Lupus is considered the prototype autoimmune disease, and investigators maintain that understanding this condition better will lead to more effective ways to diagnose and treat other autoimmune conditions. It is a fairly common disorder, developing overall in about one in every two thousand people. The disease has a predilection for women, affecting approximately one in every seven hundred white women and one in every two hundred forty-five black women between the ages of twenty and sixty-five. The precise cause is unknown, although genetic factors are believed to play a role. Hormonal, stress, and viral factors may also help to trigger flare-ups or aggravate preexisting disease.
The signs and symptoms of lupus are diverse and reflect the fact that autoantibodies (that is, antibodies that attack the self) may be produced against many different tissue and organ components. One variant of lupus that involves only the skin, discoid lupus erythematosus, is typically a scarring, disfiguring condition. SLE, on the other hand, is characterized by much more widespread organ involvement. In addition to fever, fatigue, weight loss, and loss of appetite, SLE sufferers may experience facial and body rashes, heightened sun sensitivity, canker sore-like irritations in the mouth and nose, arthritis (joint inflammation, swelling, and pain), and kidney, lung, nerve, and blood system problems.
Diagnosing lupus requires a thorough history and physical examination combined with a sophisticated immunologic blood workup. The antinuclear antibody test, usually referred to as the ANA titer, is a highly sensitive screening test for lupus. The test derives its name from the fact that the antibodies are directed specifically at the material within the nucleus of the victim's own cells. To confirm the diagnosis additional tests are often needed.
Since no cure yet exists, treatment is directed at relieving symptoms and prolonging life. Systemic corticosteroids and premier antiinflammatory agents such as prednisone are the mainstays of therapy. Occasionally other antiinflammatory drugs, such as aspirin, indomethacin (Indocin), and antimalarial agents (such as chloro-quine and hydroxychloroquine) may be prescribed. Happily, more than 90 percent of patients today survive more than fifteen years with that condition that at one time was almost universally fatal. For further information, write The National Lupus Erythematosus Foundation, 2635 North First Street, Suite 206, San Jose, California 95134.
