$Unique_ID{BRK02013} $Pretitle{} $Title{What is Lupus?} $Subject{lupus inflammatory disease connective tissue systemic lupus erythematosus SLE disseminated LE muscles joints arthritis pleurisy lungs kidneys kidney strokes stroke seizures seizure psychiatric actions nervous system rash rashes hair loss fatigue immune system autoimmune antibodies birth control pills menopause female hormones corticosteroids inflammation bacterial infections bacterial infection diet stress sun light} $Volume{} $Log{ Immune Cell Production Sites I*0004501.scf Immune Cell Production Sites II*0004502.scf Humoral Immunity*0004601.scf Cell-Mediated Immunity*0004602.scf} Copyright (c) 1993 Tribune Media Services, Inc. What is Lupus? ------------------------------------------------------------------------------ QUESTION: I don't think I have ever seen you write anything about lupus, although I read your column faithfully whenever it is printed in our paper. I know this is a difficult disease to describe, but our family has such need for information about this problem, that I was delegated to write to ask for your help. Would you please describe the disease and what we can expect to happen to our sister in the coming years? I can't tell you how much we would all appreciate your help. ------------------------------------------------------------------------------ ANSWER: There are varying forms of this inflammatory disease which affects the connective tissue in the body, that can run from a mild type to a severe form that requires immediate treatment. It is known as systemic lupus erythematosus (SLE) or disseminated LE. The disease is often difficult to diagnose, for it can affect almost every organ in the body, and can produce a wide variety of symptoms. When muscles and joints become inflamed and painful, the disease resembles arthritis. It can produce a shortness of breath and pain that looks like pleurisy when it attacks the lungs, cause a variety of symptoms when affecting the kidney, and provoke strokes, seizures and psychiatric actions when the nervous system becomes involved. Rashes are typical; especially a rash that bridges the nose and resemble a "butterfly", as well as painless sores in the mouth and nose, and hair loss. In many cases, none of these situations are readily apparent, and the patient complains only of fatigue, just not feeling up to par. The disease is far more frequent in women than in men, as almost 90 percent of the cases are women. Black women are more affected than their white counterparts. SLE is a disease of the immune system, an autoimmune disorder that occurs when the body turns against itself. The immune system produces antibodies that react against the bodies own tissues, rather than foreign substances, like bacteria, that invade the system. This is probably caused by two things; an inherited predisposition to the disorder, and a second precipitating cause in the environment, like a virus or exposure to toxic chemicals. Since women are affected in such high numbers, hormones may also play a role. Birth control pills can make the condition worse, and lupus often gets a bit better after menopause, when the body stops producing female hormones. It is also possible that lupus is not merely a single disease, but comes from a number of things happening at once. The use of corticosteroids remains the standard treatment to reduce the amount of inflammation, and to reduce the severity of the symptoms. Once the condition comes under control, the amount of medication is reduced gradually over a long period of weeks or months. Other medications that suppress the immune system may also be used, but then close attention is paid to the possibility of infections. With the immune response held at bay, bacterial infections can rapidly establish a foot hold, which can complicate the treatment and the life of the patient. Diet, reduction of stress, and avoiding excessive sun light are also advised, to help reduce both the frequency and severity of the "flares", periods during which the disease becomes more intense. Research has provided a number of therapies that provide a person with a normal life-span, and continues today to seek even more definite and affective treatments. You, your sister, and your family can obtain a wealth of information from the Lupus Foundation of America, Four Research Place, Suite 180, Rockville, Maryland, 20850-3226. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.