Lupus Refers to a Group

Lupus refers to a group of diseases, the most common and serious being systemic lupus erythematosus or SLE or simply lupus (The Arthritic Society 2002). SLE is a chronic, potentially debilitating or fatal autoimmune disease wherein the immune system attacks the body cells and tissues, resulting in inflammation and tissue damage (Wikipedia 2006). It can affect any part of the body, but the parts most often affected are the heart, joints, skin, lungs, blood vessels and the brain or the nervous system. The immune system stops working properly and, instead of protecting the body against germs and disease, it attacks healthy tissues, leading to inflammation and pain on the skin, muscles or joints. There can be periods of flare-ups alternately with remissions where there is little or no inflammation (The Arthritic Society, Wikipedia, National Institute of Health).

The history of SLE can be traced to three periods, namely, the classical, neoclassical and modern (Wikipedia 2006). In the classical period, the disease was first recognized in the Middle Ages, basically through its dermatological manifestations. The term "lupus" was first used in the 12th century by the physician Rogerius in describing the classic malar rash on the skin. In the neoclassical period, Moritz Kaposi first recognized the systemic manifestation of lupus in 1872. And in the modern period, which began in 1948, the LE cell was discovered. These cells were used as diagnostic indicators of the pathophysiology and clinical-laboratory features of the disease and advances of its treatment. In 1894, the first useful medication for the disease, quinine, was first reported as effective therapy. Four years later, salicylates were introduced to combine with quinine for even greater benefit to SLE cases. This was the best combination in approaching SLE until the middle of the 20th century when Hench discovered and introduced the efficacy of costicosteroids in the treatment of lupus (Wikipedia).

Lupus can affect men, women and children of any age, but has shown to affect women of childbearing age of 15 to 45 most often by 8 to 10 times (The Arthritic Society 2002). The signs of lupus include pain in the muscles and joints of the hands, arms, shoulders, feet, knees, hips or jaw. The pain may move from one part to another and feel hot, look red or swell. There may be fever, loss of appetite, low energy and fatigue, skin rashes especially on the face or butterfly rash, sores in the mucosal or inner lining of the mouth or nose, sensitiveness to sunlight, change of color of the fingers when feeling cold, sudden and unexplained weight loss or gain, increased headache, loss of hair in the entire scalp, chest pain, high blood pressure and swelling of the feet and legs. Symptoms and signs differ from person to person and range from mild to severe. The exact cause of the disease has remained unknown. Some experts link it with hormones, although that connection has not yet been discovered or understood along with more information about the immune system. As of now, it is considered a chronic inflammatory disease of the type III hypersensitivity or serum sickness response, characterized by the body's production of antibodies against its own cells. It is generally agreed that lupus develops from genetic predisposition, environmental causes or as a drug reaction. Several genes, especially those in chromosome 6, must be affected to occasion lupus. Likewise, some medications, including certain antidepressants and antibiotics, extreme stress, exposure to sunlight, hormones and infections can also trigger the onset of lupus (The Arthritic Society).

In the 50s, most SLE patients lived for less than five years but with eventual advances in diagnosis and treatment, survival has improved (Wikipedia 2006). Today, 90% of SLE patients survive for more than 10 years with some of them without the symptoms. The most common cause of death is infection due to immunosuppression, a result in turn of medications intended to manage the disease. Chances are worse for men and children than for women. After the age of 60, the disease tends to turn benign. The only marker of prognosis in lupus is the anti-ds DNA antibody test and the most sensitive is the Anti-Smith test (Wikipedia)

The standard treatment for lupus has been limited to drugs, such as corticosteroids, anti-malarials and chemotherapy drugs (Wikipedia 2006). The only FDA-approved treatment has been the anti-malarial, Plaquenil. Researches into modern treatment have been enhanced by genetic discoveries, the mapping of the human genome in particular. There has been increased awareness and education about the disease since the 60s, which have also extended help to many sufferers. Records said there were approximately 270,000 to 1.5 million people stricken with lupus. There is no single test for lupus and it can take months or years to detect or diagnose it (National Institute of Health 2005). Many stools may be used for medical history, a complete examination, blood tests, skin biopsy, and kidney biopsy. Current treatment may involve a family doctor, a rheumatologist, a clinical immunologist, nephrologists, hematologist, dermatologist, neurologist, nurses, psychologist, and social worker. Their common goals will be to prevent or treat flares, reduce organ damage as well as swelling and pain (National Institute of Health). There have also been findings, which say that lupus affects African women three times more than Caucasians, Asians, Hispanics and Native Americans (Spencer 2006). Although survival rates have improved, more than half of SLE patients sustain permanent damage in one or more organ systems (Petri 1998). The most common manifestations are renal, hematologic and neurologic and which worsen the condition or conduce to death (Petri).