidence interval] 6.0 [2.3-16.2] in African Americans and 2.7 [1.1-6.7] in patients with an annual household income