The Disease that cries Wolf by Monika Guttman
Lupus-In which the bodies immune system
attacks it's own cells-mimics many other illnesses, thwarting
diagnosis. But once identified, new drugs and technologies have
greatly improved the prognosis
Several years ago, Helen Francisco was tired and achy all the
time, and blamed her fatigue on a series of miscarriages. A hair
stylist who worked out of her home, she gave up the more
lucrative aspects of the job-highlights, permanents, hair
coloring or any other work that involved chemicals-and began
eating a macrobiotic diet to balance her system, hoping with
relief from chemicals and no stress, she would be able to carry
a pregnancy to term. Still, the fatigue would not go away.
Soon she realized a redness on her face was getting more
pronounced. She went to a physician, who recognized the familiar
"butterfly" pattern on her cheeks and nose. Francisco was one of
the lucky ones: she was referred almost immediately to a
rheumatologist, who ran a series of tests and diagnosed her with
systemic lupus erythematosus, or lupus.
Lucky, that is, in that her lupus was diagnosed fairly
quickly. Called the "Great Imitator," lupus is often difficult
to diagnose because it is a systemic disease that can attack the
joints, skin, kidneys, nervous system, lungs, heart and
gastrointestinal tract, mimicking many other illnesses. For many
with the disease, diagnosis can take anywhere from three to ten
years.
Not that Francisco felt particularly lucky. Being diagnosed
with any autoimmune disease like lupus-where the body's immune
system essentially attacks its own cells-can be devastating,
says Rodanthi Kitridou, M.D., professor of medicine, and a
rheumatologist at the LAC+USC Lupus Center, one of the largest
in the country. Kitridou sees between 70 and 80 lupus patients a
month at both LAC+USC and the USC University Hospital. "It is
difficult to explain to patients that their body is attacking
itself and we just don't know why."
What researchers and doctors do know, however, is that new
drugs and technologies have greatly improved the prognosis for
the estimated two million Americans with lupus. Even though
there is no cure for the disease, an extraordinary 80 to 90
percent of all lupus patients can expect to have a normal life
span, thanks to research conducted at places like the USC School
of Medicine. In the 1950s, before steroids were discovered and
used in lupus treatment, the three-year survival rate was closer
to 30 percent, because patients died as their organs
deteriorated from uncontrolled inflammation and damage.
Helping patients with lupus while, at the same time,
furthering research into the disease is the goal of the new
lupus diagnostic and treatment center opening at USC University
Hospital this spring.
Notes David Horwitz, M.D., professor of medicine, molecular
microbiology and immunology, who works on lupus and rheumatoid
arthritis, "With genetic research, we have a better chance of
determining a person's susceptibility to developing lupus. And
by offering clinical trials, we can help improve the prognosis."
The improving prognosis is partly due to the fact that lupus,
which is Latin for "wolf" and so named because the common skin
rashes on the face resemble the markings on a wolf, is getting
more attention, thanks to such celebrities as Charles Kuralt and
former White House dog Millie.
More significantly, progress is due to increased attention
overall to autoimmune diseases, a broad category of conditions
that involve the body's immune system actually mistaking its own
cells for the enemy and turning an "immune response" on itself.
Other autoimmune diseases include multiple sclerosis, ulcerative
colitis, rheumatoid arthritis, psoriasis and diabetes mellitus
(Type I diabetes) and dozens of lesser-known diagnoses with
tongue-twisting names, like ankylosing spondylitis or
antiphospholipid syndrome. While some autoimmune diseases are
mild and only slightly irritating, others can be
life-threatening, extremely painful or debilitating. In all,
autoimmune diseases affect some four million people in the U.S.
alone and cost billions of dollars in health care.
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