Lupus

Lupus

An autoimmune inflammatory disease of the connective tissues, occurring mainly among middle-aged women, chiefly characterized by skin eruptions, joint pain, recurrent pleurisy, and kidney disease. Abbreviation: SLE [dictionary.com].

History

Lupus was first discovered in the middle Ages for a facial skin disorder. The disease reveals rashes and lesions on the face that is shaped like a butterfly. The term Lupus is Latin for the word wolf. 12th century physician Rogerius coined the term lupus describing these lesions resembled a wolf-like appearance on the face. The first to really dig into the mystery of this autoimmune disease was Moric Kaposi. Born in Hungary in 1837, Kaposi discovered the systemic manifestations of Lupus. It was not until 1948 when scientists discovered the LE cell (the Lupus Erythematosus cell). This revealed that the disease misleading feature that occurs with other diseases as well. Treatment for this autoimmune disease began in 1894. The first reported treatment with quinine proved to be effective therapy. In conjunction with quinine, salicylates were used to help treat the disease. Treatment for the autoimmune disease became even more effective with the use of corticosteroids. The discovery was made by Phillip Showalter Hench who won the Nobel Prize in 1950 for the treatment. [Wikipedia.com].

Who is affected?

Of those who acquire SLE, 90% of cases occur in women. It is predominately found in young women, but it can also be found men as well. Young children and older adults whose autoimmune system is not as effective can acquire this autoimmune disease.

Symptoms

If one were to have lupus some common symptoms would be exhaustion, skin rashes or joint pain. If the disease is more serious, it could affect many internal organs and muscles including your kidney or heart. Certain symptoms are linked to certain parts of the body that is affected by this disease. Around 90% of those who have this autoimmune disease experience serious fatigue. Fatigue leads to inactive ability to exercise which promotes bad health. 70% of people first experience joint or muscle pain when acquiring this disease. Almost all people who acquire lupus experience painful arthritis of joints in the body. One of the worst problems with those who experience serious arthritis acquires skin rashes on the body and face. These lesions or rashes on the face form a "butterfly" pattern on their cheeks and the bridge of their nose. An example of this can be seen here. [medscape.com]. The rash can cover appendicular and axial parts of the body as well. Approximately 50% of the people who acquire this disease are unable to experience ultraviolet B light or sun exposure.

Those who acquire lupus have a negative effect on the nervous system. Some symptoms include memory loss and headaches. The disease can also promote brain epilepsy or seizures to occur. The symptoms for lupus range differently between people who acquire lupus. Other symptoms include weight and hair loss, fever, or mental problems associated with this disease. Acquiring lupus is hard for an individual to handle and he or she may have feelings of depression or anxiety over this issue. Although rare, blistering and ulcers can occur as well. The internal organs such as the kidney and lymph nodes can be affected as well [webmd.com]. Swelling of the lymph nodes may occur and affects fighting other diseases that occur in the body. This could promote other diseases like pneumonia. Kidneys experience lesions that could affect urinary tract infection and other serious problems.

Diagnosis

Recognition of lupus is not very easy in its early stages. One of the problems is that it can be easily mistaken for other connective tissue disorders. If arthritic symptoms are the most prominent it can be easily mistaken for rheumatoid arthritis or rheumatic fever. Usually, if a young woman has a high fever, and any of the above symptoms are present, a closer and long term study will be done to diagnose the patient with SLE. Changes in the spleen and kidney are also strong indications of SLE occurring. For a proper diagnosis, the American Rheumatism Association has proposed the following criteria over a significant period time. A minimum of four of these must be met.

Facial erthyhema is apparent is many cases of lupus. This makes the patients looks like they have butterfly shaped rashes on the face. Another condition that can happen is Raynaud's phenomenon. This is a condition in which blood flow to the surface tissue of the hands and feet is temporarily decreased, usually as an overresponse to cold temperatures (www.webmd.com). Some patients have also known to be photosensitive or go bald in some areas. If the patient notices that they have sores in the oral or nasopharyngeal areas, it is another good indication if any of the other conditions are coupled with it.

Arthritis is also another sign of lupus, but not the degenerative type. Medicinenet.com says that rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. What then happens is the bones actually will degrade, but this does not happen in lupus. Lupus patients experience normal to extreme joint pain at some times.

Proteinuria is when the patient's urine has an abnormal amount of proteins in it (www.kidney.niddk.nih.gov). If the patients protein count is greater then 3.5Gm/24 h, it is assumed that there is an excess amount of serum proteins in urine (Merck).

Other signs of lupus can be that the patient has pleuritis or pericarditis, which is the inflammation of the area around the lungs and heart. The patients may be experiencing abnormal pyschosis, convulsions, or both.

Treatment

Although there is no known cure, certain treatment of lupus can reduce and prevent lesions and scarring on the skin. There are several different ways to tackle the autoimmune disease. Mild symptoms of the disease can be safely left untreated. If needed, an anti-inflammatory drug can be used to reduce symptoms. Flaring from the disease can be prevented disease-modifying antirheumatic drugs to prevent. The discovery by Hench to use corticosteroids further helps reducing the flares that do occur. The problem with steroids is the abnormal effects it has on the human body. Steroids lead to obesity diabetes, and osteoporosis, and corticosteroids can lead to abnormally increased hunger and swelling in the face. Another alternative form of treatment was developed by the Chinese thousands of years ago. in 1985. The treatment is known as [TCM] or traditional Chinese medicine. A study in 1985 confirmed accupuncture developed by the Chinese improved symptoms of SLE. The only problem is that this treatment only prevents some symptoms of lupus and more research must be accounted for this treatment. Another method to help the symptoms of SLE is to avoid sunlight and ultraviolet light [Wikipedia.com].

Current Research

Serum Thrombomodulin is a new disease marker that is hoped to show activity of diseases within the SLE. By mapping the activity of diseases within the SLE it is thought to be possible to determine the etiology of Lupus. Not much is known about Serum Thrombomodulin because it is still in the primary testing state to determine if it will do more than make visible disease already known to be related to SLE. Aside from Serum Thromobodulin research is also being compiled on the drug Prednisone. Prednisone is the primary drug used in Lupus treatement. Although there is no cure for Lupus prednisone along with other immunosupressive drugs appears to have an overall postive affect on the control, or for better words reduction of lupus symptoms. Lupus Research is extremly controversial because of the sheer amount of controls needed. Most Lupus cases have a differnet level of severity an because of this any experimental data on drugs such as prednisone have to be prefromed large number of times with differnt controls an variables. Currently today the scientific field is in the re-testing stage of Lupus drugs to find the level of succesfullness drugs have on the mass of those infected with Lupus. [LupusResearch]

Another current study is over immunosuppressants and autologous stem cell transplants to cure the autoimmune disease. Immune cells (B and T-cells) are being modified at a particular subset to provide treatment to the disease. cytokine proteins that are secreted by these cells are starting to catch the eyes of researchers. New technology of genetic mapping on the human genome has provided a faster approach to treatment. In June 2006, a Datamoniter reported certain analysis which could lead to the breakthrough treatment for numerous symptoms of Lupus [Wikipedia.com].

References

The Merck Manual (13th Edition), Robert Berkow, M.D., John H. Talbott, M.D., Merck Sharp & Dohme Research Laboratories 1977, pg 1345-1348.

Wikipedia. 2006. November 27, 2006. [[[Wikipedia.com]]].

WebMd. 2006. December 7, 2006. [WebMd.com]

Dictionary. 2006. December 7, 2006. [dictionary.com]

LupusResearch. 2006. December 8, 2006. [LupusResearch]

Kidney Research. 2006. September. [[1]]

Medicine Net. 2006 [[2]]